Factors Associated with Hepatitis B Surface Antigen Kinetics and Responses in Pegylated Interferon Alpha-2a Monotherapy for Patients with Chronic Hepatitis B

Objective Pegylated-interferon monotherapy is the standard treatment for patients with chronic hepatitis B; however, the factors associated with its therapeutic effects remain unclear. Methods Patients with chronic hepatitis B were treated with pegylated interferon α-2a for 48 weeks. We evaluated the kinetics of hepatitis B surface antigen (HBsAg) during treatment and follow-up periods and the factors associated with an HBsAg response (defined as a change in HBsAg of ≥-1 log IU/mL from baseline). Results The study population comprised 50 patients. The median baseline levels of hepatitis B virus DNA and HBsAg were 5.00 and 3.40 log IU/mL. The median values of HBsAg reduction from baseline were -0.44 (n=48), -0.41 (n=40), and -0.68 (n=11) log IU/mL at the end of treatment and at 48 and 144 weeks post-treatment, respectively. The rates of HBsAg response were 24.0% and 22.5% at the end of treatment and at 48 weeks post-treatment, respectively. A multivariate analysis identified HBsAg <3.00 log IU/mL as an independent baseline factor contributing to the HBsAg response at the end of treatment and 48 weeks post-treatment (p=1.07×10^-2 and 4.42×10^-2, respectively). There were significant differences in the reduction of the HBsAg levels at 12 weeks of treatment and in the incidence of serum ALT increase during treatment between patients with and without an HBsAg response. Conclusion These findings suggest that the baseline HBsAg level, HBsAg kinetics at 12 weeks of treatment, and ALT increase during treatment are important factors contributing to the HBsAg response in pegylated interferon α-2a monotherapy for patients with chronic hepatitis B.     

Lack of evidence of hepatic disease in patients with oral lichen planus in Serbia

OBJECTIVE: The reported frequency of chronic liver disease, and particularly, Hepatitis C virus (HCV) infection in patients with oral lichen planus (OLP) shows geographical variation. The aim of this study was to determine the prevalence of chronic hepatic disease, Hepatitis B virus and HCV infection in patients with OLP and control subjects resident in Serbia. PATIENTS AND METHODS: In this prospective study 48 patients with OLP (33 women and 15 men, with a mean age of 49.7 years) and 60 control subjects (38 women and 22 men, with a mean age of 46.7 years) were examined for the presence of serological evidence of chronic hepatic disease, Hepatitis B surface antigen (HBsAg) and anti-HCV seropositivity. RESULTS: All patients with OLP had normal liver function. HBsAg was not found in any of the patients with OLP or control group. None of the patients with OLP or control subjects were HCV seropositive. CONCLUSION: Patients with OLP resident in Serbia do not have evidence of chronic liver disease or infection with HBV or HCV. The exact aetiological role between hepatic disease and OLP remains unclear.     

Predictive role of serum HBsAg and HBcrAg kinetics in patients with HBeAg-negative chronic hepatitis B receiving pegylated interferon–based therapy

ObjectivesTo investigate the role of serum hepatitis B core-related antigen (HBcrAg) kinetics in predicting long-term outcome of pegylated interferon (PEG-IFN)-based therapy in patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis B (CHB).MethodsA total of 121 Thai patients with HBeAg-negative CHB recruited from a previous randomized trial of 48-week PEG-IFN alone or combined with entecavir were enrolled. Hepatitis B surface antigen (HBsAg) and HBcrAg levels were serially examined. Paired biopsy samples taken at baseline and after treatment were assessed for intrahepatic covalently closed circular DNA (cccDNA).ResultsPersistent virologic remission (PVR, defined by persistent hepatitis B virus (HBV) DNA <2000 IU/mL) and HBsAg clearance at 3 years after treatment were 29% (35/121) and 9% (11/121) respectively. Baseline HBcrAg correlated with HBV DNA and cccDNA but not with HBsAg. Baseline HBsAg, as well as HBsAg and HBcrAg, declines were associated with PVR, while HBsAg decline was predictive of HBsAg clearance. High baseline antigen levels (HBsAg ≥3.4 log₁₀ IU/mL plus HBcrAg ≥3.7 log₁₀ U/mL) yielded high negative predictive values of PVR (45/50, 90%) and HBsAg clearance (50/50, 100%). At week 12, declines of HBsAg, HBcrAg and both antigens combined of <0.5 log₁₀ yielded negative predictive values for PVR of 90% (71/79), 82% (61/74) and 96% (48/50) respectively.ConclusionsQuantitative HBcrAg was significantly associated with cccDNA in HBeAg-negative CHB. This novel antigen, together with HBsAg, could identify patients with low probability of PVR and HBsAg clearance in long-term follow-up.     

Resolution of HBV infection occurs sooner than recovery of renal disease in adult serum HBsAg‐negative HBV–associated glomerulonephritis

Most cases of hepatitis B virus–associated glomerulonephritis (HBV‐GN) occur in children and present with serum HBsAg positivity. Few studies have investigated adult patients with HBV‐GN who are serum HBsAg‐negative. This study aimed to determine the clinical and pathological features of adult patients with HBV‐GN who are serum hepatitis B surface antigen (HBsAg)‐negative. Clinical, pathologic, and laboratory findings were collected and analyzed in a cohort of 27 adult patients with HBV‐GN who were serum HBsAg‐negative upon diagnosis. The study population included mostly men of middle age (40‐59 years). Clinically, patients presented with nephrotic syndrome. Serum immunoglobulin G levels were low, whereas serum immunoglobulin M, immunoglobulin A, complement C3 (C3), and complement C4 (C4) levels as well as liver and renal function tests were normal in most or all patients. Among the 27 patients, 21 tested positive for HBV antibodies. Membranous nephropathy was the dominant pathological form on kidney biopsy. In addition, only a few patients showed a “full house” staining pattern and renal immune deposit of complement C1q (C1q). Serum HBsAg‐negative HBV‐GN may represent a late stage of HBV infection. We recommend routine testing for HBV markers on renal biopsy in regions where HBV is prevalent, even when tests for serum HBV markers are negative.     

无机银抗菌剂及其塑料制品的抗菌效果和毒性

为了解含银６％（ｇ／ｇ）的无机银抗菌剂的抗菌与破坏ＨＢｓＡｇ效果及毒性，进行了纸片抑菌环测定、载体定性ＨＢｓＡｇ试验与毒性试验。结果，该抗菌剂加水稀释２０、２００、４００倍的混悬液所染滤纸，分别对白色念珠菌、金黄色葡萄球菌、大肠杆菌有抑菌效果；含该剂０．５％（ｇ／ｇ）的塑料洗衣球对大肠杆菌作用 ５ｍｉｎ，有抑菌作用；以该剂１０倍稀释的悬液作用２４ｈ，才可破坏不锈钢片表面ＨＢｓＡｇ抗原性。该抗菌剂对雌、雄小鼠经口ＬＤ５０＞５０００ｍｇ／ｋｇ，对兔皮肤一次性刺激积分为０，微核试验阴性。     

血清中HBsAg浓度差异在乙型肝炎标志物模式分析中价值

目的分析不同浓度HBsAg血清中乙型肝炎标志物表现模式,以揭示其在人群中的分布特征。方法采用ELISA法与微粒子酶免疫分析技术(microparticle enzyme immunoassay,MEIA)测定5987例非肝炎流行区住院及门诊患者血清中HBsAg及其表面抗体(抗HBs)、乙肝e抗原及e抗体(HBeAg、抗HBe)和乙肝病毒核心抗体(抗HBc);根据定值参比血清和样本HBsAg荧光速率值/阴性对照荧光速率值之比(S/N值),再结合中和确证试验结果来确定HBsAg浓度,同时分析乙肝病毒血清学标志物模式;对低浓度(HBsAg≤1μg/L)再用PCR-ELISA法定量测定HBV DNA。结果:共检出HBsAg阳性784例,HBsAg浓度在5μg/L以上有636例,占HBsAg阳性81.1%;HBsAg浓度在2~5μg/L的有47例(5.99%);1~2μg/L的有69例(8.80%);1μg/L以下的有32例(4.08%)。尤其高浓度(HBsAg>5μg/L)和低浓度(HBsAg≤1μg/L)在人群中分布率分别为10.62%和0.53%;而中等浓度(1μg/L<HBsAg≤5μg/L)在人群中分布率为1.94%。结论不同浓度HBsAg血清中乙肝病毒标志物表现模式在人群中具有不同的分布特征,低水平血清HBsAg人群不容忽视,提高HBsAg的检测灵敏度有重要意义。     

复方次氯酸钠消毒剂用于口腔器械消毒的实验研究

目的研究复方次氯酸钠消毒剂对医院口腔器械消毒的效果。方法采用口腔器械模拟现场消毒试验方法对污染乙型肝炎表面抗原的灭活效果进行观察。结果用含有效氯500 mg/L以上复方次氯酸钠消毒液浸泡作用10 min,对污染到口腔器械表面的乙型肝炎表面抗原灭活率达到100%。含有效氯1000 mg/L的复方次氯酸钠消毒液连续浸泡常用口腔器械10 d未见明显腐蚀。结论本研究复方次氯酸钠消毒剂对污染到口腔器械上的乙型肝炎表面抗原具有快速的灭活效果,并且对器械基本无腐蚀。