Reply:

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/86969/1/24520_ftp.pd

Hepatitis B Treatment: What We Know Now and What Remains to Be Researched

Peer Reviewedhttps://deepblue.lib.umich.edu/bitstream/2027.42/147072/1/hep41281.pdfhttps://deepblue.lib.umich.edu/bitstream/2027.42/147072/2/hep41281_am.pd

Progress in hepatitis B: A 30‐year journey through three continents

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/107540/1/hep27120.pd

Endpoints of hepatitis B treatment

The goal of hepatitis B treatment is to prevent the development of cirrhosis, liver failure, and hepatocellular carcinoma. Ideally, clinical studies should demonstrate that hepatitis B therapies can prevent liver-related complications; however, these clinical endpoints evolve over years or decades. Therefore, clinical trials have relied on intermediate endpoints to evaluate the efficacy of treatment and to determine when treatment can be stopped. Intermediate endpoints that have been used include biochemical, histological, virological, and serological endpoints. This review will discuss the validity of these intermediate endpoints as surrogates of clinical endpoints, and the rates at which these intermediate endpoints can be achieved with currently available therapies.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/79271/1/j.1365-2893.2010.01369.x.pd

Prevention of recurrent hepatitis B post–liver transplantation

1 Factors associated with a lower rate of recurrent hepatitis B post–liver transplantation (LT) are negative hepatitis B e antigen and/or serum hepatitis B virus DNA pre-LT, hepatitis D virus superinfection, and fulminant hepatitis B. 2 Long-term intravenous hepatitis B immune globulin (HBIG) monotherapy can reduce the overall rate of recurrent hepatitis B to 20% to 35%. 3 Long-term lamivudine monotherapy is associated with a risk for drug resistance and overall 3-year rate of recurrent hepatitis B of 40% to 50%. 4 Combination prophylaxis with HBIG and lamivudine can reduce the overall rate of recurrent hepatitis B to 0% to 10%. 5 The dose and duration of HBIG therapy needed when used in combination with lamivudine may be lower, but the optimal regimen remains to be determined. 6 Lamivudine resistance before LT is associated with an increased risk for recurrent hepatitis B post-LT. 7 A cost-effective prophylactic regimen to prevent recurrent hepatitis B should be tailored according to risk.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/35278/1/500081013_ftp.pd

Reply:

Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/87032/1/24410_ftp.pd

Chronic hepatitis B

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34785/1/510340622_ftp.pd

Reply

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34793/1/510370333_ftp.pd

Occult hepatitis B virus infection: A hidden menace?

No Abstract.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34784/1/510340128_ftp.pd

Diagnosis of hepatitis C

Currently, the second- and third-generation enzyme immunoassays (EIA-2 and EIA-3) for hepatitis C virus antibody (anti-HCV) are the most practical screening tests for the diagnosis of HCV infection. The need for and the choice of supplementary or confirmatory tests depend on the clinical setting and the likelihood of a true-positive EIA result. Detection of HCV RNA in serum by polymerase chain reaction (PCR) assay is the gold standard for the diagnosis of HCV infection. However, the lack of uniformity in current PCR assays has tarnished this standard. Confirmatory tests for the diagnosis of HCV infection are in general unnecessary in anti-HCV-positive patients who present with chronic liver disease. When indicated, the most appropriate test in this setting is a qualitative PCR assay for HCV RNA. Confirmatory tests should always be performed in anti-HCV-positive blood donors and individuals with normal aminotransferase levels. The most appropriate approach is to retest for anti-HCV using recombinant immunoblot assay (RIBA) and then test for HCV RNA using PCR assay in those who are RIBA positive or indeterminate. Liver histology is the gold standard in assessing severity of liver disease. Quantitative tests for serum HCV RNA levels do not help to determine the severity of liver disease. At the moment, HCV genotyping should be considered a research tool and not a part of the diagnostic work-up in clinical practice. The goals of treatment for chronic hepatitis C are sustained biochemical and virological response. Viral clearance should be determined by qualitative PCR assay. Quantifying serum HCV RNA level can help in predicting response to interferon treatment, but further studies using more standardized assays are needed to determine if these values can be used to select patients for treatment.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/34770/1/510260709_ftp.pd