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Introduction: The clinical significance of persistent positive in Hepatitis B Virus (HBV) DNA level in patients receiving antiviral therapy is not well known. We investigated factors associated with persistent viremia (PV) in patients with chronic hepatitis B (CHB) given 78-week entecavir., Methods: A total of 394 treatment-naïve CHB patients who had undergone liver biopsy at baseline and week 78 of treatment were analyzed in this prospective multicentre study. We identified patients with PV (above the lower limit of quantification, 20 IU/ml) after 78 weeks of entecavir therapy. Stepwise, forward, multivariate regression analyses of specified baseline parameters were apllied to identify factors associated with PV. Futhermore, we assessed the incidence of hepatocellular carcinoma (HCC) in all patients using models of the risk of HCC development., Results: Of the 394 patients, 90 (22.8%) still with PV after 78-week antiviral treatment. Factors associated significantly with PV (vs complete virological response, CVR) were HBV DNA level ≥8 log10 IU/mL (OR, 3.727; 95% CI, 1.851-7.505; P < 0.001), Anti-HBc level < 3 log10 IU/mL (OR, 2.384; 95% CI, 1.223-4.645; P=0.011), and HBeAg seropositivity (OR, 2.871; 95% CI, 1.563-5.272; P < 0.001). Patients with PV were less likely to have fibrosis progression and HCC development than those with the CVR. Of the 11 HBeAg-positive patients with HBV DNA level ≥8 log10 IU/mL and Anti-HBc level < 3 log10 IU/mL at baseline, 9 (81.8%) had persistent positivity in HBV DNA level and 0 had fibrosis progression at week 78 of treatment., Discussion: In conclusion, HBV DNA level ≥8 log10 IU/mL, Anti-HBc level < 3 log10 IU/mL and HBeAg seropositivity at baseline contribute to PV in patients with CHB receiving 78-week antiviral treatment. In addition, the rate of fibrosis progression and the risk of HCC development in patients with PV were kept low. The complete protocol for the clinical trial has been registered at clinicaltrials.gov (NCT01962155 and NCT03568578)., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2023 Li, Dong, Cao, Zhang, Zhao, Shang, Zhang, Ma, Xie, Gui, Zhang, Liu, Shang, Xie, Liu, Zhang, Wang, Zhao and China HepB Related Fibrosis Assessment Research Group.)

Background and Aims: Chronic hepatitis B (CHB) can cause liver fibrosis and lead to cirrhosis and cancer. As the effectiveness of antiviral therapy to reverse liver fibrosis is limited, We aimed to evaluate the effect of An-Luo-Hua-Xian pill (ALHX) on fibrosis regression in CHB patients treated with entecavir (ETV)., Methods: Treatment-naïve patients with CHB were randomly treated with ETV alone or combined with ALHX (ETV+ALHX) between October 1, 2013 and December 31, 2020. Demographic, laboratory, and liver histology data before and after 78 weeks of treatment were collected. The Ishak fibrosis score (F) was used and fibrosis regression required a decrease in F of ≥1 after treatment., Results: A total of 780 patients were enrolled, and 394 with a second liver biopsy after treatment were included in the per-protocol population, 132 in ETV group and 262 in ETV+ALHX group. After 78 weeks of treatment, the fibrosis regression rate in the ETV+ALHX group was significantly higher than that of the ETV group at baseline F≥3 patients: 124/211 (58.8%) vs. 45/98 (45.9%), p =0.035. The percentage of patients with a decreased liver stiffness measurement (LSM) was higher in the ETV+ALHX group: 156/211 (73.9%) vs. 62/98 (63.%), p =0.056. Logistic regression analysis showed that ETV combined with ALHX was associated with fibrosis regression [odds ratio (OR)=1.94, p =0.018], and a family history of hepatocellular carcinoma was on the contrary. (OR=0.41, p =0.031)., Conclusions: ETV combined with ALHX increased liver fibrosis regression in CHB patients., Competing Interests: The authors have no conflict of interests related to this publication., (© 2023 Authors.)

The ozone concentration characteristics of 13 cities in Beijing-Tianjin-Hebei regions from 2016 to 2020 were analyzed based on ecological environment monitoring and meteorological observation data. The influence of meteorological elements such as daily maximum temperature ( T max ), daily average ground pressure ( p ), daily average ground relative humidity (RH), and daily average ground wind speed ( v ) on ozone concentration[ ρ (O 3 -8h)] and the exceeding standard rate of O 3 -8h were discussed. The AQI, ozone concentration range, and ozone pollution level forecast accuracy rates were evaluated using the neural network statistical model. The results showed that the concentrations of O 3 -8h-90per[ ρ (O 3 -8h-90per)] of 13 cities in the Beijing-Tianjin-Hebei region from 2016 to 2020 were 157.4, 177.2, 177.3, 190.6, and 175.6 μg·m -3 , respectively. The regional ozone concentration increased by 11.6% over the five years from 2016 to 2019. From 2016 to 2019, there was an overall upward trend in volatility, followed by a decline in 2020. Compared with that in 2016, the concentration of O 3 -8h-90per in the other 10 cities increased by 6-45.5 μg·m -3 , except for in Beijing, Zhangjiakou, and Chengde, where it decreased slightly. The average value of ρ (O 3 -8h) from April to September was higher than 100 μg·m -3 , and the highest monthly average concentration of O 3 -8h was 158.10 μg·m -3 in June. The range of the over standard rate of O 3 -8h was 8.6%-19.2% in the 13 cities, and 97.8% of ozone concentrations exceeded the standard in the period from April to September. At the regional scale, the concentration of O 3 -8h had the strongest correlation with the daily maximum temperature. Furthermore, when T max was in the range of 25-28℃, the concentration of O 3 -8h in the 13 cities began to exceed the standard concentration of 160 μg·m -3 . Additionally, the concentration of O 3 -8h negatively correlated with p . When RH was below 60%, ozone concentration increased slowly with relative humidity in most cities. When RH was above 61%-70%, ozone concentration decreased with the increase in daily relative humidity in most cities. When ozone exceeded the standard concentration of 160 μg·m -3 , the dominant wind was mainly southerly wind, and the high ozone concentration in most cities tended to be concentrated in the low wind speed range of 2-3 m·s -1 and below. Moreover, the correlation coefficient range of the statistical model of OPAQ 1-9 days in advance was 0.72-0.86, the average accuracy of AQI level forecasts was 67%-86%, and the average accuracy of O 3 -8h concentration forecasts was 63%-84%. In April to September, when ozone exceeded the standard of 160 μg·m -3 , the accuracy rates of the model forecast of light ozone pollution and ozone exceeding the standard concentration of 160 μg·m -3 three days in advance were 69% and 66%, which can provide a reference for the management and control of ozone pollution.