We identified seasonal human coronaviruses, influenza viruses and rhinoviruses in exhaled breath and coughs of children and adults with acute respiratory illness. Surgical face masks significantly reduced detection of influenza virus RNA in respiratory droplets and coronavirus RNA in aerosols, with a trend toward reduced detection of coronavirus RNA in respiratory droplets. Our results indicate that surgical face masks could prevent transmission of human coronaviruses and influenza viruses from symptomatic individuals.Respiratory virus infections cause a broad and overlapping spectrum of symptoms collectively referred to as acute respiratory virus illnesses (ARIs) or more commonly the 'common cold' . Although mostly mild, these ARIs can sometimes cause severe disease and death 1 . These viruses spread between humans through direct or indirect contact, respiratory droplets (including larger droplets that fall rapidly near the source as well as coarse aerosols with aerodynamic diameter >5 µm) and fine-particle aerosols (droplets and droplet nuclei with aerodynamic diameter ≤5 µm) 2,3 . Although hand hygiene and use of face masks, primarily targeting contact and respiratory droplet transmission, have been suggested as important mitigation strategies against influenza virus transmission 4 , little is known about the relative importance of these modes in the transmission of other common respiratory viruses 2,3,5 . Uncertainties similarly apply to the modes of transmission of 7 ).Some health authorities recommend that masks be worn by ill individuals to prevent onward transmission (source control) 4,8 . Surgical face masks were originally introduced to protect patients from wound infection and contamination from surgeons (the wearer) during surgical procedures, and were later adopted to protect healthcare workers against acquiring infection from their patients. However, most of the existing evidence on the filtering efficacy of face masks and respirators comes from in vitro experiments with nonbiological particles 9,10 , which may not be generalizable to infectious respiratory virus droplets. There is little information on the efficacy of face masks in filtering respiratory viruses and reducing viral release from an individual with respiratory infections 8 , and most research has focused on influenza 11,12 .Here we aimed to explore the importance of respiratory droplet and aerosol routes of transmission with a particular focus on coronaviruses, influenza viruses and rhinoviruses, by quantifying the amount of respiratory virus in exhaled breath of participants with medically attended ARIs and determining the potential efficacy of surgical face masks to prevent respiratory virus transmission.

Large amounts of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2005. These include long-term follow-up studies in large community-based cohorts or asymptomatic subjects with chronic HBV infection, further studies on the role of HBV genotype/ naturally occurring HBV mutations, treatment of drug resistance and new therapies. In addition, Pegylated interferon a2a, entecavir and telbivudine have been approved globally. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings were discussed and debated. The earlier ''Asian-Pacific consensus statement on the management of chronic hepatitis B'' 263-283 DOI 10.1007/s12072-008-9080-3 was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, special indications for liver biopsy in patients with persistently normal alanine aminotransferase, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune-suppressive medications or chemotherapy and patients in the setting of liver transplantation, are also included.

Large amounts of new data on the natural history and treatment of chronic hepatitis B virus (HBV) infection have become available since 2005. These include long-term follow-up studies in large community-based cohorts or asymptomatic subjects with chronic HBV infection, further studies on the role of HBV genotype/ naturally occurring HBV mutations, treatment of drug resistance and new therapies. In addition, Pegylated interferon a2a, entecavir and telbivudine have been approved globally. To update HBV management guidelines, relevant new data were reviewed and assessed by experts from the region, and the significance of the reported findings were discussed and debated. The earlier ''Asian-Pacific consensus statement on the management of chronic hepatitis B'' 263-283 DOI 10.1007/s12072-008-9080-3 was revised accordingly. The key terms used in the statement were also defined. The new guidelines include general management, special indications for liver biopsy in patients with persistently normal alanine aminotransferase, time to start or stop drug therapy, choice of drug to initiate therapy, when and how to monitor the patients during and after stopping drug therapy. Recommendations on the therapy of patients in special circumstances, including women in childbearing age, patients with antiviral drug resistance, concurrent viral infection, hepatic decompensation, patients receiving immune-suppressive medications or chemotherapy and patients in the setting of liver transplantation, are also included.

In view of the findings that high hepatitis B virus (HBV) deoxyribonucleic acid (DNA) is associated with increased risk of chronic hepatitis B (CHB)-related complications, disease progression in CHB patients in the immune-tolerant phase is uncertain. We evaluated disease progression in 57 immune-tolerant CHB patients with high HBV DNA. Each subject underwent an initial liver biopsy. In those who remained in the immune-tolerant phase, a follow-up liver biopsy was performed after 5 years of follow-up. Patients who developed elevated serum alanine aminotransferase (ALT) levels were discontinued from the study after a follow-up liver biopsy. Traditionally, serum alanine aminotransferase (ALT) level and HBV serology analysis have been widely used for the assessment of patients with CHB infection. The annual incidence of cirrhosis has been estimated to be 2%-6% for hepatitis B e antigen (HBeAg)-positive CHB patients and 8%-10% for HBeAg-negative CHB patients. 4,5 The higher incidence of cirrhosis among HBeAg-negative patients is related to older age and more advanced liver disease at presentation. 2,4,5 More advanced fibrosis stage at presentation correlates with risk of cirrhosis, and those with milder forms of hepatitis have a longer time to cirrhosis. 6 HBeAg positivity has also been found to be associated with higher hepatic inflammation and an increased risk of HCC. Although seroconversion of HBeAg to hepatitis B e antibody (anti-HBe) often leads to hepatic inflammation subsiding and an improved prognosis, the identification of precore/core promoter mutations and recognition of HBeAg-negative CHB disease explain the disease progression noted after HBeAg seroconversion. [7][8][9][10] Recent studies have demonstrated a strong link between viral replication, liver injury, and progression to cirrhosis with increased risk of HCC in CHB-infected From the