Yun Fan Liaw

..Studies are underway in both monotherapy and combination therapy with thymalfasin and interferon and results are promising...

..Cost-cutting measures and international support are essential to improve the difficult situation in this part of the world...

..The effectiveness of antiviral therapy in preventing disease progression in patients with chronic hepatitis B and advanced fibrosis or cirrhosis is unknown...

..In conclusion, a better understanding of the pathogenetic mechanisms and natural course of hepatitis flares, wiser selection of patients and the timing of drug therapy are crucial to achieve better treatment results...

..The GLOBE trial has compared the efficacy and safety of telbivudine versus lamivudine treatment over 2 years in patients with chronic hepatitis B...

..In addition, experiments have shown that the defective replication competency of rt M 204 I/V restores upon addition of lamivudine...

..In addition, studies are needed to decide whether switching to or adding on a second drug, and with which drug, is the most cost-effective strategy...

..A large amount of new data on the treatment of chronic hepatitis B has become available such that the 2003 consensus statement requires revision and update...

..Antiviral or immunomodulatory therapy should be considered seriously for these patients...

..The treatment outcomes are still far from satisfactory. The development of safe and affordable anti-HBV agents/strategies is needed to further improve outcomes...

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..The ability to achieve a high rate of sustained or maintained HBV suppression with a low risk of drug resistance would be the ultimate goal in the treatment of chronic HBV infection...

..The impact of adefovir resistance is less clear but is responsive to lamivudine therapy. In conclusion, monitoring of viral breakthrough to start effective intervention is mandatory during direct antiviral therapy...

..Studies are underway in both monotherapy and combination therapy with thymalfasin and interferon and results are promising...

..The importance of HBeAg seroconversion is underscored by current CHB treatment guidelines that recommend limiting the duration of antiviral therapy in HBeAg-positive patients who achieve seroconversion...

..The development of new strategies, including selection of patient and timing of therapy, and new drugs are needed to further improve the therapeutic efficacy...

..Further development of new drugs and new strategies, such as combination or sequential therapy, may help to better achieve the goals of treatment for chronic hepatitis B in the new century...

..To stop LAM and switch to ADV in patients with breakthrough is a reasonably safe and cost-effective approach...

..Although chronic infection with hepatitis B virus (HBV) has been established as a cause of hepatocellular carcinoma (HCC), the roles of viral load and HBV genotype remain unclear...

..However, drug resistance is a serious risk on prolonged nucleos(t)ide analogue therapy, and this poses a critical challenge. Prevention and proper management of drug resistance are crucial to ensure long-term success...

..In conclusion, HBV genotype, age, and additional treatment are the major determinants for the sustained HBeAg response to lamivudine therapy...

..It is generally believed to be a benevolent sign, implicating clearance of viremia. The aim of this study is to examine the authenticity of this dogma...

..The risk and the predictors of liver disease progression in carriers of inactive hepatitis B virus (HBV) are unclear...

..The aim of the present study was to investigate whether spontaneous seroclearance of hepatitis B surface antigen (HBsAg) in patients with chronic hepatitis B could be attributed to the presence of pre-S/S gene mutations...

..Their relative roles in the decline of HBsAg prevalence with increasing age are unknown...

..0053). In conclusion, increased exposure to estrogen during adulthood may provide a protective effect against HCC. Nevertheless, an early menarche, which results in early estrogen exposure, does not confer protection for HBsAg carriers...

..07, 95% confidence interval = 1.67 to 38.93) than for those with the Arg/Arg genotype. Thus, GST status appears to affect the risk of HCC associated with this XRCC1 polymorphism...

..A case-control study including patients with early HCC and HBsAg carriers who are presumed to be at the minimal potential of HCC as controls might better identify factors significantly associated with HCC development...

..The natural course following acute hepatitis C virus (HCV) superinfection has not been well studied. The aim of this study was to investigate the impact of acute HCV superinfection...

..Longitudinal studies on the relationship between hepatitis B virus (HBV) genotypes and reactivation of hepatitis B and progression to cirrhosis were very rare...

..We investigated HBV DNA levels in inactive carriers and identified factors that correlated with this state among anti-HBe-positive carriers with HBV DNA levels of 10(4) copies/mL or greater (5.26 copies/mL = 1 IU/mL)...

..It is concluded that in HBeAg-negative chronic hepatitis B patients with ALT levels above 5x ULN, a 6-12 month course of lamivudine therapy may achieve sustained an off-treatment response in approximately one-third of patients...

..Precore mutant ratios tended to correlate with ALT levels and anti-HBe seroconversion, but high precore mutant ratios were associated with persistent hepatitis after anti-HBe seroconversion and increased risk of cirrhosis...

..Hepatocellular carcinoma (HCC) recurrence after ablation therapy for primary tumors is common...

..We assessed the influence of genetic variants in the hepatitis B virus (HBV) core, which is a principal immunologic target, on the progression to hepatocellular carcinoma (HCC) in a cohort of 4841 male HBV carriers followed up for 16 years...

..These results implicate PAPSS1 as a candidate HCC-susceptibility gene in hepatitis B carriers...

..However, the relapse rate was high (60% during 1-year follow-up). Further study is needed to establish how to improve a sustained HBeAg response...

..Follow-up of patients beginning at the early phase of infection might provide data with less referral bias than in previous studies...

..However, the treatment outcomes are still far from satisfactory. The development of safe and affordable anti-HBV agents/strategies is needed to further improve outcomes...

..Predictors of reactivation of hepatitis B following hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B have rarely been reported before and deserve further study...

..It is important to identify factors that predict the development of hepatic decompensation during exacerbation so that antiviral therapy can be initiated immediately...

..Biochemical and clinical benefits were also demonstrated. Entecavir was well tolerated, and early mortality rates were consistent with rates observed in similar populations treated with lamivudine...

..Hepatocyte expression of HBV surface, core, and x antigens (HBsAg, HBcAg and HBxAg), semi-quantitated by immunopathology, were correlated with clinical and virological data in 80 patients with chronic hepatitis B...

..We examined the HCC risk associated with HBV genotypes and common variants in the precore and basal core promoter (BCP) regions...

..The long-term outcomes of interferon-alpha (IFN-alpha) therapy in hepatitis B e antigen (HBeAg) seropositive patients remain controversial. This study was conducted to address this issue...

..The low HBsAg seroclearance rates in previous studies might be due to the relative short period of follow-up...

..The significance of such mutations in hepatocarcinogenesis remains elusive. Here, we aimed to understand the oncogenicity of HBV pre-S/S nonsense mutations identified in patients with HCC that developed after lamivudine therapy...

..CONCLUSIONS: HBeAg status, HBV-DNA, ALT levels and treatment duration are the major determinants for the YMDD mutation during lamivudine therapy, and should be considered in designing the therapeutic strategy...

..Quitting smoking or drinking alcohol could reduce the excess risk, but only after a long interval of cessation...

..However, hepatitis B virus is rarely eliminated, and drug resistance is a major drawback during long term therapy. The development of new drugs and strategies is needed to improve treatment outcomes...

..The outcome of patients following this therapeutic guideline has not been clearly investigated...

..For HCC not prevented by these measures, surveillance using ultrasonography and serum alpha-fetoprotein assay every 3 to 6 months is able to detect HCC at an earlier stage and allows curative therapy with survival benefit...

..We performed a comparative study on the expression of alpha-smooth muscle actin (alpha-SMA) in hepatic stellate cells (HSCs), a marker of HSC activation, in patients with chronic hepatitis B and hepatitis C...

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..Serum levels of hepatitis B surface antigen (HBsAg) decrease gradually during chronic hepatitis B virus infection. We investigated the association between levels of HBsAg and HBsAg seroclearance...

..The frequency of HBV viremia was significantly (P = .002) lower in patients with anti-HBsAg seroconversion (6 of 69 [8.7%]) than in those without seroconversion (15 of 49 [30.6%])...

..CONCLUSION: Patients with HBeAg seroconversion before age 30 have excellent prognosis, whereas patients with delayed HBeAg seroconversion after age 40 have significantly higher incidences of HBeAg-negative hepatitis, cirrhosis, and HCC...

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..Studies to assess the effects of antiviral therapy, and in particular interferon treatment, are also discussed together with virological, biochemical and histological profiles following HBsAg seroclearance and the long-term outcomes...

..However, the treatment outcomes still need to be improved, and more effective, safe and affordable anti-HBV agents/strategies are needed...

..CONCLUSION: All treatments were well tolerated in patients with decompensated liver disease due to CHB with improvement in virologic, biochemical, and clinical parameters...

..results suggest that p14(ARF), p16(INK4a) and p53 are differentially disrupted through distinct molecular mechanisms at different stages in HCC and that p14(ARF) and p53 appear to function in the same tumor suppression pathway in HCC..

..ALT of at least 2 times ULN is therefore an appropriate threshold for anti-HBV therapy, whereas those with ALT 1 to 2 times ULN require liver biopsy for decision...

..Significantly, it achieves high frequencies of tetramer staining of CD8+ T cells allowing the data of different individuals to be easily compared and sequentially evaluated. The mechanisms involved in this method are discussed...

..005). In conclusion, the results suggest that spontaneous HBeAg seroconversion confers favorable long-term outcomes. However, active hepatitis still may develop and lead to cirrhosis and HCC...

..Adefovir or entecavir is preferred in patients with decompensated cirrhosis who require long duration of treatment, due to the lower rate of development of resistance...

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..In conclusion, by combining three different methods, we have obtained a panel of frequently down regulated genes in HCC, including BMAL2. Antisense overexpression of BMAL2 enhances cell proliferation...

..CONCLUSIONS: The prognosis following spontaneous HBsAg seroclearance is excellent, except in patients with cirrhosis or those with concurrent hepatitis C virus or hepatitis delta virus infection...

..CONCLUSIONS: Familial aggregation of HCC in HBsAg carriers is associated with familial clustering of liver cirrhosis...

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..In terms of the mechanisms of action, a combination of Talpha1 and nucleoside or nucleotide analogs is a logical approach in the control of chronic HBV infection and a randomized control study is ongoing...

..These high prevalences indicated high maternal HBV replication status. CONCLUSIONS: Perinatal transmission and maternal viral load are important risk factors in hepatocarcinogenesis...

..CONCLUSIONS: Chronic viral infection rather than a hereditary factor is the main cause of a familial tendency for HCC. Dual infection of hepatitis B and C virus increases the risk of HCC or decompensated liver diseases...

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..The basic mechanisms that regulate the viral interactions largely remain to be investigated...

..CONCLUSIONS: Hepatitis C virus infection facilitates gallstone formation...

..Expert opinions may differ from those of practicing hepatologists and gastroenterologists. We aimed to explore this issue further after a critical review of the literature...

..CONCLUSION: A sustained virological response secondary to IFN monotherapy or IFN/RBV combination therapy could reduce the risk for HCC and improve survival of CHC patients...

..We investigated the mechanisms underlying the inflammatory hepatocarcinogenesis by examining whether genetic variations in cytokines, antioxidant enzymes, and DNA repair genes affect the HCC risk...

..Thus, there is a need to standardize nomenclature relating to hepatitis B antiviral resistance, and to define genotypic, phenotypic, and clinical resistance to NA therapy...

..No such relationship was detected among women without the family history. In conclusion, our observations suggest that the AR-CAG alleles may contribute to HCC predisposition among women through a mechanism different from that for men...

..Reducing hepatitis B virus (HBV) replication to minimal levels is emerging as a key therapeutic goal for chronic hepatitis B...

..Asians and Caucasians had similar rates of response to lamivudine at comparable ALT levels...

..5 to 102.1) among those who were positive for both HBsAg and HBeAg, as compared with men who were negative for both. CONCLUSIONS: Positivity for HBeAg is associated with an increased risk of hepatocellular carcinoma...

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..CONCLUSION: Through 96 weeks of treatment, 1 mg entecavir resulted in continued clinical benefit in lamivudine-refractory HBeAg-positive chronic hepatitis B patients with a safety profile comparable to lamivudine...

..In preclinical and phase II studies, entecavir demonstrated potent antiviral activity against lamivudine-resistant HBV...

..Nevertheless, the data needs further validation, particularly since the predictive accuracy for patients with cirrhosis is low...

..In conclusion, activation of Th1 immunity accompanied by enhancement of CTL activity during therapy is a common immune mechanism for successfully treating hepatitis B and C, and therefore may have important therapeutic implications...