中华肝脏病杂志最新文献

{"title":"[Long-term therapeutic outcomes of antiviral treatment in patients with chronic hepatitis B infection with normal alanine aminotransferase, mild liver inflammation, and fibrosis].","authors":"Y C Shi, Y W Tan","doi":"10.3760/cma.j.cn501113-20240917-00494","DOIUrl":"10.3760/cma.j.cn501113-20240917-00494","url":null,"abstract":"<p><p><b>Objective:</b> To study the long-term prognostic outcomes of antiviral therapy in patients with chronic hepatitis B (CHB) accompanied with normal alanine aminotransferase (ALT), mild or slight inflammation, and/or liver fibrosis. <b>Methods:</b> A retrospective study method was used. Patients with CHB who underwent liver biopsy at Zhenjiang Third People's Hospital, affiliated with Jiangsu University, from January 2005 to July 2022 were included. Baseline data, clinical data, and clinical outcome events at the end of follow-up were collected. Cox proportional hazards regression and Kaplan-Meier survival analysis were used to assess the risk of clinical events. <b>Results:</b> A total of 149 CHB cases with normal ALT with mild or slight inflammation or fibrosis were included. Eighty-six cases were treated with antiviral therapy, while 63 were not. The median follow-up time was 82.00 (45.50,153.00) months. In the follow-up endpoint events, four cases (4.65%, 4/86) in the antiviral group had liver cirrhosis, while none had progressed to hepatocellular carcinoma. Five cases (7.94%, 5/63) in the non-antiviral group had liver cirrhosis, and two cases (3.17%, 2/63) had hepatocellular carcinoma. Kaplan-Meier survival analysis showed that the cumulative risk of clinical events did not significantly increase in the non-antiviral group (<i>P</i>>0.05). The presence of liver fibrosis with high-normal ALT levels at baseline were associated with an increased risk of clinical events (<i>P</i><0.05). Cox analysis showed that baseline age, high ALT level, and presence of liver fibrosis were independent risk factors for clinical events. The two groups differed significantly in terms of the proportion of HBVDNA below the detection value and ALT normalization rate at the endpoint (<i>P</i><0.05). However, there was no significant difference in the HBsAg negative conversion rate between the two groups at the end (<i>P</i>>0.05). <b>Conclusion:</b> The occurrence risk of long-term liver adverse events was not significantly improved by antiviral treatment in patients with chronic hepatitis B accompanied by normal ALT levels, mild or slight inflammation, and/or liver fibrosis. However, clinical outcomes were associated with baseline age, higher ALT levels, and liver fibrosis, suggesting that these factors are independent risk factors for the occurrence of clinical events.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"8-13"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Current status of genotyping of pregnant women with hepatitis C and its impact on pregnancy outcomes].","authors":"M Cai, Y Ding, Q X Li, Y L Jiang, Y W Zhang, X Yue","doi":"10.3760/cma.j.cn501113-20240821-00378","DOIUrl":"10.3760/cma.j.cn501113-20240821-00378","url":null,"abstract":"<p><p><b>Objective:</b> To understand the current genotype distribution, epidemiological characteristics, and their relationship with pregnancy outcomes in pregnant women with hepatitis C in Nanjing city. <b>Methods:</b> An epidemiological survey method was used to analyze the data of 113 pregnant women with hepatitis C who were successfully genotyped and admitted to Nanjing Second Hospital from January 2018 to December 2023. The comparison of the quantitative data was analyzed by a t-test or rank-sum test between the two groups. The comparison of the enumeration data was analyzed using the <i>χ</i>² test, adjusted <i>χ</i>² test, or Fisher's exact probability method between the two groups. <b>Results:</b> A total of six kinds of genotypes (1b, 2a, 3a, 3b, 6a, 6n) were identified in 113 cases. The primary genotype was 1b (accounted for 76.1%), followed by 6, 3, and 2 rare genotypes, while 1 mixed type (type 2 mixed with type 6) and genotypes 4 and 5 were non-identified. The proportion of genotype 1b increased with the extension of the birth cohort, and the difference was statistically significant (<i>χ</i>²=24.35, <i>P</i>＜0.001). There was a difference in genotyping proportions with educational and employment background (<i>χ</i>²=14.74, <i>P</i>＜0.001; <i>χ</i>²=19.50, <i>P</i>＜0.001). The proportion of non-1b types increased in populations with low educational backgrounds and unemployment. The proportion of type 1b was higher in those with a history of blood transfusion and hospitalization during infancy (<i>χ</i>²=5.57, <i>P</i>=0.018; <i>χ</i>²=5.17, <i>P</i>=0.023). The proportion of non-1b type was higher in those with a history of drug abuse (<i>χ</i>²=22.32, <i>P</i>＜0.001). Normal pregnancy outcomes had no statistically significant difference between genotype 1b and non-1b groups. However, all pregnant women who experienced adverse infant outcomes had genotype 1b. <b>Conclusion:</b> Pregnant women with hepatitis C in Nanjing city are mainly genotype 1b, with genotype 3b<5%, and there is no significant difference in maternal and infant outcomes among different genotype subtypes. Therefore, no testing of genotype for women of childbearing age. However, the focus should be on the management of pregnancy, health education, and postpartum preparation for direct acting antiviral treatment.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"21-24"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459964","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Emphasis on scientific research related to viral hepatitis].","authors":"H Ren, P Hu","doi":"10.3760/cma.j.cn501113-20241127-00600","DOIUrl":"10.3760/cma.j.cn501113-20241127-00600","url":null,"abstract":"<p><p>The Chinese Journal of Hepatology second supplementary issue in 2024 focused on viral hepatitis. The context of hepatitis B and C encompassed the exploration of expanding treatment advantages, research on the treatment of special populations, the clinical cure concept, and the regional and special population genotyping, treatment of patients who failed to receive direct-acting antiviral drugs, and medical prevention and elimination fusion models. The supplement's findings reflect the current trends in prevention and treatment, such as epidemiology, clinical practice, and elimination models, and serve as references for exploring antiviral treatment plans and hepatitis elimination models, assisting readers to experience the academic dynamism of liver disease, address elimination challenges, and facilitate goal attainment.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"1-2"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459966","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Study on hepatitis C intervention measures to improve the referral, treatment, and cure rate in hospitals].","authors":"H H Cheng, D C Cai","doi":"10.3760/cma.j.cn501113-20241017-00544","DOIUrl":"10.3760/cma.j.cn501113-20241017-00544","url":null,"abstract":"<p><p><b>Objective:</b> To explore and discuss hepatitis C processes of diagnosis, treatment, and management through intervention measures as well as the necessity of whole management attempt in education, screening, diagnosis, treatment, and follow-up in hospitals. <b>Method:</b> The baseline status of HCV RNA detection, departmental distribution, consultation requests, specialist visits, and diagnosis and treatment of anti-HCV positive patients who visited the outpatient and inpatient departments of the Infectious Diseases of the Second Affiliated Hospital of Chongqing Medical University from November 2019 to November 2020 was analyzed. Statistical analysis was re-conducted on the status of HCV RNA detection, departmental distribution, consultation requests, specialist visits, and treatment among anti-HCV positive patients following the implementation of intervention measures for patients and clinicians in the hospital. The differences were evaluated using the Pearson chi-square test. The Wilson score and the gamma distribution method were used to calculate the 95% confidence interval (95% <i>CI</i>). <b>Results:</b> The rates of consultation, referral, diagnosis, and treatment did not increase significantly following the intervention in the hospital for hepatitis C, and there was no statistically significant difference compared with the data before the intervention. <b>Conclusion:</b> The vast majority of anti-HCV-positive patients in non-infectious and a few infectious disease departments did not receive timely disease assessment, referral, diagnosis, and treatment because hospitals lacked a standard, consistent, and stringent whole management process for hepatitis C screening, thereby causing missed detection, diagnosis, and treatment.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"38-43"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459107","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Exploring the harm elimination model with regard to viral hepatitis C in China's western region].","authors":"X Wu, Y Yang, Q Cao, L S Gan, G H Wu, D C Cai","doi":"10.3760/cma.j.cn501113-20241103-00564","DOIUrl":"10.3760/cma.j.cn501113-20241103-00564","url":null,"abstract":"<p><p>Hepatitis C virus (HCV) infection, a kind of infectious disease that poses a major threat to human health, has attracted widespread attention worldwide. The prevention and control of hepatitis C are especially challenging in China's western region due to the complexity of the geographical background, the relatively backward economic development level, and the diversity of cultural background. The main purpose of this paper is to deeply explore the harm elimination model for hepatitis C in China's western region through a detailed analysis of the current epidemic status, an in-depth discussion of its harm, and a comprehensive evaluation of prevention and control strategies, combined with the specific characteristics so as to propose a practical elimination model and specific measures. Additionally, we aspire to provide valuable references and concepts for the prevention and control on national scale through these studies recommendations, thereby effectively reducing the threat of the hepatitis C virus to human health..</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"63-67"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459967","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of chronic hepatitis B patient with sequential treatment of tenofovir and pegylated interferon alpha].","authors":"Z Huang, Y P Wang, J P Li","doi":"10.3760/cma.j.cn501113-20240926-00507","DOIUrl":"10.3760/cma.j.cn501113-20240926-00507","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"44-47"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459959","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A clinically cured case of chronic hepatitis B].","authors":"Y Q Zhang, Z Y Zhang, X X Li, M H Li","doi":"10.3760/cma.j.cn501113-20241001-00524","DOIUrl":"10.3760/cma.j.cn501113-20241001-00524","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"50-53"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459961","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Analysis of the efficacy and safety profile of sofosbuvir/velpatasvir/voxilaprevir in the treatment of patients with chronic hepatitis C with failed DAAs therapy].","authors":"Y Guo, S T Zhao, Y Zhu, C Yang, J P Li, L H Zhang, C M Yang, H G Xiong, D Zhang, G J Tian, B H Gao, L Guo, J Xia","doi":"10.3760/cma.j.cn501113-20240822-00380","DOIUrl":"10.3760/cma.j.cn501113-20240822-00380","url":null,"abstract":"<p><p><b>Objective:</b> To explore the efficacy and safety profile of sofosbuvir/velpatasvir/voxilaprevir ± ribavirin (SOF/VEL/VOX±RBV) for salvage treatment of chronic hepatitis C patients who have failed direct-acting antivirals (DAAs). <b>Methods:</b> Patients with chronic hepatitis C who failed DAAs±RBV treatment and were treated in five hospitals in Chongqing, Guangdong, Guizhou, and Guangxi from January 2022 to December 2023 were included in this retrospective study. One or more courses of DAAs±RBV therapy were evaluated for all patients who had been previously treated. Virological rebound occurrence was observed during the follow-up. SOF/VEL/VOX±RBV was used for one course of salvage treatment. Virological and biochemical indicators were analyzed before salvage therapy, post-treatment, and drug discontinuation at 12 weeks. Adverse drug events were recorded during treatment. Data between groups were compared using t-tests or non-parametric tests. <b>Results:</b> A total of 26 cases of chronic hepatitis C who had failed DAAs±RBV were included in this study, with an age of (52.9±9.6) years. Twenty-one cases (80.8%) were male, sixteen (61.5%) had a history of drug abuse, two (7.7%) had combined human immunodeficiency virus infection, and fourteen (53.8%) had combined cirrhosis. The previous DAA regimen of 21 cases (80.8%) included SOF/VEL. The baseline HCV RNA load of salvage treatment was (5.8±1.6) log₁₀ IU/ml, and 16 cases (61.5%) were genotype 3. All patients completed the 12-week SOF/VEL/VOX±RBV salvage treatment and achieved sustained virological response (SVR) at the end of treatment. All 22 cases were followed up for 12 weeks following treatment completion and attained SVR12, including patients with genotype 3 and cirrhosis. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) had normalized return rates of 94.1% and 93.8%, respectively, following therapy. ALT, AST, FIB-4 index, APRI, and aPMAP scores were significantly lower than those before treatment (<i>Z</i>=-3.980, -3.875, -3.461, -3.582, <i>P</i><0.05). The proportion of patients in the high-risk group of liver cancer dropped (52.6% before treatment and 33.3% after treatment), and more patients were reclassified to medium-and low-risk groups. Two cases (7.7%) experienced nausea and diarrhea, one case (3.8%) had a headache, and one case (3.8%) had fatigue, all of which were well managed during treatment. There were no serious adverse events, deaths, or interruptions of treatment due to adverse reactions. <b>Conclusions:</b> SOF/VEL/VOX is a safe and effective salvage treatment option for chronic hepatitis C patients who have failed DAAs therapy, and may be particularly beneficial to refractory populations infected with genotype 3 and combined with cirrhosis.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"25-30"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459963","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[Immune status of inactive HBsAg antigen carriers with chronic HBV infection].","authors":"X X Wang, S Ren, S J Zheng, X Y Chen","doi":"10.3760/cma.j.cn501113-20240910-00488","DOIUrl":"10.3760/cma.j.cn501113-20240910-00488","url":null,"abstract":"<p><p>Hepatitis B e antigen-negative, normal alanine aminotransferase, low or undetectable HBV DNA, and HBsAg levels below 1 000 IU/ml are characteristics of the immune control stage (IC) in inactive hepatitis B surface antigen (IHC) carriers with chronic hepatitis B virus (HBV) infection. This stage improves the host's innate and adaptive immune responses, thereby reducing the ability for viral evasion. The expression of intrahepatic immune genes and metabolism-related genes, including pattern recognition receptors, antiviral effector factors, and interferon pathways, is upregulated in patients at this stage. The functions of innate immunity are also restored, including those of dendritic cells, natural killer cells, and macrophages during the IC stage, while in adaptive immunity, the exhaustion and partial functional reconstruction of HBV-specific T lymphocytes and B lymphocytes are weakened. These suggest that patients in the IHC stage may become an advantageous population for achieving clinical cure of hepatitis B due to their immunological characteristics, which differ statistically from those of patients in the immune tolerance and immune active stages.</p>","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"54-62"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459968","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"[A case of chronic hepatitis B who achieved clinical cure with pegylated interferon alfa intermittent and combination therapy].","authors":"S Y Wang, W Deng, M H Li","doi":"10.3760/cma.j.cn501113-20240930-00519","DOIUrl":"10.3760/cma.j.cn501113-20240930-00519","url":null,"abstract":"","PeriodicalId":24006,"journal":{"name":"中华肝脏病杂志","volume":"32 S2","pages":"48-50"},"PeriodicalIF":0.0,"publicationDate":"2024-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143459960","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}