Systematic review: Cessation of long-term nucleos(t)ide analogue therapy in patients with hepatitis B e antigen-negative chronic hepatitis B

Background It has been debated whether finite nucleos(t)ide analogue therapy is feasible in HBeAg-negative chronic hepatitis B. Aim To review this issue systematically. Methods Using text terms HBsAg and various nucleos(t)ide analogues, PubMed was searched between 1995 and 2014 to find studies on therapy >6 months in adult HBeAg-negative chronic hepatitis B patients with off-therapy follow-up >6 months. Results Twenty-two studies with a total of 1732 patients were identified and included. The median duration of therapy, consolidation therapy and off-therapy follow-up ranged from 6 months to 8 years, 4 to 96 weeks and 6 to 80 months respectively. Patients were monitored with serum ALT and HBV DNA monthly in the first 1-3 months and every 3-6 months afterwards in most studies. The 1-year off-therapy 'virological relapse' (HBV DNA >2000 IU/mL) and 'clinical relapse' (HBV DNA > 2000 IU/mL + ALT elevation) occurred in <70% and <50% of the patients, respectively, and <40% of the patients received re-treatment. These rates were higher in patients with shorter treatment, shorter consolidation therapy and those treated with less potent nucleos(t)ide analogues. Off-therapy severe flares were rare and hepatic decompensation was reported in only one patient with cirrhosis. Biochemical relapse reflecting enhanced immune-mediated hepatocyte killing may lead to a higher chance for off-therapy HBsAg seroclearance and be possibly desirable. Conclusion With an appropriate stopping rule and a proper off-therapy monitoring plan, cessation of long-term nucleos(t)ide analogue therapy prior to HBsAg seroclearance in HBeAg-negative chronic hepatitis B is a feasible alternative to indefinite treatment. © 2015 John Wiley & Sons Ltd

Low potential detection of nicotine at multiwalled carbon nanotube-alumina-coated silica nanocomposite

Electrocatalytic oxidation of nicotine at multiwalled carbon nanotube (MWCNT)-alumina-coated silica (ACS) nanocomposite modified glassy carbon electrode are described. The sensing performance of the MWCNT-ACS nanocomposite modified glassy carbon electrode for the electrooxidation of nicotine was investigated using cyclic voltammetry and amperometry in 0.1 M phosphate buffer solution (pH 8). The MWCNT-ACS nanocomposite modified glassy carbon electrode exhibited the abilities to decrease the electrooxidation potential, to prevent the electrode surface fouling, and to raise the current responses. The MWCNT-ACS nanocomposite responded rapidly to nicotine with a sensitivity of 1.786 A M(-1) cm(-2) and a detection limit of 1.42 mu M (according to 3 sigma criterion). A signal almost 180 times more sensitive was obtained at MWCNT-ACS nanocomposite modified glassy carbon electrodes as compared to bare glassy carbon electrode. The nicotine oxidation potential obtained in this study is much lower than that at boron-doped diamond electrodes. (C) 2009 Elsevier B.V. All rights reserved