ABSTRACT
Objective:To evaluate the safety of discontinuing nucleoside/nucleoside analogue (NAs) therapy in patients with compensated hepatitis B cirrhosis after HBsAg negative conversion.Methods:A total of 3 783 patients with hepatitis B cirrhosis in compensated stage were treated with NAs at Taizhou Hospital, Taizhou Municipal Hospital and Taizhou Enze Hospital from January 2008 to December 2020. The clinical data and laboratory tests results of 85 patients with HBsAg negative conversion were retrospectively analyzed, including 36 cases discontinued the drug, and 49 continued to use drug. Chi-square test and rank-sum test were used for data analysis.Results:During the 24 and 48 months of follow-up, the ALT levels were within the normal range in both groups. There were no significant differences in positive rates of anti-HBs and HBeAg ( χ2=0.75, 0.39 and 0.90, P=0.78 0.84 and 0.34; χ2=0.40, 0.00 and 0.00, P=0.84, 1.00 and 1.00) between two groups. After 48 months of follow-up, 2 cases of primary liver cancer occurred in the discontinuation group and no primary liver cancer occurred in the continuation group ( χ2=0.89, P=0.34). Throughout the follow-up, HBsAg remained negative and HBV DNA load was below the lower limit of detection in both groups. Conclusions:Discontinuation of NAs can be considered after the HBsAg negative conversion in patients with compensated hepatitis B cirrhosis.
ABSTRACT
Protein ubiquitination is widely observed in cells and is a modification after protein translation. Hepatitis B virus (HBV) and ubiquitination of related proteins have attracted more and more attention. This article reviews HBV and the ubiquitination of related proteins, so as to provide a reference for further research on the regulation of HBV replication and the ubiquitination of related proteins, as well as new ideas and methods for curing chronic HBV infection.
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Objective To investigate the optimal interventional therapy for primary hepatocellular carcinoma (HCC) complicated by main portal vein tumor thrombus.Methods Three-stage treatment, i.e. transcatheter arterial chemoembolization (TACE) combined with portal vein stenting and 125I seeds strand implantation, biliary stenting plus 125I seeds strand implantation and endoscopic variceal ligation, was carried out in one patient with primary HCC complicated by main portal vein tumor thrombus. The clinical results were analyzed combined with a review of the relevant literature in order to compare the efficacies of various interventional therapies employed in clinical practice nowadays. Results The sequential therapies of the three-stage treatment program were successfully accomplished. The patient was followed up for over five years and lived well when the report was made. Conclusion At present, TACE combined with portal vein stenting and implantation of 125I seeds strand is the optimal treatment for primary HCC associated with portal vein tumor thrombus.
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Objective To study the expressions of programmed death 1 (PD-1) and programmed death ligand 1 (PD-L1) in liver injury of acute liver failure (ALF) in rats and the role of PD-1/ PD-L1 in liver inflammatory injury. Methods SD rats were divided into two groups: 6 in normal group and 30 in ALF model group. The ALF models in rats were induced by D-galactosamine (D-Gal). The sera and hepatic tissue samples were collected at 12, 24, 48, 72 and 120 hours after D-Gal injection. Expressions of PD-1 mRNA and PD-L1 mRNA in hepatic tissue samples were detected by reverse transcription-polymerase chain reaction (RT-PCR). Comparison of measurement data between groups was done by t test. Correlation test was performed using Pearson linear correlation analysis. Results The levels of alanine animotransferase (ALT) and aspartate animotransferase (AST) at 12 h of D-Gal injection were (217. 3±33. 7) U/L and (397. 2± 101.3) U/L, respectively,which were both significantly higher than those in normal group [(30. 5 ±3. 1) U/L and (78. 6±4.2) U/L, respectively; t=-8. 921 and -6. 121, respectively; both P＜0.01] and peaked at 48 h.The expression of PD-1 mRNA in model group at 12 h (0. 385±0. 074) was significantly higher than that in normal group (0. 097±0.009) (t= -7. 725, P＜0.01) , and peaked at 48 h (0. 927±0. 132),then decreased obviously at 72 h. The expression of PD-L1 mRNA in the liver tissue of normal rats was very little, while that in model group was increased gradually over time, then peaked at 48 h (0. 593±0. 105; t =- 10. 076, P＜0. 01). The expressions of PD-1 and PD-L1 were positively correlated with ALT level (r=0. 807 and 0. 792, respectively; both P＜0. 01). Conclusion The expressions of PD-1/PD-L1 may play an important role in liver inflammatory injury in rat model of acute liver failure.