Risk factors for acute hepatitis B and its progression to chronic hepatitis in Shanghai, China

Zhang, Hongwei; Yin, Jianhua; Li, Yanting; Li, Chengzhong; Ren, Hong; Gu, Cheng; Wang, Huanyu; Liang, Xuesong; Zhang, Peng; Zhao, Jingfeng; Tan, Xiaojie; Lu, Wei; Schaefer, Stephan; Cao, Guangwen

doi:10.1136/gut.2008.157149

Cited by 122 publications

(118 citation statements)

References 40 publications

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“…However, there is no specific treatment for hepatitis B, a serious and widely epidemic disease. Liver failure due to CHB, especially HBeAg-positive CHB, is one of the unsolved medical problems and results in a significant number of deaths in China [2]. Therefore, treatment strategies for hepatitis B patients are urgently needed.…”

Section: Discussionmentioning

confidence: 99%

“…A nationwide survey in China showed that the prevalence of hepatitis B surface antigen (HBsAg) was around 1.5% in children under 8 years of age, and 7.18% in the nationwide population between 1 and 59 years of age [2]. HBV has become the most important cause of chronic hepatitis and end-stage liver disease in China [2]. Treatment of chronic hepatitis B (CHB) with peginterferon has been reported in several independent studies, mainly of Caucasian patients.…”

Section: Introductionmentioning

confidence: 99%

“…More than 240 million have chronic (long-term) liver infections, and 600,000 people die every year due to the acute or chronic consequences of hepatitis B [1]. A nationwide survey in China showed that the prevalence of hepatitis B surface antigen (HBsAg) was around 1.5% in children under 8 years of age, and 7.18% in the nationwide population between 1 and 59 years of age [2]. HBV has become the most important cause of chronic hepatitis and end-stage liver disease in China [2].…”

Section: Introductionmentioning

confidence: 99%

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Peginterferon and Chinese herbs exert a combinatorial effect in HBeAg-positive chronic hepatitis B

Gao

Cheng

et al. 2016

J Infect Dev Ctries

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Introduction: Traditional Chinese herbs are widely used for the treatment of chronic hepatitis B (CHB) in China. The aim of this study was to perform a meta-analysis of randomized controlled trials (RCTs) comparing peginterferon therapies with peginterferon plus Chinese herbal therapies in hepatitis B e antigen (HBeAg)-positive CHB patients. Methodology: The main biomedical databases were searched to identify RCTs that compared the efficiency of peginterferon with peginterferon plus Chinese herbs in CHB patients. Results: The literature search yielded 616 studies, and 8 RCTs (624 patients) matched the selection criteria. Combined therapies of peginterferon plus Chinese herbal therapies were superior to peginterferon therapies alone in achieving the serum HBV DNA clearance rate (64.5% vs. 45.0%), serum HBeAg clearance rate (47.4% vs. 33.5%), and HBeAg seroconversion rates (39.2% vs. 23.1%) at the end of treatment. Combined therapies were more effective than peginterferon alone therapies in the improvement of liver fibrosis related biomarkers, including hyaluronic acid, procollagen type III, type IV collagen, and lamina. Combined therapies also resulted in fewer relapses, fewer adverse events, and more rapid alanine transaminase normalization. Conclusions: The current evidence suggests that peginterferon plus Chinese herbal therapies were associated with higher virological response than peginterferon alone in HBeAg-positive CHB patients.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Peginterferon and Chinese herbs exert a combinatorial effect in HBeAg-positive chronic hepatitis B

Gao

Cheng

et al. 2016

J Infect Dev Ctries

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“…Another study from China demonstrated that patients with acute hepatitis B due to genotype C2 were more likely to progress to CH than those with genotype B2. 35 Between 1988 and 1992, 4841 Taiwanese HBV carrier men were followed and 154 developed new HCC. Genotyping was done in these 154 and 316 controls (those who did not develop HCC).…”

Section: Hepatitis B Virus Genotypes and Disease Progressionmentioning

confidence: 99%

Hepatitis B Virus Genotyping: Is the Time Ripe for Routine Clinical Use?

Madan¹,

Tyagi²

2012

Journal of Clinical and Experimental Hepatology

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“…Newborns become chronic HBV carriers at a very high rate (about 90%), while immune-competent adults are generally described as developing chronic infection at a rate of 5-10%. HBV subgenotype C2 is more prone to causing chronic infection than HBV subgenotype B2 following acute hepatitis B [2]. Up to 40% of patients with chronic HBV infection will develop the life-threatening complications of HCC or decompensated liver cirrhosis (LC).…”

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confidence: 99%

Exploring risk factors of hepatitis B virus-associated hepatocellular carcinoma: prospective verse retrospective studies

Cao

2010

J Gastroenterol

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Major risk factors for hepatocellular carcinoma (HCC) vary by region and population. Chronic infection with hepatitis B virus (HBV) and/or hepatitis C virus (HCV), heavy alcohol intake, aflatoxin exposure, haemochromatosis, nonalcoholic fatty liver disease, obesity, diabetes mellitus and tobacco smoking have been suggested to be risk factors of HCC. However, chronic infection with HBV remains the major cause of HCC in the world. More than 50% of HCC cases worldwide and 80% of HCC cases in most high-risk areas, such as the Asia-Pacific region and Africa, are attributable to HBV infection. The relative risk of HCC among individuals infected with HBV ranges from 5 to 49 in case-control studies and from 7 to 98 in cohort studies [1].In HBV endemic regions, HBV infection is usually acquired perinatally or in childhood, whereas in HBV nonendemic areas, it is mostly transmitted during adolescence or adulthood. Newborns become chronic HBV carriers at a very high rate (about 90%), while immune-competent adults are generally described as developing chronic infection at a rate of 5-10%. HBV subgenotype C2 is more prone to causing chronic infection than HBV subgenotype B2 following acute hepatitis B [2]. Up to 40% of patients with chronic HBV infection will develop the life-threatening complications of HCC or decompensated liver cirrhosis (LC). Chronic hepatitis B (CHB), LC and HCC are progressive liver diseases and consecutive stages of HBVassociated hepatocarcinogenesis, although CHB may precede the asymptomatic hepatitis B surface antigen (HBsAg) carrier (ASC) state and HCC does not have to pass through the CHB or LC stage. Hepatitis B e antigen (HBeAg) expression indicates active viral replication. HBeAg expression, high viral load and alanine aminotransferase (ALT) levels are associated with an increased risk of HCC. HBV subgenotypes B2 and C2 are endemic in most parts of Asia, while subgenotype B1 is endemic in Japan. Chronic infection with HBV C2 is frequently associated with an increased risk of LC and HCC in patients older than 50 years, whereas chronic infection with HBV B2 is associated with HCC or HCC recurrence in young, mostly non-cirrhotic, patients. In comparison with infection with HBV B2 or C2, infection with HBV B1 is associated with fulminant hepatitis B, a lower incidence of HCC and the development of HCC when older. Different HBV genotypes display their own distinct mutation pattern in the preS region and in the enhancer II (EnhII)/basic core promoter (BCP)/precore region of the HBV genome. Takahashi and colleagues identified HCC-associated HBV mutations through the comparative analysis of full-length HBV isolates (95% genotype C) from sera of 40 Japanese patients with HCC. They found that deletions and missense mutations in the preS2 region, A1762T and G1764A (often appearing simultaneously, termed A1762T/G1764A) and T1753C/A mutations in the BCP region and G1613A and C1653T mutations in the EnhII region were more frequent in HCC patients [3]. This pioneering work has aroused great interest in the fie...

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Risk factors for acute hepatitis B and its progression to chronic hepatitis in Shanghai, China

Cited by 122 publications

References 40 publications

Peginterferon and Chinese herbs exert a combinatorial effect in HBeAg-positive chronic hepatitis B

Peginterferon and Chinese herbs exert a combinatorial effect in HBeAg-positive chronic hepatitis B

Hepatitis B Virus Genotyping: Is the Time Ripe for Routine Clinical Use?

Exploring risk factors of hepatitis B virus-associated hepatocellular carcinoma: prospective verse retrospective studies

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