Distribution of disease phase, treatment prescription and severe liver disease among 1598 patients with chronic hepatitis B in the Chronic Hepatitis Cohort Study, 2006–2013

Spradling, Philip R.; Xing, Jian; Rupp, Loralee B; Moorman, Anne C.; Gordon, Stuart C.; Teshale, Eyasu; Lü, Mei; Boscarino, Joseph A.; Schmidt, Mark; Trinacty, Connie Mah; Holmberg, Scott D.

doi:10.1111/apt.13802

Cited by 27 publications

(35 citation statements)

References 29 publications

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“…The clinical stages of CHB are generally classified as the immune tolerant phase (IT), immune active phase (IA) and inactive CHB phase (IC) based on serum alanine aminotransferase (ALT), HBV DNA levels and HBeAg status [ 1 , 2 ]. Some patients cannot be classified into the above stages and fall into the grey zone (GZ) [ 3 ]. Current guidelines recommend the presence of an active liver inflammation using histology or elevated ALT serum levels greater than twofold the ULN plus elevated HBV DNA above 2000 IU/mL (HBeAg negative) or 20,000 IU/mL (HBeAg positive) as criteria for initiating antiviral therapy [ 1 ].…”

Section: Introductionmentioning

confidence: 99%

Veritable antiviral capacity of natural killer cells in chronic HBV infection: an argument for an earlier anti-virus treatment

Zhou

et al. 2017

J Transl Med

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BackgroundThere is limited information on innate immunity, especially natural killer (NK) cell function, in different chronic hepatitis B (CHB) stages. Therefore, we examined whether the clinical staging strategy accurately reflects veritable NK cell immunity.MethodsA total of 237 eligible CHB patients and 22 healthy controls were enrolled in our study. Demographic and clinical data were collected, and the CHB phases (immune active-IA, immune tolerant phase-IT, inactive CHB-IC, and grey zone-GZ) were classified according to the latest American Association for the Study of Liver Disease guidelines. Peripheral blood mononuclear cells from patients and healthy controls were tested for NK cell frequency, phenotype and function using flow cytometry.ResultsA significant decrease in activating receptor NKp44 and NKp46 expression and significant increase of exhaustion molecule Tim-3 expression were observed in NK cells from CHB patients. Reduced cytokine secretion and preserved or elevated cytotoxic function were also observed. Patients in the IT group exhibited comparable cytokine secretion and cytolytic capacity as age-matched IA patients. NK cell anti-viral functions were preserved in GZ patients. Some of the NK cell function in patients who were excluded from treatment by the current treatment guidelines was less compromised than patients who qualified for treatment.ConclusionOur findings provide evidence of veritable NK cell immunity during different natural history phases in treatment-naïve patients with chronic HBV Infection. Chronic HBV infection hindered NK cell function in CHB patients. However, the presumed IT and GZ statuses of CHB patients based on the clinical parameters may not accurately reflect the inner immune status of these patients and should be reconsidered. Some patients excluded from treatment by the current treatment guidelines may be able to be selected as candidates for treatment.Electronic supplementary materialThe online version of this article (doi:10.1186/s12967-017-1318-1) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Veritable antiviral capacity of natural killer cells in chronic HBV infection: an argument for an earlier anti-virus treatment

Zhou

et al. 2017

J Transl Med

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“…12 Not surprisingly, patients with HBeAg-negative infection were older than those with HBeAg-positive infection, also similar to that reported from the USA. 13 In our study, the middle-aged group was the most predominant in both men and women. This is in line with the recent reports that the prevalence of HBsAg in childbearingaged men and women still being around 6% in rural and endemic areas in China.…”

Section: Discussionmentioning

confidence: 48%

Baseline Characteristics and Treatment Patterns of the Patients Recruited to the China Registry of Hepatitis B

Shan¹,

You²,

Niu³

et al. 2019

Journal of Clinical and Translational Hepatology

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Background and Aims: Chronic hepatitis B virus (HBV) infection remains a major public health problem globally. Here, we describe the baseline characteristics and treatment profiles of HBV-infected patients recruited to the China Registry of Hepatitis B. Methods: Inclusion criteria were patients with different stages of chronic HBV infection and complete key data. Exclusion criteria were patients with hepatocellular carcinoma. The baseline clinical, laboratory and treatment profiles were analyzed. Results: Finally, 40,431 patients were included. The median age was 43 years, with 65.2% being men and 51.3% being positive for hepatitis B e antigen (HBeAg). The most common initial diagnosis was chronic hepatitis B (81.0%), followed by cirrhosis (9.3%), inactive carrier of hepatitis B surface antigen (HBsAg) (6.7%), and immune tolerant phase of hepatitis B infection (3.0%). Among the 21,228 patients who were on treatment, 88.0%, 10.0% and 2.0% received nucleos(t)ide analogues (NAs), interferon or combination of NAs and interferon, respectively. The proportion of patients who received preferred NAs (entecavir or tenofovir disoproxil fumarate) had increased from 13.5% in 2003 to 79.7% in 2016. Conclusions: We concluded that middle-aged men accounted for most of the patients with chronic hepatitis B in this cross-sectional study. About half of the patients were HBeAg-positive. NAs were the most commonly used therapy, and use of the preferred NAs had steadily increased in the past decade.

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“…Hadziyannis et al [15] [8]. In USA, Spradling et al reported 7% of inactive carriers and 0.6% of immunological tolerance in a study that included 1598 patients, where only 55% of whom were included [19]. In Cuba, Marlen et al found 7% of inactive carriers in a cohort study of 146 chronic HBV carriers [20].…”

Section: Discussionmentioning

confidence: 99%

Biological Profile of Chronic Hepatitis B Infection and Its Predictive Factors According to Liver Histological Activity at the Renaissance Hospital, N’djamena, Chad

Mahamat-Saleh

Moussa

Bolti

et al. 2020

Preprint

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Background: the profile of chronic viral hepatitis B has been little studied in Chad. The factors predictive of the presence of hepatic fibrosis are not well known. The aim of the study was to determine the biological profile of chronic HBsAg carriers according to the new European classification of chronic hepatitis B.Method: This is a prospective cross-sectional study carried out in the gastroenterology outpatient department at the Renaissance Hospital in N’Djamena from January, 2018 to July, 2019. All patients with chronic HBsAg were included and documented for at least one year. Patients with hepatitis C, hepatitis D or HIV are known alcoholic patients and were excluded from the study. The biological profile was determined according to four forms; HBeAg positive chronic infection, HBeAg positive chronic hepatitis, HBeAg negative chronic infection, HBeAg negative chronic hepatitis and HBsAg negative phase. Factors associated with presence of significant liver fibrosis were founded by logistical regression.Results: The average age of the patients were 42.4 years old. The sex ratio was 1.43 in favor of men and a total number of 106 patients were included. The median of the transaminase concentrations were 24 IU/ml (AST) and 21 IU/ml (ALT). 61 patients had HBeAg negative chronic infection (59.8%) and 37 patients had HBeAg negative chronic hepatitis (36.2%). HBeAg positive chronic infection and HBeA positive chronic hepatitis were both seen in 2% of the cases. Significant liver fibrosis was independently associated with the ALT levels (Odds ratio=1.038 [1.009-1.068]; p=0.009).Conclusion: Chronic HBeAg-negative B infection is the main form found in chronic HBeAg-positive carriers. Transaminases are a predictive factor for the presence of hepatic fibrosis.

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Distribution of disease phase, treatment prescription and severe liver disease among 1598 patients with chronic hepatitis B in the Chronic Hepatitis Cohort Study, 2006–2013

Abstract: SUMMARY BackgroundLimited information exists regarding the distribution of disease phases, treatment prescription and severe liver disease among patients with chronic hepatitis B (CHB) in US general healthcare settings.

Cited by 27 publications

References 29 publications

Veritable antiviral capacity of natural killer cells in chronic HBV infection: an argument for an earlier anti-virus treatment

Veritable antiviral capacity of natural killer cells in chronic HBV infection: an argument for an earlier anti-virus treatment

Baseline Characteristics and Treatment Patterns of the Patients Recruited to the China Registry of Hepatitis B

Biological Profile of Chronic Hepatitis B Infection and Its Predictive Factors According to Liver Histological Activity at the Renaissance Hospital, N’djamena, Chad

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