ObjectiveTo systematically review the efficacy of different nucleosides (acids) in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. MethodsThe Cochrane Library, PubMed, EMbase, Web of Science, CNKI, WanFang Data, and VIP databases were electronically searched to collect randomized controlled trials (RCTs) of different nucleosides (acids) to prevent HBV reactivation after chemotherapy in cancer patients from inception to June 7th, 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Network meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 43 RCTs involving 3 269 patients were included. There were 7 interventions, namely entecavir (ETV), lamivudine (LAM), adefovir dipivoxil (ADV), telbivudine (LdT), tenofovir dipivoxil (TDF), lamivudine combined with entecavir (LAM+ETV), and lamivudine combined with adefovir dipivoxil (LAM+ADV). The results of network meta-analysis showed that the efficacy of reducing the reactivation rate of ETV, LAM, ADV, LdT, TDF, LAM+ETV, LAM+ADV were superior than the control group. The ETV, LAM and ADV were not as effective as LAM+ETV. The leading drug combinations were LAM+ETV (94.8%), LdT (81.5%) and LA+ADV (58.0%). ConclusionsCurrent evidence shows that LAM+ETV, LdT, and LA+ADV are more effective in preventing hepatitis B virus reactivation after chemotherapy in cancer patients. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify the above conclusions.
Objective To study the relationship of hepatitis B virus （HBV） to spontaneous rupture of hepatocellular carcinoma （HCC-SR） and its mechanism. Method The related literatures about theory of HCC-SR were consulted and reviewed. Results The injury of small arteries was usually followed in patients with HCC-SR， which was related to vascular autoimmune injury caused by the HBV infection. The small arteries in which immune complex deposited were readily injured， as a result HCC-SR happened while vascular load increased. Conclusion The HBV infection resulted in vascular autoimmune injury maybe a important factor in the pathogenesis of HCC-SR.
Objective To compare adefovir monotherapy with adefovir-thymosin alpha-1 combination therapy for chronic hepatitis B. Methods We searched The Cochrane Library, MEDLINE, PubMed, the Chinese Biomedical Database (CBM), CNKI, Wanfang, and VIP databases up to February 2010 to identify randomized controlled trials (RCTs) comparing adefovir plus thymosin alpha-1 versus adefovir alone for chronic hepatitis B. We also scanned references of all included studies and pertinent reviews. The methodological quality assessment and data extraction were conducted by two reviewers independently according to the Cochrane Reviewer’s Handbook 5.0.2 . Meta-analyses were performed using RevMan 5.0 software. Results Eleven trials involving 895 patients were included. The results of meta-analyses shoued: the HBeAg seroconversion rate of the combination therapy group was higher than that of the monotherapy group, both at the sixth month and the twelfth month (RR=1.77, 95%CI 1.38 to 2.27; RR=1.74, 95%CI 1.44 to 2.10); and there were also significant differences between the two groups for secondary outcomes including HBV-DNA negative, ALT normalization, etc.Conclusion Adefovir-thymosin alpha-1 combination therapy might be more effective than adefovir monotherapy for chronic hepatitis B. Significant differences are even observed at the sixth month. However, the results should be interpreted with caution because of the low quality of the included studies. High-quality, large-scale RCTs are needed to further prove the results.
Objective To evaluate the efficacy and safety of antiviral drugs for hepatitis B with YMDD motif variant. Methods We electronically searched MEDLINE (1989-April, 2004), EMBASE (1989-April, 2004), CBMdisc (expand) (1989-April, 2004), and handsearched unpublished Chinese conference proceedings. Randomized and quasi-randomized trials in patients with chronic hepatitis B with YMDD motif variant correlative to lamivudine were collected. Two reviewers extracted the data and assessed the quality of literature independently. The data were then analyzed by RevMan 4.2 software. Results Five studies involving 6 trials and 284 patients were included. According to the results of meta-analysis, antiviral therapy with adefovir plus lamivudine showed significantly better effects on the clearance of serum HBV-DNA and HBeAg and normalization of ALT than that of lamivudine alone (RR 16.61, 95%CI 2.29 to 120.71; RR 6.66, 95%CI 1.23 to 35.88 and RR 6.26, 95%CI 2.29 to 17.12 respectively); also, oxymatrine plus thymothin showed obviously better effects on the clearance of serum HBV-DNA and HBeAg (RR 2.96, 95%CI 1.26 to 6.93 and RR 2.51, 95%CI 1.05 to 5.98 respectively).But adefovir alone showed no better effects on clearance of serum HBV-DNA and HBeAg than that of lamivudine alone (RR 11.00, 95%CI 0.65 to 186.02 and RR 7.00, 95%CI 0.39 to 126.92 respectively); interferon plus lamivudine showed no better effects on the clearance of serum HBV-DNA, HBeAg and the normalization of ALT (RR 3.50, 95%CI 0.90 to 13.58; RR 4.90, 95%CI 0.70 to 35.10 and RR 2.80, 95%CI 0.91 to 8.12 respectively). Chinese herbs plus lamivudine showed no better effects on the clearance of serum HBV-DNA (RR 1.16, 95%CI 0.89 to 1.51). There were no significant side effects in the groups, except flu like symptom in the interferon group, slight kidney impairment in the adefovir group, and aggravation of rare cases in lamivudine group. Conclusions Antiviral therapy with adefovir plus lamivudine, or oxymatrine plus thymothin, shows better effects than with lamivudine alone in terms of antiviral therapy and clinical outcome improvement. However, the evidence is too weak to draw a definite conclusion in this systematic review. Larger sample size and rigorously designed randomized, double blind, placebo control trials are required for future study.
ObjectiveTo analyze the influencing factors for hepatitis B virus (HBV) infection screening in lymphoma patients prior to chemotherapy with a focus on HBV reactivation after chemotherapy. MethodsThe HBV infection screening data of 449 patients with lymphoma treated by chemotherapy between June 2010 and July 2012 were analyzed retrospectively. ResultsAmong the 449 patients, 387 (86.2%) were screened for HBV before initiation of chemotherapy, and patients with elevated aminotransferase levels were more likely to receive pre-chemotherapy HBV testing (OR=2.509, P=0.040). HBV reactivation was observed in 16.1% (9/56) of the HBsAg-positive patients after chemotherapy, and it was more likely to occur in patients with the use of rituximab (29.2% vs. 6.3%; P=0.030). Prophylactic antiviral therapy can significantly reduce the incidence of chemotherapy-induced HBV reactivation (12.0% vs. 50.0%; P=0.046). Two cases of reactivation occurred in patients who were HBsAg negative and hepatitis B core antibody positive. ConclusionHBV reactivation, especially for people with the use of rituximab, is a common complication in patients with HBV infection. HBV infection testing should be considered for lymphoma patients who were planned for chemotherapy. Prophylactic antiviral therapy can greatly decrease the incidence of HBV reactivation.
Objective By means of evidence-based clinical practice, to find more effective treatment for a hepatitis B related nephritis patient with renal failure. Methods The following databases as Up to Date (May 2011), The Cochrane Library (Issue 5, 2011), PubMed (1978 to 2011) and CNKI (1978 to 2011) were searched to identify systematic reviews and randomized controlled trials (RCTs) of treating hepatitis B related nephritis with glucocorticoid, immunosuppressor or antiviral therapies, and the quality of collected clinical evidence was evaluated by using GRADEpro software. Results The glucocorticoid or combined immunosuppressors was not recommended for existing adverse effects and not acting on the remission of hepatitis B related nephritis and reduction of proteinuria. However, the antiviral therapy used alone was recommended for acting on the remission of hepatitis B related nephritis and the reduction of proteinuria. In view of adverse effects and expensive price of interferon, the nucleoside analogue antiviral agent was suggested. Considering the renal toxicity of adefovir and tenofovir, and possible drug-resistance of lamivudine, the entecavir (0.5 mg qd) was finally selected with patient’s agreement, and the supporting therapies such as lowering blood pressure, and protecting the kidney and liver were adopted continually. After one month treatment, 24-hour urinary protein got reduced, serum albumin got increased, kidney function got stable, and hepatitis B virus DNA quantity got reduced. Conclusion For treating hepatitis B related nephritis with kidney failure, entacavir can reduce 24-hour urinary protein, raise serum albumin, stabilize kidney function and reduce hepatitis B virus DNA in a short term, but its long-term efficacy still requires further studies.
Long non-coding RNA (lncRNA) is a type of nucleic acid sequence that exceeds 200 nucleotides in length and cannot encode any complete protein. In recent years, its important regulatory role in various pathophysiological processes has been gradually clarified, however, few studies have reported its role in carcinogenic virus infection. This article summarizes the currently known lncRNAs abnormally expressed in hepatitis B virus-induced hepatocellular carcinoma, and focuses on the mechanisms of lncRNAs regulating the occurrence and development of hepatitis B virus-related hepatocellular carcinoma such as controlling virus replication and host immunity, cell cycle and proliferation, invasion and metastasis, autophagy and apoptosis of liver cancer cells, hoping to provide a theoretical basis for the molecular targeted therapy of hepatocellular carcinoma.
Objective To explore the relationship between the HBsAg positive patients suffering from hepatocellular carcinoma (HCC) and HBV DNA genotype. Methods By using PCR type-specific primers combined with sequencing of genotype, we analyzed the genotype of HBV DNA in the serum of 500 patients with positive HBsAg in our hospital. Among them, 150 cases suffered from HCC. Results Genotype B and C were both predominant genotypes in HBsAg positive patients. But in HCC group, the rate of genotype C was 65.33% （98/150）, which was significantly higher than that in non-HCC group (88/350, 25.14%), while genotype B, in contrast, was 28.67% （43/150） and 68.86% （241/350）， χ2=75.45， Plt;0.05. The distribution of HBV DNA genotype B or genotype C in different gender or different age groups were not statistically significantly different in cases of HCC (Pgt;0.05). Conclusion Genotype C of HBV DNA is more common in patients with HCC, and maybe there is relationship between genotype C and the occurrence of HCC.
ObjectiveTo explore the predictive value of serum prothrombin induced by vitamin K absence-Ⅱ (PIVKA-Ⅱ) detection for the biological characteristics of hepatitis B virus (HBV)-associated hepatocellular carcinoma (HCC).MethodsThis retrospective study included 394 patients with HBV-related HCC who were newly diagnosed and treated with surgical resection in West China Hospital of Sichuan University between June 2017 and December 2018. Their clinical information such as tumor size, tumor number, tumor cell differentiation, presence of microvascular invasion (MVI), distant metastasis, and portal vein tumor thrombus was collected from the medical record. The laboratory test results of patients during diagnosis and before surgery were collected, including alpha-fetoprotein (AFP), PIVKA-Ⅱ, alanine aminotransferase (ALT), aspartate aminotransferase (AST), gamma-glutamyl transferase (γ-GGT), etc., and the relationships between PIVKA-Ⅱ levels and tumor biological characteristics were analyzed. Non-normal continuous variables were presented as medium (lower quartile, upper quartile).ResultsCompared with the patients with low HCC serum PIVKA-Ⅱ levels (≤40 mAU/mL), patients with high serum PIVKA-Ⅱ levels (>40 mAU/mL) had larger tumor diameters [5.00 (3.00, 9.00) vs. 2.50 (1.63, 4.95) cm, P<0.001], more severe Barcelona Clinic Liver Cancer (BCLC) stage (P<0.001), and higher AFP [186.05 (6.86, 1 210.00) vs. 17.83 (4.33, 231.95) ng/mL, P<0.001], ALT [38.00 (26.00, 66.25) vs. 32.00 (22.00, 51.00) U/L, P=0.018], AST [42.00 (30.00, 76.00) vs. 34.00 (25.50, 48.25) U/L, P<0.001], and γ-GGT [71.00 (39.00, 165.50) vs. 55.50 (25.00, 93.00) U/L, P=0.005], and were more likely to form portal vein tumor thrombi (16.61% vs. 3.75%, P=0.003) and MVI (43.67% vs. 11.11%, P<0.001). In BCLC stage 0 HCC patients, the positive rate of PIVKA-Ⅱ was only 51.35%. Multivariate logistic regression analysis showed that PIVKA-Ⅱ>40 mAU/mL was an independent predictor of MVI [odds ratio=6.588, 95% confidence interval (CI) (1.645, 26.383), P=0.008]. The area under receiver operating characteristic curve of PIVKA-Ⅱ level predicting MVI was 0.761 [95%CI (0.693, 0.830)], with a sensitivity of 66.22% and a specificity of 79.06%.ConclusionIn HBV-related HCC patients, high PIVKA-Ⅱ is associated with the poor biological characteristics of tumor, and is an independent risk factor for tumor MVI.
ObjectivesTo systematically review the association between serum leptin level and hepatitis C virus.MethodPubMed, EMbase, Web of Science, CNKI, CBM, VIP and WanFang Data databases were electronically searched to collect case-control studies on the association between serum leptin level and hepatitis C virus from 2007 to July, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 11 studies including 1 115 patients were included. The results of meta-analysis showed the serum leptin level was higher in hepatitis C patients than in healthy people (SMD=0.68, 95%CI 0.44 to 0.91, P<0.000 01). The results of subgroup analysis showed that, in hepatitis C patients whose serum leptin levels detected by RIA and European population, serum leptin levels were higher. Women had higher serum leptin levels than men in hepatitis C virus patients (P<0.000 01).ConclusionThe serum leptin level is associated with hepatitis C virus and the serum leptin levels of women are higher than those in men. Due to limited quantity and quality of the included studies, more high quality studies are required to verify above conclusions.