The relationship between serum HBsAg levels and liver inflammation and fibrosis in patients with chronic hepatitis B / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relation of hepatitis B surface antigen (HBsAg) level with chronic hepatitis B (CHB) and liver inflammation and fibrosis.</p><p><b>METHODS</b>A total of 301 patients who diagnosed CHB and underwent liver biopsy were enrolled into the study. Meantimes, the biochemical markers, ferritin (FERR), serum HBsAg and HBV DNA quantitation were detected. The relation between HBsAg level and liver pathology were determined by spearman rank correlation analysis. The receiver operating characteristic curve was used to evaluate the accuracy of HBsAg level for liver inflammation and fibrosis.</p><p><b>RESULTS</b>The body mass index (BMI), age, gender, genotype and family history had no effective on liver inflammation and fibrosis (P < 0.05). With the progressing of inflammation and fibrosis, the serum AST and ALT raise obviously (chi2 = 71.193, 96.344, 47.847, 63.981; P = 0.000, 0.000, 0.000, 0.000). When fibrosis reached to S4, the level of HBV DNA decreased obviously (chi2 = 33. 322; P = 0.000). With the aggravation of inflammation and fibrosis, the serum HBsAg gradually descended (chi2 = 68.173,15.719; P = 0.000, 0.000). The areas under operating characteristics curves of HBsAg predicted < or = G3 and < or = S3 were 0.732 and 0.793, and the specificity were 0.778, 0.891, and sensitivity were 0.685, and 0.633, respectively.</p><p><b>CONCLUSION</b>The level of HBsAg of Chinese CHB patients descended gradually with the aggravation of liver inflammation and fibrosis. The serum HBsAg had a higher specificity to predict < or = G3 and < or = S3 of CHB patients. But there had superiority of predicting fibrosis than inflammation.</p>

The studies on clinical value of AFP-L3 detected by microspincolum method for judgment of treatment response in patients with HCC undergoing TACE / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To explore the clinical value of Lens culinaris agglutinin-reactive alpha-fetoprotein detected by microspincolum method for judgment of treatment response in patients with hepatocellular carcinoma undergoing transcatheter arterial chemoembolization.</p><p><b>METHODS</b>Twenty eight patients with HCC undergoing TACE follow-up in hospital were recruited. AFP and AFP-L3 were measured in all the patients before and after TACE, and correlations were analyzed between AFP-L3% and response to treatment.</p><p><b>RESULTS</b>Among the twenty eight patients with HCC undergoing TACE, 8 out 11 case in AFP-L3% descent group had well treatment response, 5 out 17 case in AFP-L3% elevated group had well treatment response(Chi2 = 4. 858, P < 0. 05).</p><p><b>CONCLUSIONS</b>The detection of AFP-L3 by microspincolum method is useful to judgment of treatment response in patients with HCC undergoing TACE.</p>

Genotypes and evolution characteristics of three patients with poor response to initial treatment of Lamivudine and Adefovir dipivoxil for hepatitis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To understand the genotype characteristics and its evolution of patients with poor response to initial combined treatment of Lamivudine and Adefovir dipivoxil for chronic hepatitis B.</p><p><b>METHODS</b>We detected the HBV genotypes of three patients-S1, S2, S3, who with poor response to initial treatment of Lamivudine and Adefovir dipivoxil for chronic hepatitis B over 12 months by the application of cloning and sequencing method at the time point of baseline,4 weeks after treatment, 12 weeks, 24 weeks, 48 weeks, 60 weeks. 25 clones were randomly selected to identify and sequence at each time point.</p><p><b>RESULTS</b>The total number of clones from 3 patients with poor response to initial combined treatment of Lamivudine and Adefovir dipivoxil for chronic hepatitis B at each time point was 398. About patient S1 at baseline, genotype C accounting for 8.3%, genotype B, for 91.7%, so genotype B was in dominant (22/24). But genotype C has gradually developed to 100% after treatment for 60 weeks. About patient S2 and S3, genotype B was the only type at baseline. However type B has gradually "drift" to type C during treatment. When treatment for 60 weeks, type C has taken the absolute advantage 75% for S2, and 100% for S3.</p><p><b>CONCLUSIONS</b>The cloning and sequencing can represent the overall genotype level better. HBV genotype has performed the evolution trend that genotype has drifted from B to C during long-term drug pressure, which is the main reason for poor response to initial combined treatment of Lamivudine and Adefovir dipivoxil for chronic hepatitis B.</p>

Three-year efficacy and side effect of adefovir dipivoxil for the treatment of the old patients with chronic hepatitis B virus infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate 3-year antiviral efficacy and side effect of adefovir dipivoxil (ADV) on the old patients with hepatitis B chronic infection.</p><p><b>METHODS</b>31 HBeAg-negative chronic hepatitis B virus infected old patients (include 8 patients with chronic hepatitis B and 23 patients with liver cirrhosis) with serum HBV DNA levels > 1000 copies/ml, and ALT > 2 times the upper limit of normal, without company with other liver diseases, cancer, renal dysfunction, and autoimmune disease. All the patients were treated with ADV orally (10 mg once daily) for 36 months. HBV DNA and biochemical and blood routine indexes were checked after treated.</p><p><b>RESULT</b>Serum total bilirubin, direct bilirubin, alamine aminotransferase, aspartate aminotransferase and load of HBV DNA decrease significantly after therapy (P < 0. 001). Other biochemical indexs and blood routine are no significant changes (P > 0.05).</p><p><b>CONCLUSION</b>The way to treat with ADV is safe and effective for old patients with chronic hepatitis B virus infection.</p>