ObjectiveTo systematically review the efficacy of different nucleosides (acids) in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of different nucleosides (acids) to prevent HBV reactivation after chemotherapy in cancer patients from inception to June 7th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 43 RCTs involving 3 269 patients were included. There were 7 interventions, namely entecavir (ETV), lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), tenofovir dipivoxil (TDF), lamivudine combined with entecavir (LAM+ETV), and lamivudine combined with adefovir dipivoxil (LAM+ADV). The results of network meta-analysis showed that the efficacy of reducing the reactivation rate of ETV, LAM, ADV, LdT, TDF, LAM+ETV, LAM+ADV were superior than the control group. The ETV, LAM and ADV were not as effective as LAM+ETV. The leading drug combinations were LAM+ETV (94.8%), LdT (81.5%) and LA+ADV (58.0%). ConclusionsCurrent evidence shows that LAM+ETV, LdT, and LA+ADV are more effective in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
ObjectiveTo evaluate the effectiveness of mass vaccination campaign of hepatitis A vaccine (Hep A) and Measles-Mumps-Rubella live attenuated vaccine (MMR) vaccine in children in stricken regions of 4.20 Lushan earthquake in Sichuan province. MethodsAs the requirements of Sichuan Provincial Health Bureau, the mass campaign was implemented in Lushan county, Baoxing county and the victim settlement localities of other 6 counties during May 6th to 12th, 2013. Hep A and MMR were vaccinated, which targeted children aged from 18 months to 14 years and children aged from 8 months to 14 years, respectively. The vaccination rates were evaluated through reports and on-site rapid review of earthquake regions. ResultsAs of May 16th, 2013, 38 988 doses of Hepatitis A vaccine and 38 696 doses of MMR vaccine were vaccinated in 8 counties of Ya'an. Based on reports, the vaccination rates of Hep A and MMR vaccine of Ya'an were 99.01% and 98.87%, respectively. Based on reviews, vaccination rates of Hep A and MMR vaccine of Lushan and Baoxing were 97.40% and 97.06%, respectively. ConclusionMass vaccination campaign of Hep A and MMR in children in stricken regions of 4.20 Lushan earthquake in Sichuan province yields expected results. The mass campaign is wellorganized and implemented effectively, and the coverage matches the requirements. Timely decision, assistance from associated prefectures and the establishment of Childhood Immunization Information System play an important role in the campaign.
ObjectiveTo investigate the influence of strengthening intervention on antiviral treatment compliance for cirrhosis patients following chronic hepatitis B. MethodsOne hundred patients with cirrhosis following chronic hepatitis B undergoing antiviral treatment between January 2007 and January 2009 were randomly divided into intervention group and control group with 50 patients in each group.Patients in the control group received routine care.For patients in the intervention group,besides routine care,strengthening education on the disease,medication guide,and weekly telephone follow-up after discharge were also added.On the time points of 6,12,18,24,30,36 months after patients were discharged,we followed them up with self-designed questionnaire,and compared the two groups of patients on the rates of fully complying with doctors,not fully complying with doctors and completely not complying with doctors.And the reasons were also analyzed. ResultsEighteen months after being discharged,the two groups had no significant difference in the rate of complying with doctors (P>0.05),while the difference was significant 24,30,36 months after leaving the hospital (P<0.05).The reasons were not following the doctors were mainly high cost and unsatisfying treatment effect.In the control group,the reasons also included lack of knowledge about the disease and lack of guidance and supervision. ConclusionThrough strengthening nursing intervention,patients'treatment compliance can be improved significantly.
ObjectiveTo evaluate liver perfusion in pregnant women with hepatitis between 13 and 41 weeks of gestation by three-dimensional color power Doppler angiography (3D-CPA) vascular indexes. MethodsThis study involved 73 pregnant women with hepatitis and 44 healthy pregnant women who had the pregnancy examination between February 2012 and June 2013. We sampled in the area which was near the right lobe of the pregnant women liver's portal vein branch, and obtained the vascularization index (VI), flow index (FI) and vascularization flow index (VFI) via the virtual organ computer-aided analysis (VOCAL) method. Then, we compared the liver perfusion differences between the pregnant women with hepatitis and healthy pregnant women. ResultsThe hepatic flow indexes obtained by 3D-CPA were significantly different between the HBV-DNA viral load and the control groups. The cutoff values of the three vascular indexes of patients with hepatitis with HBV-DNA viral load and the healthy pregnant women were respectively VI=8.760 (P<3×10-4); FI=22.180 (P<6×10-7); and VFI=1.575 (P<3×10-5). ConclusionApplication of the 3D-CPA on liver perfusion may differentiate pregnant women with hepatitis B from normal ones, thus offer a support for clinical prevention and treatment for pregnant women with hepatitis B.
Objective By means of evidence-based clinical practice, to find more effective treatment for a hepatitis B related nephritis patient with renal failure. Methods The following databases as Up to Date (May 2011), The Cochrane Library (Issue 5, 2011), PubMed (1978 to 2011) and CNKI (1978 to 2011) were searched to identify systematic reviews and randomized controlled trials (RCTs) of treating hepatitis B related nephritis with glucocorticoid, immunosuppressor or antiviral therapies, and the quality of collected clinical evidence was evaluated by using GRADEpro software. Results The glucocorticoid or combined immunosuppressors was not recommended for existing adverse effects and not acting on the remission of hepatitis B related nephritis and reduction of proteinuria. However, the antiviral therapy used alone was recommended for acting on the remission of hepatitis B related nephritis and the reduction of proteinuria. In view of adverse effects and expensive price of interferon, the nucleoside analogue antiviral agent was suggested. Considering the renal toxicity of adefovir and tenofovir, and possible drug-resistance of lamivudine, the entecavir (0.5 mg qd) was finally selected with patient’s agreement, and the supporting therapies such as lowering blood pressure, and protecting the kidney and liver were adopted continually. After one month treatment, 24-hour urinary protein got reduced, serum albumin got increased, kidney function got stable, and hepatitis B virus DNA quantity got reduced. Conclusion For treating hepatitis B related nephritis with kidney failure, entacavir can reduce 24-hour urinary protein, raise serum albumin, stabilize kidney function and reduce hepatitis B virus DNA in a short term, but its long-term efficacy still requires further studies.
The infection of Hepatitis B virus (HBV) can result in severe consequences, including chronic hepatitis, liver fibrosis, cirrhosis, and even liver cancer. Effective antiviral treatment has the potential to slow down the progression of the disease. HBV serum biomarkers play a crucial role in the dynamic management of chronic hepatitis B (CHB) patients. However, the conventional hepatitis B virus markers, such as hepatitis B serologic testing and HBV DNA, are insufficient to meet the clinical requirements. This review provided a comprehensive overview of the current research on the quantification of HBsAg and anti-HBc, HBV RNA and HBV core-associated antigen, which summarized the crucial role these markers play in the administration of antiviral medications, predicting the efficacy of treatment and anticipating the likelihood of virologic rebound following drug cessation, as well as assessing disease progression in CHB patients.
Objective To systematically review the efficacy and safety of interferon based antiviral therapy for children with hepatitis B. Methods PubMed, EMbase, The Cochrane Library, WanFang Data and CNKI databases were searched to collect randomized controlled trials (RCTs) of interferon based antiviral therapy for children with hepatitis B from inception to December 2016. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software. Results A total of 12 studies involving 723 patients were included. The results of meta-analysis showed that: follow-up <12 months, the virological response rate (RR=2.82, 95%CI 1.98 to 4.02, P<0.000 01), serum HBeAg clearance rate (RR=3.02, 95%CI 1.95 to 4.67,P<0.000 01) and ALT normalization rate (RR=1.42, 95%CI 1.19 to 1.70,P=0.000 1) were significantly higher in the interferon group than the control group. Follow-up >12 months, the virological response rate (RR=1.75, 95%CI 1.18 to 2.60, P=0.006) and serum HBeAg clearance rate (RR=2.17, 95%CI 1.28 to 3.65, P=0.004) were also significantly higher in the interferon group. Severe adverse effects were not reported in included studies. Conclusion Current evidence shows that higher virological response is found in HBV infected children with interferon treatment. Due to limited quality and quantity of the included studies, more high quality studies are needed to verify above conclusion.
ObjectiveTo perform a meta-analysis on the positive rate of hepatitis C virus (HCV) antibody among pregnant females in China from 2008 to 2018, so as to provide scientific references for the prevention and treatment of HCV infection among pregnant females.MethodsDatabases including PubMed, Web of Science, SinoMed, CNKI, VIP, and WanFang Data were electronically searched to collect observational studies on the positive rate of HCV antibody among pregnant females in China from January, 2008 to December, 2018. Two reviewers independently screened literature, extracted data and evaluated risk of bias of included studies. Meta-analysis was then performed using Stata 15.0 software.ResultsA total of 108 studies involving 657 765 individuals were included. Results of meta-analysis showed that the overall positive rate of HCV antibody among pregnant females in Chinese was 0.235% (95%CI 0.189% to 0.286%). Subgroup analysis showed that the positive rate of HCV antibody among pregnant females in western China to be the highest 0.291% (95%CI 0.221% to 0.378%), the northeast China to be 0.240% (95%CI 0.099% to 0.442%), the central China to be 0.235% (95%CI 0.016% to 0.319%), and the east China to be the lowest 0.193 % (95%CI 0.119% to 0.281%). The HCV antibody positive rate of pregnant females from hospital was 0.291% (95%CI 0.221% to 0.372%) and was higher than that from AIDS surveillance site which was 0.164% (95%CI 0.122% to 0.207%).ConclusionsThe prevalence of HCV antibody among pregnant females maintains at a low level in China.
ObjectiveTo explore the influence of paternal serum HBV-DNA load levels and pregnant women's HBsAb on vertical transmission of hepatitis B virus (HBV) from HBsAg positive fathers to infants in order to provide effective methods for paternal-fetal ventrical transmission of HBV prevention. MethodsUsing HBsAg and HBV-DNA as indicators to screen pregnant women and their husbands after gained consent, 121 families with HBVM negative or only HBsAb positive and HBV-DNA negative pregnant women, HBsAg positive husbands and their newborns were selected. In this case-control study, according to neonatal cord blood HBV-DNA detection, 23 newborns with cord blood HBV-DNA positive were selected as cases, 98 newborns as controls. ResultsThe positive rate of neonatal cord blood HBV-DNA was 19.0% (23/121); and there was dose-response relationship between paternal serum HBV-DNA load levels and neonatal cord blood HBV-DNA positive (trend χ2=60.108, P=0.000). The analysis of ROC curve showed that paternal serum HBV-DNA load level (106 copies/mL) is a better demarcation point to forecast the occurrence of vertical transmission of HBV from HBsAg positive fathers to infants, because there was a better sensitivity and specificity during forecast; and HBsAb negative pregnant women's were statistically significant (χ2=12.399, P=0.000). There was no significant difference at the positive rate of neonatal cord blood HBV-DNA between the case group and control group when paternal serum HBV-DNA load levels exceed 107 copies/mL (P > 0.05). ConclusionPaternal serum HBV-DNA load levels and HBsAb negative pregnant women are the risk factors of vertical transmission of HBV from HBsAg positive father to infants. Paternal serum HBV-DNA load level (106 copies/mL) is an appropriate index of the occurrence of vertical transmission.
ObjectiveTo detect the expression of indoleamine2, 3-dioxygenase (IDO) and HBV preS mRNA in HepG2 cells and its inhibitory effect on the proliferation of human peripheral blood lymphocyte. MethodsThe AdIDOEGFPpreS was transfected to human hepatocarcinoma cell line HepG2 and the specific fragment of IDO mRNA and HBV preS mRNA in these HepG2 cells were detected by RT-PCR. Then the transfected HepG2 cells were cocultured with human peripheral blood lymphocyte and the inhibitory effect of IDO on the proliferation of human peripheral blood lymphocyte was observed. ResultsThe IDO and HBV preS mRNA were successfully transferred to HepG2 cells, so the specific fragment of IDO and HBV preS mRNA could be found in the transfected HepG2 cells but not in the control group HepG2 cells by RT-PCR. Furthermore, the relative expression intensity of IDO and HBV preS were 1.27 and 1.18, respectively. When co-cultured with human peripheral blood lymphocyte, the counts per minute in the transfected HepG2 cells 〔(7 471±1 375) beats/min〕 was significantly less than that in the control group 〔(13 821±1 997) beats/min〕, Plt;0.001. ConclusionThe target gene IDO and HBV preS can be transferred and expressed in HepG2 cells successfully, which can obviously suppress the proliferation of human peripheral blood lymphocyte.