Antiviral treatment for chronic hepatitis B

An updated review of the antiviral agents currently available or under trial for the treatment of chronic hepatitis B is presented. There are two broad groups: (1) immunomodulators including interferon α (which also has a direct antiviral effect), thymosin α1 and Theradigm-HBV and (2) viral suppressors such as famciclovir and lamivudine. These agents are still in clinical trial worldwide, singly or in combination. Their long term efficacy in the treatment of hepatitis B remains to be evaluated.published_or_final_versio

An update on hepatocarcinogenesis

Hepatocellular carcinoma is the most common cancer occurring in males in the world and has an annual incidence worldwide of 1 million. There are variations in its geographical distribution. It is the second most common cancer in Southeast Asia, including Hong Kong and ranks third among males in China.published_or_final_versio

The natural history of chronic hepatitis B infection

Chronic hepatitis B infection is a global health problem that affects about 300 million people. Of these, 75% are Chinese. Most Chinese who become chronic carriers, contract the virus during the perinatal period. The natural history of these chronic hepatitis B carriers includes an initial immune tolerance phase, followed by immune clearance and an inactive hepatitis B non-replicative phase with the development of cirrhosis that may be complicated by hepatocellular carcinoma. The classification of hepato-cellular carcinoma has recently been revised. Based on immunohistochemical studies, it has been found that patients with hepatocellular carcinoma and biliary markers have a poorer survival than patients with hepatocellular carcinoma but who have negative biliary markers. Sometimes, a fourth phase, a hepatitis B envelope-negative hepatitis B virus replicative phase, reflecting the emergence of a pre-core mutant strain, may follow. Our improved understanding of the natural history of chronic hepatitis B infection has led to more effective approaches towards the control of this viral infection and its sequelae. Most importantly, immunisation against hepatitis B virus in the perinatal setting has been shown to prevent chronic infection.published_or_final_versio

Updates in the treatment of chronic hepatitis B

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Hepatitis B virus with primary resistance to adefovir [11]

Correspondencepublished_or_final_versio

Do statins reduce the risk of hepatocellular carcinoma in patients with chronic hepatitis B?

In subjects with chronic hepatitis B (CHB), the lifetime risk of developing hepatocellular carcinoma (HCC) is estimated to be 25-37 times compared to non-infected subjects. The process of hepatocarcinogenesis is complex and involves well-documented host, viral, and environmental risk factors. The most important risks include host factors such as older age, male gender, the presence of cirrhosis, and viral factors such as the viral load, genotype, and the presence of basal core promoter mutations. To date, antiviral therapy is the only intervention demonstrated to significantly reduce the risk of HCC development in CHB patients. Although oxidative stress has been implicated in cancer development, there is no established benefit shown from treatment with antioxidizing agents such as silymarin, green tea, and vitamin E.published_or_final_versio

Identification of hepatitis B virus DNA reverse transcriptase variants associated with partial response to entecavir

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Improved hydrogen-sensitive properties of MISiC Schottky sensor with thin NO-grown oxynitride as gate insulator

Thin oxynitride grown in NO at low temperature was successfully used as gate insulator for fabricating MISiC Schottky hydrogen sensors. Response properties of the sensors were compared with other MISiC Schottky sensors with thicker or no oxynitride. It was found that the thin oxynitride played an important role in increasing device sensitivity and stability. Even at a low H 2 concentration, e.g., 100-ppm H 2 in N 2, a significant response was observed, indicating a promising application for detecting hydrogen leakage. Moreover, a rapid and stable dynamic response on the introduction and removal of H 2/N 2 mixed gas was realized for the sensor. Improved interface properties and larger barrier height associated with the thin oxynitride are responsible for the excellent response characteristics. As a result, NO oxidation could be a superior process for preparing highly sensitive and highly reliable MISiC Schottky hydrogen sensors.published_or_final_versio

COLD-PCR for early detection of hepatitis B virus antiviral drug resistance mutations

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Future prevention and treatment of chronic hepatitis B infection

Vaccination for hepatitis B virus (HBV) infection and treatment for chronic hepatitis B, while effective for primary prevention and control of the disease, still have their limitations. Global coverage of HBV immunization needs improvement. Several patient populations are noted to have suboptimal seroprotective rates after HBV vaccination. There are currently several potential new vaccines undergoing animal and human studies, most notably vaccines containing immunostimulatory DNA sequences. Long-term nucleoside analogue therapy is necessary in achieving permanent virologic suppression. Potential new treatments explore new mechanisms of action, including the inhibition of hepatitis B surface antigen release, targeting antifibrotic mechanism, and immunomodulation through novel interferons and therapeutic vaccines. The clinical application of potential new vaccines and therapies would enhance the prevention of HBV infection and treatment of chronic hepatitis B. © 2012 by Lippincott Williams & Wilkins.postprin