In Situ MXene Anchored Structure for Highly Durable Solar Steam Generation.

As a promising fresh water harvesting technology, interfacial solar steam generation has attracted growing interest. Efficient solar absorption and long-term operational performance are critical requirements of this technology. However, developing robust evaporators to promote practical applications under extreme conditions is still a grand challenge. Herein, we propose a light-assisted strategy to in situ prepare a Ti3C2Tx MXene anchored structure (MXAS) for enhanced solar evaporation with superior mechanical properties (compressive strength of 78.47 MPa, which can withstand a pressure of 3.92 × 106 times its own weight). Light irradiation enlarges the interlayer spacing of MXene and improves the solar absorption capability. Under one sun, the three-dimensional MXAS evaporator exhibits a steam generation rate of 2.48 kg m-2 h-1and an evaporation efficiency of 89.3%, and it demonstrates long-term durability when testing in seawater. This strategy provides valuable insights into the potential application of a high-performance water evaporation system.

Enhanced Electricity Generation from Graphene Microfluidic Channels for Self-Powered Flexible Sensors.

As a novel energy harvesting method, generating electricity from the interaction of liquid-solid interface has attracted growing interest. Although several functional materials have been carried out to improve the performance of the flow-induced hydrovoltaic generators, there are few reports on influencing the droplet flow behavior to excavate its electricity generation by governing the device structure. Here, the output performance of the graphene microfluidic channel (GMC) structure is ∼13 times higher than that of the flat-open space graphene morphology. The strong slip flow and high surface charge density near the graphene-droplet interface originate from the GMC structure, which produces an effective liquid-solid interaction and rapid relative movement of the droplet. Additionally, based on the GMC structure a self-powered pressure sensor is designed. The droplet motion is regulated by external forces to generate specific voltages, which provide a new approach for the development of wearable self-powered electronics.

Mixed-Dimensional van der Waals Heterostructures for Boosting Electricity Generation.

The emerging technology of harvesting environmental energy using hydrovoltaic devices enriches the conversion forms of renewable energy. It provides more concepts for power supply in micro/nano systems, and hydrovoltaic technology with high performance, usability, and integration is essential for achieving sustainable green energy. Comparing the discovery of multiscale nanomaterials, working layers with innovative microstructures have gradually become the dominant trend in the construction of graphene-based hydrovoltaic devices. However, reports on promoting ion/electron redistribution at the solid-liquid interface through the substrate effect of graphene are accompanied by tedious procedures, nondiverse substrates, and monolithic regulation of enhancement mechanisms. Here, the electrophoretic deposition (EPD)-driven SiC whiskers (SiCw)-assisted graphene transfer process is adopted to alleviate the complexity of the device fabrication caused by graphene transfer. The resulting output performance of the graphene/SiCw (GS) mesh films is significantly boosted. The high integrity of graphene and prominent negative surface charge near the graphene-droplet interface are derived from the overlayer and underlayer inside the graphene-based mixed-dimensional van der Waals (vdW) heterostructures, respectively. Additionally, a self-powered desalination-monitoring system is designed based on integrated hydrovoltaic devices. Electricity harvested from the ionic solutions is reused for deionization, representing an efficient strategy for energy conversion and utilization.

Gradient Titanium Oxide Nanowire Film: a Multifunctional Solar Energy Utilization Platform for High-Salinity Organic Sewage Treatment.

The treatment of high salt organic sewage is considered to be a high energy consumption process, and it is difficult to degrade organic matter and separate salt and water simultaneously. In this study, a gradient structure titanium oxide nanowire film is developed, which can realize the thorough treatment of sewage under sunlight. Among the film, part TiO2-x has enhanced photocatalytic properties and can completely degrade 0.02 g·L-1 methylene blue in 90 min under 2 sun. Part TinO2n-1 has excellent photothermal conversion efficiency and can achieve 1.833 kg·m-2·h-1 water evaporation rate at 1 sun. Through the special structure design, salt positioning crystallization can be realized to ensure the film's stable operation for a long time. The gradient hydrophilicity of the film ensures adequate and rapid water transfer, while the water flow can induce a significant hydrovoltaic effect. The measured VOC is positively correlated with light intensity and photothermal area and corresponds to the water evaporation rate.

Interface Engineering of a Ti4O7 Nanofibrous Membrane for Efficient Solar-Driven Evaporation.

Solar-driven interfacial evaporation provides a feasible and sustainable way to solve the fresh water shortage using abundant solar energy and has recently attracted considerable attention. However, it has been limited by the evaporation rate and solar-heat conversion efficiency of the current materials. Herein, a novel Ti4O7 membrane with synergetic photothermal and electrothermal effects was developed using a straightforward in situ approach. Based on interface engineering, the interface between the surface of the membrane and water was hydrophobically modified, and a thermal insulation layer was added to the bottom of the membrane. The optimized self-floating membrane with excellent sunlight absorbability and conductivity achieved a remarkably high evaporation rate of 7.51 kg m-2 h-1 with a voltage of 3 V as compensation under one-sun irradiation (1 kW m-2). Moreover, the bilayered membrane displayed efficient salt ion rejection, and the collected water can meet the World Health Organization (WHO) standard required for potable water.

Telbivudine versus lamivudine in Chinese patients with chronic hepatitis B: Results at 1 year of a randomized, double-blind trial.

UNLABELLED: Chronic hepatitis B and its life-threatening sequelae are highly prevalent in China. There is a need for effective new therapies to suppress hepatitis B virus (HBV) replication and ameliorate liver disease. In this study, we compared the efficacy of telbivudine, a nucleoside analogue, with lamivudine in Chinese patients. In this phase III, double-blind, multicenter trial conducted in China, 332 patients with compensated hepatitis B e antigen (HBeAg)-positive or HBeAg-negative chronic hepatitis B were randomly assigned to treatment with 600 mg of telbivudine or 100 mg of lamivudine daily for 104 weeks. The primary efficacy endpoint was reduction in serum HBV DNA levels at week 52 of treatment. Secondary endpoints included clearance of HBV DNA to undetectable levels, HBeAg loss and seroconversion, therapeutic response, and alanine aminotransferase (ALT) normalization. Viral resistance and safety were assessed. At week 52, among 290 HBeAg-positive patients, mean reductions of serum HBV DNA were significantly greater in telbivudine recipients than lamivudine recipients (6.3 log(10) versus 5.5 log(10), P < 0.001), and HBV DNA was polymerase chain reaction-negative in significantly more telbivudine recipients than lamivudine recipients (67% versus 38%, P < 0.001). ALT normalization (87% versus 75%, P = 0.007), therapeutic response (85% versus 62%, P = 0.001), and HBeAg loss (31% versus 20%, P = 0.047) were also significantly more common in the telbivudine group. Treatment effects showed similar patterns in the smaller HBeAg-negative group (n = 42). Viral resistance in telbivudine recipients was approximately half that observed with lamivudine; however, this difference was not statistically significant. Clinical adverse events were similar in the two treatment groups. CONCLUSION: In Chinese patients with chronic hepatitis B, telbivudine treatment for 52 weeks provided greater antiviral and clinical efficacy than lamivudine, with less resistance.

[Clinical features and prognosis of decompensated hepatitis C virus related cirrhosis].

OBJECTIVE: To study the clinical features and prognosis of hepatitis C virus (HCV)-related cirrhosis after the first occurrence of complications. METHODS: The clinical data of 89 decompensated HCV-related cirrhosis patients were analyzed. Univariate and multivariate analyses of the factors influencing the clinical decompensation were conducted. RESULTS: Ascites was the most frequent first decompensation (44.9%), followed by upper gastrointestinal bleeding (23.6%), and self-originated peritonitis (20.2%), and hepatic encephalopathy (11.2%). During the follow-up of 62 months (60-66 months) ascites was the most frequent first decompensation (47. 2%), followed by self-originated peritonitis (18.0%), upper gastrointestinal bleeding (15.7%), and hepatic encephalopathy (7.9%). The 5-year survival rates after of the patients with hepatic encephalopathy, ascites, upper gastrointestinal bleeding and self-originated peritonitis as the first decompensated complications were 64.5%, 85.0%, 75.0%, and 83.3% respectively. Multivariate regression analysis showed that esophageal and gastro varices and bilirubin were independently correlated with survival. CONCLUSION: Hepatitis C is a slowly progressing disease. Decompensation occurring in hepatitis C is significantly correlated with survival.

[An acute norovirus gastroenteritis outbreak in a hospital].

OBJECTIVE: To investigate and analyze a case of acute norovirus gastroenteritis outbreak in a hospital. METHODS: Data were collected through the on-the-spot investigation and faecal specimens were tested by polymerase chain reaction-reverse transcription (RT-PCR). Serum specimens were tested by Western blot. RESULTS: The outbreak lasted 26 days. A total of 87 cases were reported, including 65 inpatients, 15 healthcare workers, 6 accompanies, and 1 pantryman. Twelve (60%) of 20 stool specimens were norovirus-positive by RT-PCR and 19 of 24 blood samples were norovirus-positive by Western blot. The outbreak was effectively controlled by isolating and treating the patients, extensive disinfection, and health education. CONCLUSION: The gastroenteritis outbreak was caused by norovirus with unkown infection source.

[The histopathologic and clinical analysis of viral chronic hepatitis patients with negative serological viral markers].

OBJECTIVE: To analyze the histopathological and clinical features of viral chronic hepatitis patients with negative serological viral markers. METHODS: 62 hepatitis patients with negative serological markers were assayed with serological viral hepatitis markers, liver function test and liver biopsies were enrolled in the study. Serum HBV DNA of HBV cases was analyzed by PCR. Liver specimens were examined by immunohistochemistry for HBsAg and HBcAg. RESULTS: The fit rate of histopathological diagnosis with clinical diagnosis is 53.2%, the fit rate is 69.1% in moderate chronic hepatitis group. The immunohistochemistry showed that HBsAg and/or HBeAg positive rate was 45.2%, 53.6% had moderate chronic hepatitis and 25% had mild hepatitis. 13 (46.4%) had G1 hepatitis, 10 (35.7%) had G2 hepatitis, 3 (10.8%) had G3 hepatitis and 2 (7.1%) had G4 hepatitis, and serum HBV DNA positive rate was 35.7%. There were no differences in HBV DNA levels between different hepatitis group and fibrosis stage group (P > 0.05). There were no differences in all indexes between HBV DNA negative group and HBV DNA positive group (P > 0.05). There were no differences in all indexes between HBV patients and other patients (P > 0.05). CONCLUSION: Occult HBV infection may account for a high proportion of the cases with chronic hepatitis of unknown etiology. Most patients are chronic mild hepatitis, but they still have HBV replication and can progress to liver cirrhosis. Serum PCR test, liver biopsy and immunohistochemistry are helpful for the diagnosis.

[The degree of HBV suppression with 24 week telbivudine- or lamivudine-treatment in hepatitis B patients predicts the efficacy of the treatment at week 52].

OBJECTIVES: To investigate the possibilities of an association between the degrees of HBV suppression with nucleoside treatments at week 24 and week 52 in hepatitis B patients and to find a useful predictor for treatment efficacy. METHODS: In this phase III, double-blind, multicenter trial, we compared the efficacy of telbivudine treatment with lamivudine treatment in 332 Chinese compensated chronic hepatitis B patients. The patients were randomly assigned to a daily 600 mg telbivudine treatment group or daily 100 mg lamivudine group for 24 weeks. They were then categorized into 4 groups according to their serum HBV DNA levels (copies/ml) at week 24: a PCR-undetectable group (< 300 copies/ml); a QL- < 10(3) copies/ml group; a 10(3)-<10(4) copies/ml group; and a > or = 10(4) copies/ml group. The treatments were continued as they previously had been for another 28 weeks and the patients serum HBV DNA levels were examined again. RESULTS: At week 52, mean reductions of serum HBV DNA were significantly greater in the telbivudine-treated patients than in the lamivudine-treated group (6.2 log10 vs 5.4 log10, t = 3.6, P < 0.01). Viral resistance was twice as common in lamivudine-treated patients compared to those receiving telbivudine. Telbivudine was well-tolerated with an adverse event profile similar to that of lamivudine. The lower the HBV DNA level achieved at week 24, the higher HBV DNA non-detectable by PCR. ALT normalization and HBeAg seroconversion achieved at week 52, and viral resistance at week 48 decreased parallel to the degree of HBV DNA inhibition. CONCLUSION: HBV DNA PCR-undetectable at week 24 in nucleoside-treated hepatitis B patients suggests a better efficacy at week 52 and lower viral resistance at week 48. The degree of suppression of HBV at week 24 may be used as a predictor of 1-year outcome.

Long-Term Telbivudine Treatment Results in Resolution of Liver Inflammation and Fibrosis in Patients with Chronic Hepatitis B.

INTRODUCTION: The long-term goal of chronic hepatitis B (CHB) treatment is improvement of liver disease and prevention of cirrhosis. The aim of this study was to assess whether prolonged telbivudine treatment improves liver inflammation and fibrosis. The primary objective was to evaluate the proportion of patients with absence/minimal inflammation (Knodell necroinflammatory score ≤3) on liver biopsy at Year 5. METHODS: Fifty-seven patients aged 16-70 years with a clinical history of CHB and active viral replication (38 hepatitis B e antigen [HBeAg] positive and 19 HBeAg negative) were followed for 6 years: 33 received telbivudine 600 mg/day continuously for 5 years; 24 received lamivudine 100 mg/day for 2 years and then telbivudine for 3 years. Liver biopsies were taken pre-treatment and after 5 years of treatment. RESULTS: At baseline, mean (standard deviation) serum hepatitis B virus (HBV) DNA load was 8.5 (1.7) log10 copies/mL, Knodell necroinflammatory score was 7.6 (2.9), and Ishak fibrosis score was 2.2 (1.1). After antiviral treatment (median duration: 261 weeks), liver histology improved with increased proportions of patients with absence/minimal liver inflammation (Knodell necroinflammatory score ≤3), from 16% (9/57) at baseline to 98% (56/57), and absence/minimal fibrosis (Ishak score ≤1), from 25% (14/57) at baseline to 84% (48/57). At Year 5, HBV DNA load was <300 copies/mL for all patients; cumulative HBeAg loss and seroconversion rates were 88% and 77%, respectively. At Year 6, 95% of patients with abnormal baseline glomerular filtration rate (60-90 mL/min/1.73 m(2)) improved to normal GFR (>90 mL/min/1.73 m(2)). CONCLUSION: Long-term telbivudine treatment with profound and durable viral suppression significantly improved liver histology, thus achieving the long-term goals of CHB treatment. FibroScan(®) results after 5 and 6 years of treatment (in almost 20% of patients) were consistent with this information. FUNDING: Novartis and National Science and Technology Major Project (2012ZX10002003). TRIAL REGISTRATION: ClinicalTrials.gov # NCT00877149.

Promoting hepatic growth factor in the treatment of heavy type hepatitis and severe chronic hepatitis: a multicenter clinical study.

BACKGROUND: The mortality rate of heavy type hepatitis is high. No special treatment is available except general treatment. This multicenter clinical study was designed to observe the safety and efficacy of promoting hepatic growth factor (PHGF) in the treatment of heavy type hepatitis and severe chronic hepatitis. METHODS: 347 patients with heavy type hepatitis and 324 with severe chronic hepatitis were subjected to administration of 120 microg of PHGF per day for 4 weeks on the basis of general treatment. Those who were being effectively treated would last additional 2 to 4 weeks. Blood routine, urine routine, blood urea nitrogen (BUN), blood creatinine (Cr), blood ammonia, alpha fetoprotein (AFP), electrolyte, alanine transaminase (ALT), aspartate transaminase (AST), serum total bilirubin (TBIL), serum direct bilirubin (DBIL), prothrombin time activity (PTA), total protein (TP) and albumin (ALB) were detected in the patients before treatment, 2 weeks after treatment, and at the end of the treatment. Any side-effect would be recorded. RESULTS: In the patients with severe chronic hepatitis, the total effective rate of the treatment was 88.9%. The levels of ALT, AST and TBIL decreased significantly (P<0.001), whereas those of PTA and ALB increased significantly (P<0.001), and the level of AFP increased slightly. In patients with heavy type hepatitis, the total effective rate of this treatment was 78.4%, and patients at different stage showed different results. The total effective rates of patients with early, medium and terminal stage heavy type hepatitis were 89.9%, 84.8% and 27.5%, respectively. No severe side-effect was shown. CONCLUSION: PHGF is effective and safe in the treatment of patients with heavy type hepatitis and severe chronic hepatitis. But it should be administered early in patients with heavy type hepatitis so as to get better curative effects.

Cloning and analysis of the genomic DNA sequence of augmenter of liver regeneration from rat.

OBJECTIVE: To search for genomic DNA sequence of the augmenter of liver regeneration (ALR) of rat. METHODS: Polymerase chain reaction (PCR) with specific primers was used to amplify the sequence from the rat genome. RESULTS: A piece of genomic DNA sequence and a piece of pseudogene of rat ALR were identified. The lengths of the gene and pseudogene are 1508 bp and 442 bp, respectively. The ALR gene of rat includes 3 exons and 2 introns. The 442 bp DNA sequence may represent a pseudogene or a ALR-related peptide. Predicted amino acid sequence analysis showed that there were 14 different amino acid residues between the gene and pseudogene. ALR-related peptide is 84 amino acid residues in length and relates closely to ALR protein. CONCLUSION: There might be a multigene family of ALR in rat.

[Treatment of chronic hepatitis C by bicyclum, a randomized double-blind placebo controlled trial].

OBJECTIVE: To evaluate the efficacy and safety of bicyclum, a China made new hepatocyte protecting agent, in the treatment of chronic hepatitis C (CHC). METHODS: Thirty-nine CHC patients matched demographically and clinically were randomized into two groups: bicyclum group (group A, n = 20) and placebo/bicyclum crossovergroup (group B, n = 19). Bicyclum 75mg/d or placebo was administered to these two groups respectively for 3 months. Then the patients in group A received bicyclum for further 3 months and were observed for 3 months after the treatment discontinued; and the patients in group B received bicyclum 75mg/d for six months and were observed for 3 months after the treatment discontinued. Investigation items included clinical manifestations,liver function, serum HCV RNA and anti-HCV. RESULTS: In group A, the serum ALT was 120 +/- 43 U/L before treatment and was 57 +/- 32 U/L after treatment ( P < 0.01) In group B the baseline serum ALT was 126 U/L +/- 48 U/L. After the placebo administration the serum ALT was 127 U/L +/- 97 U/L (P > 0.05) and the clinical feature showed no improvement. After bicyclum treatment for 6 months, the serum ALT in group B was 68 +/- 45 U/L, significantly lower than that before bicyclum treatment ( P < 0.01) and clinical symptoms improved. The overall ALT normalization response rate were 64.1% and 48.7% at the end of bicyclum treatment and 3 months after the treatment discontinued respectively for the total 39 patients. The serum HCV-RNA became negative in 5 and 2 patients at end of treatment and 3 months after the treatment discontinued. Adverse drug reactions were mild and uncommon. Mild dizziness occurred in 1 patient in each group. CONCLUSION: Bicyclum is effective in improving ALT and clinical manifestations of CHC patients. It is safe and well tolerated and shows few adverse reactions.

[The study on heterogeneity of hepatitis B virus DNA].

OBJECTIVE: To investigate the HBV quasispecies groups in the patients with chronic HBV infection. METHODS: Specific primers ware synthesized according to HBV strain found in China, the preC/C gene, reverse transcriptase region, whole S region, X gene and whole genome ware amplified by PCR method from the serum of 18 patients with chronic HBV infection, and then the PCR products were subcloned into pGEM Teasy vectors. Positive clones with target sequences were selected out for sequencing. Sequence comparison of the selected clones ware made to find the difference. RESULTS: The homology between clones from one patient of preC/C gene, reverse transcriptase of polymerase region, whole S region, X gene and whole genome are 98.0% approximately 99.1%, 98.7% approximately 99.3%, 97.5% approximately 100%, 93.0% approximately 98.2% and 96.6% approximately 97.5%, respectively. There was a high-frequency A83 substitution and core antigen internal deletion (CID) in preC/C region. Substitution, deletion and frame-shift by insertion or deletion of short sequence were found in 4 open reading frames. Deletion in X gene (Core promoter, CP) will not only result in the polymorphism of X protein at the carboxyl end, but also regulate the expression of HBeAg. Coding sequence of truncated middle surface antigen and defective HBV genome could also be detected in this study. CONCLUSION: There are HBV quasispecies groups in patients with chronic HBV infection. Hot deletion region in X region (CP) will influence the prognosis of the HBV infection. Individually characterized substitutions in amino acid sequence of viral protein is worthy of further study.

[A clinical study of the efficacy and safety of secretory human interferon alpha-2a treatment for chronic hepatitis B].

OBJECTIVE: To investigate the efficacy and safety of secreted interferon in treatment of chronic hepatitis B. METHODS: A multi-center randomized open-label controlled clinical trial was carried out. The patients of the study group were treated by secretory human interferon alpha-2a, and the patients of the control group were treated with an ordinary interferon. RESULTS: ALT normalization rate in the secreted interferon group was 48.3% and it was higher at the end of treatment than that of the control group, but there was no difference between the two groups at the end of the follow-up. HBV DNA dropped more in the study drug group, but there was no difference in the normalization rate between the two groups. HBeAg seroconversions in secreted interferon group and in the control interferon group were 19.0% and 18.4% respectively. The safety of the two types of interferon was satisfactory. CONCLUSIONS: Secreted interferon was superior to ordinary interferon in ALT normalization and HBV DNA drop at the end of treatment in chronic hepatitis B patients, but there was no difference at the end of the follow-up. There was also no difference in HBeAg negative and HBeAg seroconversion between the two groups.

Kinetics of serum HBsAg in Chinese patients with chronic HBV infection with long-term adefovir dipivoxil treatment.

BACKGROUND: Knowledge on Hepatitis B surface antigen (HBsAg) kinetics in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment is limited. The aims of this study were to investigate HBsAg kinetics in patients with chronic hepatitis B virus (HBV) infection treated with long-term ADV and to evaluate different characteristics between patients with and without HBsAg loss. METHODS: We retrospectively evaluated HBsAg kinetics in 24 Chinese patients with chronic HBV infection who achieved continuous virologic suppression during ADV therapy. HBV genotype was determined at baseline. Liver biochemistry, hepatitis B e antigen status, serum HBV DNA, and HBsAg levels were measured at baseline, 6 months, and once every year thereafter. RESULTS: Of these 24 patients, 3, 1, and 20 patients were followed up for 3, 5, and 6 years, respectively. Baseline serum HBsAg level had a moderate correlation with baseline HBV DNA level (r = 0.52, P = 0.01). The median rate of HBsAg reduction during the therapy period was 0.08 lg IU × ml(-1) × y(-1). Baseline serum HBsAg level was significantly higher than other time points (P ranges from 0.046 to 0.002). The HBsAg reduction rate during the first year was similar to that in other years (P > 0.05). The HBsAg reduction rate during the first year in patients with eventual HBsAg loss was significantly faster than that in patients without HBsAg loss (P = 0.005). CONCLUSIONS: Serum HBsAg levels in Chinese CHB patients receiving long-term ADV demonstrated a gradual reduction. Patients with eventual HBsAg loss had a significantly faster HBsAg reduction rate during the first year than those without HBsAg loss.

Kinetics and prediction of HBsAg loss during long-term therapy with nucleos(t)ide analogues of different potency in patients with chronic hepatitis B.

BACKGROUND & AIMS: About 350-400 million people are infected with hepatitis B virus (HBV) chronically and 1 million people die of hepatitis B virus (HBV)-related liver diseases. Nucleos(t)ide analogues (NAs) have been used for the treatment against HBV. However, few studies have investigated the long-term effects of different nucleos(t)ide analogues on levels of hepatitis B surface antigen (HBsAg) in patients with chronic hepatitis B (CHB). The aims of this study were to measure the magnitude of HBsAg reduction by long-term monotherapy with adefovir dipivoxil (ADV) and entecavir (ETV), to compare HBsAg reduction between the two drugs of different potency and to predict the expected time needed to achieve HBsAg loss. METHODS: We retrospectively evaluated the kinetics of HBsAg in 67 patients with CHB who all exhibited persistent viral suppression. These patients were treated with ADV or ETV for at least 6 years. HBV genotype was determined at baseline. Liver biochemistry, HBV serological markers, serum HBV DNA and HBsAg titers were determined at baseline, half year and yearly from year 1 to 6. RESULTS: Serum HBsAg titers after treatment with ADV or ETV were significantly lower than the baseline titers (P<0.05). HBsAg reduction rate of patients treated with ETV (0.11 log10 IU/mL/ year) was higher than that treated with ADV (0.10 log10 IU/mL/year), and the calculated expected time to HBsAg loss for patients treated with ETV (approximate 24.99 years) was shorter than that with ADV (approximate 30.33 years), but there was no statistically significant difference between two groups (P>0.05). CONCLUSION: Serum HBsAg titers gradually decreased during long-term treatment with either ADV or ETV. It appears that the potency of ADV on HBsAg reduction is close to that of ETV, as long as patients have achieved persistent viral suppression.

Two-year results of a randomized, phase III comparative trial of telbivudine versus lamivudine in Chinese patients.

PURPOSE: The burden of chronic hepatitis B infection is high in China, where prevalence exceeds 7 %. This was a randomized, double-blinded, phase III study of the efficacy and safety of telbivudine and lamivudine treatment at 104 weeks in Chinese patients with chronic hepatitis B. METHODS: Hepatitis B e antigen-positive (n = 290) and -negative (n = 42) adults with nucleoside analog-naïve compensated chronic hepatitis B were randomized to receive telbivudine 600 mg/day or lamivudine 100 mg/day for 104 weeks. The primary endpoint was reduction from baseline in serum hepatitis B virus (HBV) DNA at week 52. Week 104 analyses included HBV DNA reductions, undetectable HBV DNA (<300 copies/mL), ALT normalization, and e-antigen loss/seroconversion. Efficacy at week 104 was also assessed as a function of week 24 HBV DNA. RESULTS: In the intention-to-treat population (n = 332) at week 104, telbivudine was superior to lamivudine for reduction of HBV DNA [-5.48 vs. -4.00 log10 copies/mL; difference -1.49 log10 (95 % confidence interval -2.2, -0.8); p < 0.0001], for the proportion with undetectable HBV DNA (61.9 vs. 38.5 %; p < 0.0001), for ALT normalization (75.8 vs. 61.3 %; p = 0.0049), and for e-antigen loss (39.9 vs. 28.2 %; p = 0.0373). The cumulative probability of genotypic drug resistance was 15.4 % on telbivudine versus 23.6 % on lamivudine through week 104. Early virologic response at week 24 was associated with improved outcomes at week 104. Adverse events were similar to those seen in the GLOBE study. CONCLUSIONS: Telbivudine is superior to lamivudine over 2 years of chronic hepatitis B treatment in Chinese patients.