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Background: The timing of antiviral therapy for chronic hepatitis B (CHB) patients with normal alanine transaminase (ALT) or aged < 30 years is still undetermined. We aimed to elucidate the correlation between liver histology, age, and ALT level in CHB patients and analyze the histological characteristics of the liver among patients with persistently normal ALT or aged < 30 years. Methods: A retrospective analysis was conducted on 697 treatment-naive CHB patients. Liver biopsies were performed, and significant histological damage was defined as the grade of liver inflammation ≥ G2 and/or fibrosis ≥ S2 based on the Scheuer scoring system. Results: The liver inflammation grades and fibrosis stages correlated positively with age, ALT, AST, GGT levels and negatively with the counts of PLT (all p < 0.050) in HBeAg-positive patients. Higher ALT levels and lower PLT counts were independently associated with significant liver inflammation and fibrosis in both HBeAg-positive and HBeAg-negative patients. Furthermore, among those with persistently normal ALT levels, the incidence of significant liver inflammation and fibrosis were 66.1% and 53.7% in HBeAg-positive groups, and 63.0% and 55.5% in HBeAg-negative groups. Moreover, there was no significant difference in the prevalence of significant liver damage between patients aged < 30 years and those aged ≥ 30 years, in both HBeAg-positive (≥ G2 or ≥ S2: 63.8% vs. 75.8%, p = 0.276) and HBeAg-negative (≥ G2 or ≥ S2: 65.9% vs. 72.5%, p = 0.504) groups, among patients with persistently normal ALT levels. Conclusions: A considerable proportion of CHB patients with persistently normal ALT, including those below the age of 30 years, exhibited significant histological damage. This highlights the importance of initiating early antiviral therapy for HBV-infected individuals, even in the absence of elevated ALT levels. [ABSTRACT FROM AUTHOR]

Introduction: Recent studies have found that lipid levels in patients with chronic hepatitis B (CHB) may change during antiviral therapy. Objective: To assess the effects of first-line nucleot(s)ide analogues (NAs) on lipid profiles in patients with CHB using network meta-analysis. Methods: Seven electronic databases (PubMed, Embase, Cochrane Library, and four Chinese databases) were searched for cohort studies on the effect of NA on lipids in patients with CHB up to August 1, 2023. The changes of serum total cholesterol (TC), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and high-density lipoprotein cholesterol (HDL-C) were taken as outcomes. The mean difference (MD) of continuous variables and 95% confidence intervals (CI) were calculated using RevMan 5.4 and Stata 16.0 software, and network meta-analysis was based on a frequentist framework. Results: A total of 4194 patients were included in the study, including patients with CHB treated with entecavir (ETV), tenofovir disoproxil fumarate (TDF), and tenofovir alafenamide (TAF), as well as patients not receiving antiviral therapy [patients with inactive CHB who were not receiving antiviral therapy (referred as inactive CHB patients) and non-HBV-infected patients]. TDF reduced TC levels compared to the non-antiviral group (TDF vs. inactive CHB patients: MD = − 17.27, 95% CI (− 30.03, − 4.47); TDF vs. non-HBV-infected individuals: MD = − 17.10, 95% CI (− 20.13, − 14.07)). TC changes in the TAF and ETV groups were not statistically different from the non-antiviral group (TAF vs. inactive CHB patients: MD = − 2.69, 95% CI (− 14.42, 9.04); TAF vs. non-HBV-infected individuals: MD = − 2.52, 95% CI (− 8.47, 3.43); ETV vs. inactive CHB patients: MD = − 4.24, 95% CI (− 17.12, 8.64); ETV vs. non-HBV-infected individuals: MD = − 4.07, 95% CI (− 9.90, 1.75)). The ranking of the effects for lowering TC is as follows: CHB patients treated with nucleotide analogues [with varying efficacy: TDF (SUCRA = 99.9) > ETV (SUCRA = 59.3) > TAF (SUCRA = 43.6)] > inactive CHB patients (SUCRA = 27.3) > non-HBV-infected individuals (SUCRA = 19.9). As for secondary outcomes, among the three antiviral drugs, TDF had the most significant effect on lowering TG, LDL-C, and HDL-C, but none of the three drugs was statistically different from the non-antiviral group. Subgroup analysis showed that the lipid-lowering effect of TDF was more pronounced in the elderly (≥ 50 years). Conclusion: TDF was effective in lipid reduction, particularly pronounced in the older population. TAF and ETV had a neutral effect to TC, TG, LDL-C, and HDL-C. Despite a relative increase in lipids observed in patients transitioning from TDF to TAF or ETV, these changes remained within acceptable limits. [ABSTRACT FROM AUTHOR]

With the wide use of potent and safe nucloes(t‐)ide analogues (NAs) treatment, patient‐centered care is getting important. Intensive care for comorbidity has gain utmost importance in care of aging chronic hepatitis B (CHB) patients with life‐long antiviral treatment. Linkage to care of patients with CHB is essential for the goal of hepatitis B virus (HBV) eradication. As long‐term suppression of HBV DNA replication does not prevent hepatocellular carcinoma (HCC), prevention of HCC is another challenge for NAs treatment. There is a possibility of hepatocarcinogenesis in the immune‐tolerant phase and risk of loss of patients during active monitoring seeking the time point for antiviral treatment initiation. Initiation of NAs treatment from the immune‐tolerant phase would improve the linkage to care. However, universal recommendation is premature and evidence for cost‐effectiveness needs to be accumulated. Early initiation of NAs in the evidence of significant disease progression, either HBV associated or comorbidity associated, would be a better strategy to reduce the risk of HCC in patients located in the gray zone. [ABSTRACT FROM AUTHOR]

Purpose: Studies have found that both FibroScan (FS) and Gd-EOB-DTPA-enhanced T1 mapping magnetic resonance imaging (Gd-MRI) could assess liver fibrosis (LF) with high effectiveness. The aim of this study is to compare their accuracy in the quantitative evaluation of LF in patients with chronic hepatitis B (CHB), and to explore the diagnostic accuracy of their combination. Methods: 160 patients with CHB were included in this study. FS and Gd-MRI were performed within 3 months before the pathological LF staging, which was classified according to the Scheuer-Ludwig scale. The liver stiffness measurement (LSM) was obtained by FS. T1 mapping images of the liver before and 20 min after enhancement were obtained by Look-Locker Gd-MRI. Results: There were 45, 35, 31 and 49 patients with stage S1, S2, S3 and S4 LF, respectively. LSM increased and the reduction rate of T1 relaxation time of 20 min (rrT120min%) decreased with the severity of LF. The area under curve (AUC) of LSM, rrT120min% and LSM + rrT120min% for the diagnosis of ≥ S2 LF were 0.892, 0.811 and 0.900, respectively. The AUC for ≥ S3 LF was 0.883, 0.838 and 0.899, respectively. The AUC for S4 LF was 0.882, 0.894 and 0.928, respectively. Conclusion: The diagnostic accuracy of FS is better than that of Gd-MRI in the evaluation of ≥ S2 stage LF. The combination of these two methods significantly improved the diagnostic efficiency in the evaluation of S4 stage LF. [ABSTRACT FROM AUTHOR]

Background/Aim. In Serbia, pegylated interferon (PEGIFN) alpha-2a has been registered since 2013 for the treatment of patients with chronic hepatitis B (CHB). Numerous advantages, new experiences during the past five years and lack of any published data in our specific population, have initiated this study, with the aim to examine efficacy and safety of PEG-IFN in patients in a Serbian referral center. Methods. This prospective study included 36 patients with CHB who were treated in the Hepatology Department of the Clinic for Infectious and Tropical Diseases, Clinical Center of Serbia in Belgrade, during 2012-2017. Patients had a standard 48-week treatment protocol with PEG-IFN, with measurements of liver enzymes, serology and viraemia before, during, at the end of the treatment and follow-up 6 months afterwards. Treatment outcome was determined using serology (clearance of HBeAg), biochemical [normalization of alanine aminotransferase (ALT)] and virological response [hepatitis B virus (HBV) DNA < 2,000 IU/mL]. Results. Virological success in patients with HBeAg positive CHB was achieved in 50% of patients, HBeAg clearance in 62.5%, and normalization of ALT in 37.5% of patients. In patients with HBeAg negative CHB, 38% of the patients achieved virologic success, biochemical success was obtained in 47.6% of the patients and only one (4.7%) patient had HBsAg clearance. Conclusion. PEG-IFN is important for treatment of patients with CHB in well-defined situations, and in our population success rates are similar to other published studies. Although safety and tolerability are satisfactory, there is a possibility of more serious side-effects so it is necessary to monitor patients regularly during the treatment. [ABSTRACT FROM AUTHOR]

Background: Previous studies have investigated the vitamin D status in patients with chronic hepatitis B virus (HBV) infection and its relationship with HBV replication, the results however were inconsistent. The present meta-analysis was carried out to compare the vitamin D levels between patients with chronic hepatitis B (CHB) and healthy controls, and to determine whether vitamin D levels were correlated with HBV viral loads significantly.Methods: A systematic search was conducted via PubMed, Web of Science, EMBASE and the Cochrane Library to identify eligible studies until September 28, 2017. We calculated pooled mean difference (MD) and 95% confidence intervals (CI) to quantitatively estimate the difference of vitamin D levels between CHB patients and controls. In addition, correlation between serum vitamin D levels and HBV viral loads was defined by summary correlation coefficient (r value) and the corresponding 95% CI.Results: A total of 7 studies involving 814 CHB patients and 696 healthy controls were included. A significantly decreased vitamin D levels was found in CHB patients compared with healthy controls: pooled MD (95% CI) was - 2.03 ng/mL (- 2.60, - 1.46). Latitude-stratified subgroup analysis indicated this difference was more obvious in low latitude areas, with a bigger pooled MD (95% CI) of - 2.72 ng/mL (- 4.57, - 0.87). In addition, we observed an inverse correlation between serum vitamin D levels and HBV viral loads: pooled r (95% CI) was - 0.41(- 0.54, - 0.27).Conclusions: Our results showed that vitamin D levels were lower in CHB patients than that of healthy controls and inversely correlated with HBV viral loads, although future comprehensive studies are needed to clarify the underlying mechanisms. [ABSTRACT FROM AUTHOR]

Objective To investigate the clinical features of chronic hepatitis B (CHB) patients progressing to liver failure due to recurrence after withdrawal of nucleos(t)ide analogues and influencing factors for prognosis. Methods A retrospective analysis was performed for the clinical data of 40 patients with liver failure due to recurrence after drug withdrawal who were admitted to Mengchao Hepatobiliary Hospital of Fujian Medical University from January 2014 to December 2017, including general information, antiviral therapy, and biochemical and virological data. According to the treatment outcome at week 12, the patients were divided into survival group with 18 patients and death group with 22 patients, and clinical features were compared between the two groups. The t-test was used for comparison of normally distributed continuous data between groups, and the Mann-Whitney U test was used for comparison of continuous data with skewed distribution between groups. The chi-square test was used for comparison of categorical data between groups. The logistic regression analysis was performed to identify the influencing factors for recurrence and progression to liver failure after drug withdrawal. Results There were no significant differences between the death group and the survival group in median time of antiviral therapy and time from drug withdrawal to recurrence (P＞0.05), and the death group had a significantly higher proportion of patients with liver cirrhosis than the survival group (81.8% vs 27.8%, χ2=11.831, P=0.001). Compared with the death group, the survival group had significantly higher levels of albumin (t=2.302), gamma-glutamyl transpeptidase (Z=-3.671), and cholinesterase (Z=-2.134) and significantly lower total bilirubin (Z=-4.241), prothrombin time (t=-2.727), international normalized ratio (t=-2.343), and Model for End-Stage Liver Disease score (t=-3.909) (all P＜0.05). There was a significant difference in acute-on-chronic liver failure (ACLF) grade between the two groups (χ2=18.425, P＜0.001). The logistic regression analysis showed that ACLF grade (odds ratio ［OR］=9.865, 95% confidence interval ［CI］: 1.455-67.370, P=0.020) and liver cirrhosis (OR=9.988, 95%CI: 2.048-48.709, P=0.004) were independent risk factors for the prognosis of liver failure due to recurrence after drug withdrawal. Conclusion Liver failure due to recurrence after drug withdrawal has a high mortality rate, and its prognosis is not associated with antiviral regimen, course of treatment, or virological parameters. Patients with liver cirrhosis and a higher liver failure grade tend to have poorer prognosis. Patients with liver cirrhosis have a high risk after drug withdrawal and should take the medicine for a long time or even for the whole life. [ABSTRACT FROM AUTHOR]

Background/Aims: To determine factors predictive of discordance in staging liver fibrosis using liver biopsy (LB) and acoustic radiation force impulse (ARFI) elastography in patients with chronic hepatitis B (CHB). Methods: Consecutive patients with CHB who underwent LB and ARFI elastography on the same day from November 2010 to March 2013 were prospectively recruited from three tertiary hospitals. Results: We analyzed 105 patients (median age of 47 years). The F0-1, F2, F3, and F4 fibrosis stages were identified in 27 (25.7%), 27 (25.7%), 21 (20.0%), and 30 (28.6%) patients, respectively. The areas under the receiver operating characteristics curves for ARFI elastography in assessing ≥F2, ≥F3, and F4 was 0.814, 0.848, and 0.752, respectively. The discordance of at least one stage between LB and ARFI was observed in 68 patients (64.8%) and of at least two stages in 16 patients (15.2%). In a multivariate analysis, advanced fibrosis stage (F3-4) was the only factor that was negatively correlated with one-stage discordance (p=0.042). Moreover, advanced fibrosis stage was negatively (p=0.016) correlated and body mass index (BMI) was positively (p=0.006) correlated with two-stage discordance. Conclusions: Advanced fibrosis stage (F3-4) was a predictor of nondiscordance between LB and ARFI elastography; BMI also influenced the accuracy of ARFI elastography. [ABSTRACT FROM AUTHOR]

Background/Aims: We investigated factors associated with the disease progression and development of hepatocellular carcinoma (HCC) in chronic hepatitis B (CHB) patients during long-term oral nucleos(t)ide analog (NA) therapy. Methods: This retrospective study included 524 naive CHB patients who received oral NA therapy for more than 48 weeks between January 2003 and December 2007. The primary outcome was 5-year cumulative probability of disease progression and HCC development. Disease progression was defined as cirrhosis development, cirrhotic complications, HCC or liver-related mortality. Results: For the 524 patients, the cumulative probabilities of disease progression and HCC development at 1, 2, 3, 4 and 5 years were 1.1%, 6.3%, 9.0%, 11.6%, and 16.2% and 0.2%, 1.8%, 3.6%, 5.8%, and 9.3%, respectively. In multivariate analysis, age >50 years (hazard ratio [HR], 1.05) and cirrhosis (HR, 2.95) were significant factors for disease progression. Similarly, age >50 years (HR, 1.05), family history of HCC (HR, 5.48), and cirrhosis (HR, 17.16) were significant factors for HCC development. Importantly, longer duration (>12 months) of maintained virological response (<20 IU/mL) reduced the risks of disease progression (HR, 0.19) and HCC development (HR, 0.09). Conclusions: Longer duration of maintained virological response significantly reduces the risk of disease progression or HCC development in CHB patients undergoing long-term oral NA therapy. [ABSTRACT FROM AUTHOR]

The infection/clearance and antiviral therapy of hepatitis B virus (HBV) are affected by various factors, such as the host, virus, and environment. Recent studies have proven that interleukin 28B (IL - 28B) polymorphisms are highly associated with the clearance and antiviral therapy of hepatitis C virus. Since then, great attention has been paid to the role of IL - 28B genetic variations in chronic hepatitis B (CHB), with a research focus on the loci rs12979860, rs12980275, and rs8099917. This paper reviews the role of IL - 28B polymorphisms in the infection/clearance of HBV and interferon therapy of CHB. Despite the conflicting findings, IL - 28B polymorphisms are considered to have a potential clinical value in the field of CHB. [ABSTRACT FROM AUTHOR]

The treatment responses to pegylated interferon alpha (PEG - IFNɑ) in patients with chronic hepatitis B (CHB) are associated with the genetic polymorphisms, immune status, hepatitis B virus genotype, and viral load of the host. This article reviews the recent studies on influential factors for the responses to PEG - IFNɑ in CHB patients. The important predictors of the clearance and seroconversion of HBsAg and HBeAg and sustained virological response include interleukin - 28B (IL - 28B) gene polymorphism, baseline level of interferon - inducible protein - 10, IL - 17A, IL - 10, tumor necrosis factor - a, viral load and genotype, and changes in serum HBsAg and HBeAg levels at weeks 12 and 24 of treatment. [ABSTRACT FROM AUTHOR]

There are 400 million individuals infected with chronic hepatitis B virus (HBV) all over the world. The management of chronic hepatitis B (CHB) has been improved markedly over the last decade, primarily due to the availability of oral nucleoside analogue (NA) therapy. Among the numerous NAs, tenofovir disoproxil fumarate (TDF) stands out for its high therapeutic efficacy, low drug resistance, and wide disease spectrum against several types of chronic CHB that can not be cured with NAs. Thus, TDF has been widely used for clinical treatment of chronic HBV infection. This paper describes the efficacy of TDF in naive and treated patients and analyzes its effect on cirrhosis. Furthermore, the safety of TDF therapy is assessed. It is considered that TDF has low resistance rate and high safety, which provides a first - line drug for CHB treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the expression characteristics of Treg, Tr1, and Th17 cells in the peripheral blood of patients with chronic hepatitis B (CHB) and their correlations with the state of CHB. Methods A total of 40 patients with mild - to - moderate CHB and 40 patients with severe CHB who were admitted to The 180th Hospital of PLA from January 2013 to June 2014 were included into this study, and 40 healthy people with normal liver function were recruited as control group. Peripheral blood was collected from CHB patients and healthy controls, and then the percentages of Treg, Tr1, and Th17 cells in peripheral blood were determined by flow cytometry. The levels of Foxp3 mRNA and RORɣt mRNA in serum were measured by real - time PCR, and the expression levels of TGF - β1, IL - 10, and IL - 17 were measured by ELISA. Comparison of continuous data between the groups was made by one - way ANOVA analysis and LSD - t test. ResiUts (1) Compared with the control group, the two groups of CHB patients had significantly higher percentages of Tr1, Treg, and Th17 cells (P < 0.05), and had significantly higher levels of Foxp3 mRNA and RORɣt mRNA (P < 0.05) and levels of TGF - β1, IL - 10, and IL - 17 (P < 0.0 5), while the two groups of CHB patients had significantly lower Treg/Th17 ratio (P < 0.05) and Foxp3/RORɣt ratio (P < 0.05) than the healthy controls. (2)The patients with severe CHB had significantly higher percentages of Treg, Tr1, and Th17 cells (P < 0.05), and had significantly higher levels of Foxp3 mRNA and RORɣt mRNA (P < 0.05) and levels of TGF - β1, IL - 10, and IL - 17 (P < 0.05), as compared with the patients with mild - to - moderate CHB, while the patients with severe CHB had significantly lower Treg Th17 ratio (P <0.05) a d Foxp3/RORɣt ratio (P <0.05) than those with mild - to - moderate CHB. Conclusion The expression imbalance of Treg cells (especially Tr1 cells) a d Th17 cells in CHB patients is positively correlated with the progression of the disease; therefore, it may be important to correct the expression imbalance of Treg cells and Th17 cells in the treatment of CHB. Meanwhile, monitoring the percentages of Treg cells (especially Tri ceHs) and Th17 ceHs is helpful for assessing the clinica outcomes of CHB patients and guiding the clinica treatment. [ABSTRACT FROM AUTHOR]

Objective To investigate the relationship of hepatic immune cells (CD4+, CD8+, CD20+, and CD57+ T lymphocytes) with liver pathology and clinical relevance in chronic hepatitis B (CHB) patients with different HBeAg status. Methods A total of 70 CHB patients admitted to our hospital from January 2008 to December 2013 underwent liver biopsy, among whom 38 were HBeAg positive and 32 were HBeAg negative. Immunohistochemistry was used to examine the expression of CD4+, CD8+, CD20+, and CD57+ T lymphocytes in hepatic tissues, and the correlation between their expression and clinical relevance was analyzed in patients with different HBeAg status. Ranked data were analyzed by Kruskal - Walls H test. Comparison between groups was made by Nemenyi test. Correlation analysis was made by linear regression method. Results When inflammation reached to the level of G3 - G4 in patients with either positive or negative HBeAg, the expression of hepatic CD8+ and CD20+ cells in them was significantly higher than that in patients with inflammation level of G1 (all P < 0.05). When the levels of inflammation reached G4 in patients with positive HBeAg and G3 in those with negative HBeAg, the expression of hepatic CD4+ cells was significantly higher than that in patients with G1 inflammation (all P < 0.05). In patients with negative HBeAg, the CD4+, CD8+, CD20+, and CD57+ lymphocytes all showed a positive correlation with alanine aminotransferase (ALT) level (r = 0.353, 0.628, 0.693, and 0.540, respectively; all P < 0.05). In addition, CD20+ lymphocytes also showed a positive correlation with hepatitis B virus (HBV) DNA (r = 0.378, P < 0.05). However, in patients with positive HBeAg, only CD8+ and CD20+ lymphocytes showed a positive correlation with ALT level, and no correlation was found between all lymphocyte populations and HBV DNA. Conclusion The expression of CD4+, CD8+, and CD20+ lymphocytes was significantly correlated with the grade of inflammation in hepatic tissues in patients with different HBeAg status, whereas the correlations between hepatic immune cells and levels of ALT and HBV DNA vary. [ABSTRACT FROM AUTHOR]

Currently, there are two categories of antiviral drugs used for chronic hepatitis B (CHB): interferons (IFNs) and nucleos(t) ide analogues (NAs). IFNs showed lower efficacy and more adverse effects, although they achieved some anti - HBV results. NAs showed stronger antiviral activity and a lower incidence rate of adverse effects; however, there are also some problems, such as high risk of relapse after the NAs are discontinued and increased rate of drug resistance with a longer course of treatment. Therefore, it is very important for clinicians to investigate the optimal therapy against HBV to further improve efficacy and safety in the treatment of CHB. In this paper, the research on combination therapy and sequential therapy against HBV is reviewed, in the hope that clinicians may have a deeper knowledge of combination therapy and sequential therapy against HBV, so as to provide more choices for antiviral therapy of CHB patients. [ABSTRACT FROM AUTHOR]

Background: The hepatitis B virus is an important healthcare problem. According to current clinical practice, a liver biopsy is required for the diagnosis and treatment of chronic liver disease. However, a liver biopsy is an invasive, inconvenient procedure, which requires an expert pathologist opinion. Therefore requirement of biochemical tests, which are considered to indicate hepatic fibrosis and may be repeated easily, increases gradually today. Objectives: This study evaluated the correlation between hepatic fibrosis and routine laboratory values in patients with chronic hepatitis B. Patients and Methods: The files of 456 patients with CHB (chronic hepatitis B) who were referred to the infectious diseases and clinical microbiology clinic between January 2009 and March 2012 were screened retrospectively. Liver biopsy samples were examined according to Ishak scoring. Laboratory parameters and histopathology reports were recorded, and correlations between the fibrosis grade and laboratory parameters were analyzed. Results: There were 320 male and 136 female patients, with a mean age 36.7 ± 12.1 years. According to liver biopsy results, a low fibrosis score (stage 0-2) was detected in 281 patients (61.6%), and a high fibrosis score (stage 3-5) was detected in 175 patients (38.4%). Patients with a high fibrosis score had significantly higher ALT (alanine amino transferase), AST (aspartate aminotransferase), and HBV-DNA values and a significantly lower platelet count compared with those with a low fibrosis score (P = 0.001, 0.001, 0.025, and 0.001, respectively). A positive correlation was detected between the fibrosis score and age, BMI, HAI, ALT, and AST values, and a negative correlation was detected between the fibrosis score and albumin and platelet counts. In the regression analysis performed to evaluate the factors associated with high-stage fibrosis, fibrosis was determined to be associated with thrombosis, ALT, and gender. The results of the regression analysis demonstrated that the risk of fibrosis was 4.6 fold higher in men. Conclusions: According to the results obtained in our study, advanced age, higher BMI, AST, ALT, and HBV-DNA levels, and low albumin and platelet levels are correlated with advanced fibrosis in patients with CHB. [ABSTRACT FROM AUTHOR]

Background: Chronic hepatitis B is one of the world's major health concern. The etiological agent of this infection is hepatitis B virus (HBV), which can evade the immune system response. Transforming growth factor beta 1 (TGF-β1) can act against HBV by suppressing the viral replication. The TGF-β1 also plays an important role in preventing liver damage in chronically HBV infected patients. Objectives: In this study, the association of TGF-β1 +915G/C and -509C/T gene polymorphisms with chronic hepatitis B was evaluated in Iranian patients. Materials and Methods: A population-based case–control study was conducted in Taleghani Hospital, Tehran. A number of 220 patients with chronic hepatitis B and the same number of healthy control subjects were designated the case and the control groups. The PCR-Restriction Fragment Length Polymorphism Method (PCR-RFLP) method was used for genotyping both polymorphisms. Ten percent of the control samples were sequenced to confirm the results. Results: No statically significant differences in genotype distribution and allele frequency were observed for both polymorphisms between healthy controls and patients with chronic hepatitis B. Conclusions: There was no association between TGF-β1 -509C/T and +915G/C polymorphisms with chronic hepatitis B and it seems that these changes don not play a significant role in increasing the risk of chronic infection in Iranian patients. [ABSTRACT FROM AUTHOR]

To evaluate the value of FibroScan in assessing liver fibrosis in chronic hepatitis B (CHB) patients with hepatocyte steatosis. Methods Four hundred ad eighteen CHB patients who had undergone liver biopsy in Shanghai Ruiiin Hospital from January 2009 to December 2011 were enrolled in this study. These patients were divided into hepatocyte steatosis group (n = 211) and non - hepatocyte steatosis group (n = 207). FibroScan was performed in both groups on the same day. Comparisons of liver stiffness measurement (LSM) and liver fibrosis stage determined by FibroScan ad Ishak scoring system were made. Comparisons between groups were made by independent - samples t test, Kruskal - Wallis H test, ad Nemenyi test. Comparison of categorical data was made by chi - square analysis. Bivariate correlation analysis was performed using the Spearman Rak Correlation coefficient. The influential factors for LSM were determined by stepwise regression analysis. Results There was no significant difference in LSM between the patients of the same liver fibrosis stage in the two groups (P >0. 05), and LSM had a significant positive correlation with liver fibrosis stage in the non - hepatocyte steatosis group (rs =0. 650 35, P <0. 000 1) and hepatocyte steatosis group (rs =0. 637 93, P <0. 000 1). The stepwise regression analysis showed that aspartate aminotransferase (AST), alanine aminotransferase, albumin (Alb), total bilirubin, and platelet (PLT) were significant influential factors for LSM in the non - hepatocyte steatosis group and that PLT, AST, ae, Alb, ad body mass index were significant influential factors for LSM in the hepatocyte steatosis group. Conclusion FibroSca can be used as a useful tool for assessing liver fibrosis in CHB patients with hepatocyte steatosis. [ABSTRACT FROM AUTHOR]

Antiviral treatment is the key in the treatment of chronic hepatitis B. The long - term antiviral therapy with nucleos (t) ide analogues may lead to the viral gene mutations and drug resistance, and then the sensitivity of virus to the drug is decreased. In this study, the point mutations associated with four nucleos(t) ide analogues and the incidence of mutations were investigated. The rate of drug resistance to lamivudine was highest and that of resistance to entecavir was lowest. Recent research showed that hepatitis B virus (HBV) genotype was associated with drug resistance to nucleos(t)ide analogues. In order to prevent drug resistance, the indications for antiviral therapy should be determined strictly, and then the nucleos(t) ide analogues with high efficacy and low drug resistance can be selected. And if drug resistance develops, it is necessary to add or change to another nucleos(t ide analogue without cross resistance. [ABSTRACT FROM AUTHOR]

Background: Hepatitis B virus (HBV) reactivation is one of the most common precipitating events associated with acute decompensation (AD) or acute-on-chronic liver failure (ACLF) in chronic hepatitis B (CHB)-related cirrhotic patients. However, whether their serum HBV deoxyribonucleic acid (DNA) levels are associated with ACLF incidence and short-term mortality rate is still ambiguous.Methods: The ACLF incidences, 28-day and 90-day liver transplantation (LT)-free mortality rates, previous nucleoside/nucleotide analogues (NUCs) treatments and serum HBV DNA levels at admission (ad-levels) of 111 hospitalized patients with AD of CHB-related cirrhosis were analyzed.Results: 43 (38.7%) patients developed ACLF. The 28-day and 90-day LT-free mortality rates of the ACLF cases were 15.4 and 40.9%, respectively. Though NUCs inhibited HBV replication effectively, there were no differences in the ACLF incidence between antiviral treatment-naïve patients and NUCs treatment-experienced patients with or without interruptions (37.5, 41.7 and 45.5%, respectively, P>0.05). The serum HBV DNA ad-level was similar between the patients with and without ACLF development (logarithms: 4.50 ± 1.96 vs 4.32 ± 1.99; ≥2000 IU/ml: 67.4% vs 67.6%; both P>0.05), so was between the ACLF patients died or survived in 28 or 90 days (logarithms: 4.31 ± 1.91 vs 5.54 ± 2.53, 4.81 ± 1.76 vs 4.84 ± 2.40, respectively, both P>0.05).Conclusion: Serum HBV DNA ad-level and previous NUCs treatment are not associated with incidence of ACLF and short-term mortality rate in the hospitalized patients with AD of CHB-related cirrhosis. [ABSTRACT FROM AUTHOR]