WHO Guidelines for Prevention, Care and Treatment of Individuals Infected with HBV

Vittal, Anusha; Ghany, Marc G.

doi:10.1016/j.cld.2019.04.008

Cited by 49 publications

(44 citation statements)

References 36 publications

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“…There were some limitations in our study. Chronic HBV infection progresses through four phases 4,5 . The main purpose of this study is to study the correlation between HBsAg, HBeAg, HBV DNA, ALT and cytokine levels.…”

Section: Discussionmentioning

confidence: 99%

“…Patient in immune tolerant (IT) phase was defined as HBeAg‐positive, high circulating HBV DNA and persistent normal ALT levels. The histological activity of patients was dormant and the risk of disease progression was low in the IT phase 4‐6 . The criteria of chronic HBV infection in immune tolerance phase were: continuous HBsAg positive for 6 months, high HBeAg level and HBV DNA load (>10 7 IU/mL), and persistent normal ALT (<19 IU/L in female and <30 IU/L in male), or there was no obvious inflammation and fibrosis in liver histology.…”

Section: Methodsmentioning

confidence: 99%

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Association of cytokines with hepatitis B virus and its antigen

Chen

et al. 2020

Journal of Medical Virology

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To investigate the characteristics of cytokines in patients with different HBV infection status and their correlation with HBV DNA, HBsAg, and HBeAg levels. Peripheral blood samples were collected from patients with chronic HBV infection in immune tolerance phase (IT), HBeAg‐positive chronic hepatitis B (CHB), and acute hepatitis B (AHB) groups, and levels of cytokines were detected by Luminex technique, and analyzed by FLEXMAP 3D analyzer. The correlation between cytokines and HBV DNA load, HBsAg, HBeAg, and alanine aminotransferase (ALT) level in patients with chronic HBV infection was analyzed. In total 312 subjects (184 males and 128 females) were enrolled in the study. There were significant differences among IT, CHB, and AHB groups in Flt‐3L value (P = .003; H = 12.312), IFN‐γ (P = .001; H = 11.723), IL‐10 (P = .001; H = 18.736), IL‐17A ((P = .001; H = 12.735), and TGF‐β1 (P = .001; Z = 48.571). IFN‐α2 levels in CHB group were significantly higher than those in IT and AHB groups (15.24 vs 35.78 pg/mL, P = .000; Z = 3.727; 13.88 vs 35.78 pg/mL, P = .024; Z = −2.258. In CHB group, the levels of HBsAg and ALT were positively correlated with the levels of IL‐10 (r = .173; P = .006; r = 0.176; P = .006, respectively), while HBeAg level was positively correlated with the IFN‐α2 level (r = .153; P = .016). In AHB group, the HBsAg level was positively correlated with Flt‐3L, IFN‐α2, IL‐10, and IL‐6 (r = .402; P = .023; r = .436; P = .016; r = .524, P = .002; r = .405; P = .022, respectively). HBeAg level was positively correlated with IFN‐γ and IL‐17A levels (r = .400; P = .023; r = .373; P = .036, respectively), and ALT level was positively correlated with IL‐6 levels (r = .367; P = .039). In either AHB or CHB group, HBV DNA load was only related to TGF‐β level (r = .493; P = .004; r = −.218, P = 0.009 respectively). The correlation between Flt‐3L and HBsAg (F = 7.422; P = .007); IL‐17, IL‐6, and HBeAg (F = 5.757; P = .017; F = 6.156; P = .014) were statistically significant. There was significant correlation between TGF‐β2 and HBV DNA (F = 11.795; P = .001), and between ALT and HBsAg, HBV DNA (F = 26.089; P = .000; F = 4.724; P = .031). HBsAg, HBeAg, and HBV DNA were correlated with cytokines and ALT in patients with HBV infection. The level of IFN‐α2 was significantly higher in patients with CHB. HBV DNA load was only correlated with the level of TGF‐β in acute or CHB.

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Section: Discussionmentioning

confidence: 99%

Section: Methodsmentioning

confidence: 99%

Association of cytokines with hepatitis B virus and its antigen

Chen

et al. 2020

Journal of Medical Virology

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“…primary liver cancer), [ 3] among which CHB is responsible for 30% of all deaths from cirrhosis and 40% from hepatocellular carcinoma (HCC). [ [4][5][6] China is one of the highest prevalence country with about 20 million CHB cases, accounted for 21.5% among 93 million cases of HBV infection. Without timely testing and treatment, most CHB will develop into cirrhosis, HCC or finally lead to death.…”

Section: Abstract Chronic Hepatitis B Cirrhosis Traditional Chinesementioning

confidence: 99%

“…The antiviral therapy is the primary link to slow the conversion of CHB into cirrhosis, which can effectively restore liver function and improve survival rate in patients with CHB. [1 [1][2][3][4][5][6][7][8][9][10][11][12] Currently, the US Food and Drug Administration (FDA) has approved two types of anti-hepatitis B virus drugs: interferon (IFN) and nucleos(t)ide analogs (entecavir, lamivudine, telbivudine, adefovir, and tenofovir), although nucleoside analogues are well tolerated and exhibit an early and potent antiviral effect, the selection of resistant mutants and nephrotoxicity during long-term therapy limit their use. [ [13][14] Chinese herbal medicine (CHM), as one of the most popular complementary and alternative therapies of CHB, a large number of studies have reported its anti-hepatitis B virus effect.…”

Section: Abstract Chronic Hepatitis B Cirrhosis Traditional Chinesementioning

confidence: 99%

Efficacy and safety of YinQiSanHuang-antiviral decoction on chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

Lv²,

et al. 2020

Preprint

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Introduction: Chronic hepatitis B (CHB) is a global public health problem. Antiviral therapy is the primary treatment. Studies shown that combined therapy of traditional Chinese medicine (TCM) and conventional antiviral drugs has better efficacy than conventional antiviral for treatment of CHB. YinQiSanHuang-antiviral decoction (YQSH) is a TCM compound preparation, and has shown its effect on anti-hepatitis B virus and slowing progression of hepatitis B-related liver diseases. To evaluate the efficacy and safety of YQSH combined with entecavir and its preventive effect on hepatitis B cirrhosis, we designed this randomized, double-blind and placebo-controlled trial, which objective is “the combination of YinQiSanHuang-antiviral decoction with entecavir reduce the annual incidence of liver fibrosis / cirrhosis to 1%”.Methods: This is a multicenter, randomized, placebo-controlled, double-blinded trial, 5 hospitals involved in. Totally 802 patients are randomly allocated to two groups: the YQSH group (n=401) or the placebo group (n=401). The YQSH group receives YQSH with Entecavir, the placebo group receives granule of placebo with Entecavir. Patients receive treatment for 52 weeks, and then are followed up for 52±2 weeks. The primary outcome measure is the annual incidence of cirrhosis. The secondary outcome measures are HBV-DNA negative rate, HBsAg negative rate, HBeAg seroconversion rate, liver function (Alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma glutamyl transferase (GGT), alkaline phosphatase (ALP), serum albumin (ALB) and total bilirubin (TBIL)), spleen thickness, evaluation scores of patients’ clinical symptoms and safety assessment. Outcomes will be assessed at baseline and after treatment.Discussion: Combination therapy could become a trendy of treatment of CHB, this trial expecting to provide credible clinical evidence for the future combination of TCM and conventional antiviral drugs for the treatment of CHB.Trial registration: ChiCTR1900021521, this protocol was registered in the Chinese Clinical Trial Registry (URL: http://www.chictr.org.cn) on February 25th, 2019.

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“…As a global health problem, more than 257 million people worldwide suffer from chronic HBV infection [1,2]. In 2015, an estimated 887, 000 deaths resulted from hepatitis B, mostly from cirrhosis and hepatocellular carcinoma (HCC, i.e., primary liver cancer) [3]; of these CHB is responsible for 30% of all deaths from cirrhosis and 40% of those from HCC [4][5][6]. China's prevalence is one of the highest, with about 20 million CHB cases, accounting for 21.5% of the 93 million cases of HBV infection.…”

Section: Introductionmentioning

confidence: 99%

Efficacy and safety of YinQiSanHuang-antiviral decoction in chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

et al. 2020

Trials

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Introduction Chronic hepatitis B (CHB) is a global public health problem. Antiviral therapy is the primary treatment. Studies have shown that a combined therapy of traditional Chinese medicine (TCM) and conventional antiviral drugs has better efficacy than conventional antiviral for treatment of CHB. YinQiSanHuang-antiviral decoction (YQSH) is a TCM compound preparation that has shown an effect on anti-hepatitis B virus and on slowing progression of hepatitis B-related liver diseases. To evaluate the efficacy and safety of YQSH combined with entecavir and its preventive effect on hepatitis B cirrhosis, we designed this randomized, double-blind and placebo-controlled trial. The objective is that the combination of YinQiSanHuang-antiviral decoction with entecavir will reduce the annual incidence of liver fibrosis/cirrhosis to 1%. Methods This is a multicenter, randomized, placebo-controlled, double-blinded trial involving five hospitals. A total of 802 patients are randomly allocated to two groups: the YQSH group (n = 401) or the placebo group (n = 401). The YQSH group receives YQSH with entecavir; the placebo group receives granules of placebo with entecavir. Patients receive treatment for 52 weeks and then are followed up for 52 ± 2 weeks. The primary outcome measure is the annual incidence of cirrhosis. The secondary outcome measures are hepatitis B virus DNA negative rate, hepatitis B surface antigen negative rate, hepatitis B e antigen seroconversion rate, liver function (alanine aminotransferase, aspartate aminotransferase , gamma-glutamyl transferase , alkaline phosphatase , serum albumin, and total bilirubin), spleen thickness, evaluation scores of patients’ clinical symptoms, and safety assessment. Outcomes will be assessed at baseline and after treatment. Discussion Combination therapy could become a trend for treatment of CHB, and this trial expects to provide credible clinical evidence for the future combination of TCM and conventional antiviral drugs for the treatment of CHB. Trial registration Chinese Clinical Trial Registry: ChiCTR1900021521. Registered on 25 February 2019.

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WHO Guidelines for Prevention, Care and Treatment of Individuals Infected with HBV

Cited by 49 publications

References 36 publications

Association of cytokines with hepatitis B virus and its antigen

Association of cytokines with hepatitis B virus and its antigen

Efficacy and safety of YinQiSanHuang-antiviral decoction on chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

Efficacy and safety of YinQiSanHuang-antiviral decoction in chronic hepatitis B: study protocol for a randomized, placebo-controlled, double-blinded trial

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