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World Journal of Hepatology 2024年第3期16卷 465-476页

作者： Shi-Yi Liu Dian Wang Jing Liu Lu-Ping Yang Gong-Ying Chen Department of Medicine Zhejiang Chinese Medical UniversityHangzhou 310053Zhejiang ProvinceChina Department of Medicine Hangzhou Normal UniversityHangzhou 310011Zhejiang ProvinceChina Department of Infectious and Hepatology Diseases Affiliated Hospital of Hangzhou Normal UniversityHangzhou 310015Zhejiang ProvinceChina

BACKGROUND Although hepatitis B virus infection is the leading cause of chronic liver injury globally,nonalcoholic fatty liver disease(NAFLD)is gradually gaining attention as another major chronic liver disease.The number of patients having chronic hepatitis B(CHB)with concomitant hepatic steatosis has increased.AIM To analyze the effect of NAFLD on the response to antiviral treatment in patients with CHB.METHODS Relevant English studies were systematically searched across PubMed,EMBASE,Web of Science,and Cochrane Library until October 2023.Studies in which the treatment outcomes were compared between patients with CHB only and those with CHB and hepatic steatosis were included.RESULTS Of the 2502 retrieved studies,11 articles were finally included.Biochemical response until 48 wk(OR=0.87,95%CI:0.50–1.53,P=0.000)and 96 wk(OR=0.35,95%CI:0.24–0.53,P=0.24)and virological response until 96 wk(OR=0.80,95%CI:0.43–1.49,P=0.097)were lower in patients with hepatic steatosis than in patients with CHB alone.CONCLUSION Hepatic steatosis lowers the biochemical response to antiviral treatment in patients with CHB.

关键词： Nonalcoholic fatty liver disease Hepatitis B virus antiviral treatment effect Meta-analysis

Predicting hepatocellular carcinoma: A new non-invasive model based on shear wave elastography

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World Journal of Gastroenterology 2024年第25期30卷 3166-3178页

作者： Dong Jiang Yi Qian Yi-Jun Gu Ru Wang Hua Yu Hui Dong Dong-Yu Chen Yan Chen Hao-Zheng Jiang Bi-Bo Tan Min Peng Yi-Ran Li Department of Ultrasound Eastern Hepatobiliary Surgery HospitalThe Third Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of Pathology Shanghai Eastern Hepatobiliary Surgery HospitalThird Affiliated Hospital of Naval Medical UniversityShanghai 200433China Department of College of Art and Science Case Western Reserve UniversityClevelandOH 44106United States Ultrasound Diagnosis PLA Naval Medical CenterShanghai 200437China

BACKGROUND Integrating conventional ultrasound features with 2D shear wave elastography(2D-SWE)can potentially enhance preoperative hepatocellular carcinoma(HCC)predictions.AIM To develop a 2D-SWE-based predictive model for preoperative identification of HCC.METHODS A retrospective analysis of 884 patients who underwent liver resection and pathology evaluation from February 2021 to August 2023 was conducted at the Oriental Hepatobiliary Surgery Hospital.The patients were divided into the modeling group(n=720)and the control group(n=164).The study included conventional ultrasound,2D-SWE,and preoperative laboratory tests.Multiple logistic regression was used to identify independent predictive factors for RESULTS In the modeling group analysis,maximal elasticity(Emax)of tumors and their peripheries,platelet count,cirrhosis,and blood flow were independent risk indicators for malignancies.These factors yielded an area under the curve of 0.77(95%confidence interval:0.73-0.81)with 84%sensitivity and 61%specificity.The model demonstrated good calibration in both the construction and validation cohorts,as shown by the calibration graph and Hosmer-Lemeshow test(P=0.683 and P=0.658,respectively).Additionally,the mean elasticity(Emean)of the tumor periphery was identified as a risk factor for microvascular invasion(MVI)in malignant liver tumors(P=0.003).Patients receiving antiviral treatment differed significantly in platelet count(P=0.002),Emax of tumors(P=0.033),Emean of tumors(P=0.042),Emax at tumor periphery(Pantiviral treatment efficacy.

关键词： Shear wave elastography Predicting model Microvascular invasion antiviral treatment Hepatocellular carcinoma

Influence of weight management on the prognosis of steatohepatitis in chronic hepatitis B patients during antiviral treatment

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Hepatobiliary & Pancreatic Diseases International 2021年第5期20卷 416-425页

作者： Xiu-Juan Chang Yi-Wen Shi Jing Wang Hua-Bao Liu Yan Chen Xiao-Ning Zhu Yong-Ping Chen Zu-Jiang Yu Qing-Hua Shang Lin Tan Qin Li Li Jiang Guang-Ming Xiao Liang Chen Wei Lu Xiao-Yu Hu Qing-Hua Long Lin-Jing An Zi-Yuan Zou Vincent Wai-Sun Wong Yong-Ping Yang Jian-Gao Fan Department of Liver Disease Chinese PLA General Hospitalthe Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China Center for Fatty Liver Department of GastroenterologyXinhua Hospital Affiliated to Shanghai Jiao Tong University School of MedicineShanghai Key Lab of Pediatric Gastroenterology and NutritionShanghai 200092China Department of Liver Disease Affiliated Traditional Chinese Medicine Hospital of Southwest Medical UniversityLuzhou 610072China Department of Liver Diseases Traditional Chinese Medicine Hospital of ChongqingChongqing 400038China Department of Infectious and Liver Diseases Liver Research Centerthe First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000China Department of Infectious Disease the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052China Center of Therapeutic Liver Disease the 960th Hospital of Chinese PLATaian 271000China Liver Disease Department Fuyang 2nd People's HospitalFuyang 236015China Department of Liver Diseases Fuzhou Infectious Diseases HospitalFuzhou 350025China Department of Infectious Diseases Southwest HospitalArmy Military Medical UniversityChongqing 400038China Department of Infectious Diseases Guangzhou 8th People’s HospitalGuangzhou 510060China Department of Hepatic Diseases Shanghai Public Health Clinical CenterShanghai 201508China Department of Liver Diseases Tianjin Second People’s HospitalTianjin Institute of HepatologyTianjin 300192China National Integrative Medicine Clinical Base for Infectious Diseases and Department of Infectious Diseases Affiliated Hospital of Chengdu University of Traditional Chinese MedicineChengdu 610000China Department of Infection and Liver Disease Yichun People’s HospitalYichun 336028China Department of Medicine and Therapeutics The Chinese University of Hong KongHong KongChina

Background:Although concomitant nonalcoholic steatohepatitis(NASH)is common in chronic hepatitis B(CHB),the impact of viral factors on NASH and the outcome of CHB patients concomitant with NASH remain unclear.We aimed to investigate the outcomes of NASH in CHB patients receiving antiviral treatment.Methods:In the post-hoc analysis of a multicenter trial,na?ve CHB patients receiving 72-week entecavir treatment were enrolled.We evaluated the biochemical,viral and histopathological responses of these patients.The histopathological features of NASH were also evaluated,using paired liver biopsies at baseline and week 72.Results:A total of 1000 CHB patients were finally enrolled for analysis,with 18.2%of whom fulfilling the criteria of NASH.A total of 727 patients completed entecavir antiviral treatment and received the second biopsy.Serum HBe Ag loss,HBe Ag seroconversion and HBV-DNA undetectable rates were similar between patients with or without NASH(P>0.05).Among patients with NASH,the hepatic steatosis,ballooning,lobular inflammation scores and fibrosis stages all improved during follow-up(all Pantiviral treatment deserves further evaluation.

关键词： Nonalcoholic steatohepatitis Hepatitis B NASH resolution antiviral treatment Weight management

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World Journal of Gastroenterology 2020年第22期26卷 2931-2947页

作者： Tea L Laursen Thomas D Sandahl Konstantin Kazankov Jacob George Henning Gronbæk Department of Hepatology and Gastroenterology Aarhus University HospitalAarhus N DK-8200Denmark Storr Liver Centre Westmead Institute for Medical ResearchWestmead HospitalSydney NSW 2145Australia University of Sydney Sydney NSW 2145Australia

More than five years ago,the treatment of hepatitis C virus infection was revolutionized with the introduction of all-oral direct-acting antiviral(DAA)drugs.They proved highly efficient in curing patients with chronic hepatitis C(CHC),including patients with cirrhosis.The new DAA treatments were alleged to induce significant improvements in clinical outcome and prognosis,but the exact cause of the expected benefit was unclear.Further,little was known about how the underlying liver disease would be affected during and after viral clearance.In this review,we describe and discuss the liver-related effects of the new treatments in regards to both pathophysiological aspects,such as macrophage activation,and the time-dependent effects of therapy,with specific emphasis on inflammation,structural liver changes,and liver function,as these factors are all related to morbidity and mortality in CHC patients.It seems clear that antiviral therapy,especially the achievement of a sustained virologic response has several beneficial effects on liver-related parameters in CHC patients with advanced liver fibrosis or cirrhosis.There seems to be a timedependent effect of DAA therapy with viral clearance and the resolution of liver inflammation followed by more discrete changes in structural liver lesions.These improvements lead to favorable effects on liver function,followed by an improvement in cognitive dysfunction and portal hypertension.Overall,the data provide knowledge on the several beneficial effects of DAA therapy on liverrelated parameters in CHC patients suggesting short-and long-term improvements in the underlying disease with the promise of an improved longterm prognosis.

关键词： Chronic hepatitis C antiviral treatment Inflammation Liver fibrosis Liver cirrhosis Metabolic liver function Galactose elimination capacity Urea synthesis capacity Portal hypertension Hepatic encephalopathy

Traditional Chinese medicine in antiviral treatment

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TMR Integrative Medicine 2020年第14期4卷 1-8页

作者： Hua Wang Qin Wang Jia-Yu Chen Guo-Juan Shi Lin-Wei Chen Taizhou Hospital Affiliated to Nanjing University of Chinese Medicine Taizhou 225300China

The Novel Coronavirus(COVID-19),which broke out in Wuhan,China in December 2019,attracted worldwide attention.With a long incubation period and strong infectiousness,COVID-19 poses a great threat to the life and health worldwide with high incidence,high pathogenicity and low sensitivity to antibiotics.At present,there are less kinds of antiviral drugs,including rimantadine hydiochloride,acyclovir,interferon,zidovudine,ribavirin,etc.,which maybe lead to severe adverse reactions of the nervous system,hematopoietic system,liver and kidney system,as well as side effects such as nausea,vomiting,upper abdominal discomfort and diarrhea.Meanwhile,the development of antiviral drugs requires huge investment and time,the development of effective antiviral drugs and vaccine lags far behind the rapidly developed disease.Traditional Chinese medicine has played an important role against the infection,especially in the fight against severe acute respiratory syndrome,H1N1 influenza,H7N9 flu virus,middle east respiratory syndrome and Ebola virus infection.In this paper,the classification,mechanism,existing problems and the prospect of traditional Chinese medicine in antiviral treatment has been summarized in order to provide certain reference for the research and prescription screening of traditional Chinese medicine anti-COVID-19 drugs.

关键词： Traditional Chinese medicine antiviral treatment Mechanism Research status Prospect

2014 update of the Chinese guidelines for diagnosis and treatment of avian influenza A（H7N9） virus infection

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Chinese Medical Journal 2014年第13期127卷 2543-2547页

作者： Shen Yinzhong Lu Hongzhou Department of Infectious Diseases Shanghai Public Health ClinicalCenter Fudan University Shanghai 201508 China

The National Health and Family Planning Commission of China published an updated guidance （2014 version） on clinical management in Chinese on January 26, 2014.The guidelines come as human cases of avian influenza A... 详细信息

关键词： avian influenza A（H7N9） virus diagnosis antiviral treatment guideline

Prolonged SARS-CoV-2 Viral Shedding in Patients with COVID-19 was Associated with Delayed Initiation of Arbidol treatment and Consulting Doctor Later: A Retrospective Cohort Study

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Current Medical Science 2021年第6期41卷 1096-1104页

作者： Xin-liang HE Ya-ya ZHOU Wei FU Yu-e XUE Meng-yuan LIANG Bo-han YANG Wan-li MA Qiong ZHOU Long CHEN Jian-chu ZHANG Xiao-rong WANG Department of Respiratory and Critical Care Medicine Union HospitalTongji Medical CollegeHuazhong University of Science and TechnologyWuhan 430022China

Objective:To study data about SARS-CoV-2 virus shedding and clarify the risk factors for prolonged virus shedding.Methods:Data were retrospectively collected from adults hospitalized with laboratory-confirmed coronavirus disease-19(COVID-19)in Wuhan Union Hospital.We compared clinical features among patients with prolonged(a positive SARS-CoV-2 RNA on day 23 after illness onset)and short virus shedding and evaluated risk factors associated with prolonged virus shedding by multivariate regression analysis.Results:Among 238 patients,the median age was 55.5 years,57.1%were female,92.9%(221/238)were administered with arbidol,58.4%(139/238)were given arbidol in combination with interferon.The median duration of SARS-CoV-2 virus shedding was 23 days(IQR,17.8-30 days)with a longest one of 51 days.The patients with prolonged virus shedding had higher value of D-dimer(P=0.002),IL-6(P<0.001),CRP(P=0.005)and more lobes lung lesion(P=0.014)on admission,as well as older age(P=0.017)and more patients with hypertension(P=0.044)than in those the virus shedding less than 23 days.Multivariate regression analysis revealed that prolonged viral shedding was significantly associated with initiation arbidol≥8 days after symptom onset[OR:2.447,95%CI(1.351-4.431)],≥3 days from onset of symptoms to first medical visitation[OR:1.880,95%CI(1.035-3.416)],illness onset before Jan.31,2020[OR:3.289,95%CI(1.474-7.337)].Arbidol in combination with interferon was also significantly associated with shorter virus shedding[OR:0.363,95%CI(0.191-0.690)].Conclusion:Duration of SARS-CoV-2 virus shedding was long.Early initiation of arbidol and arbidol in combination with interferon as well as consulting doctor timely after illness onset were helpful for SARS-CoV-2 clearance.

关键词： SARS-CoV-2 viral shedding risk factors antiviral treatment arbidol

Chronic hepatitis B in pregnant women: Current trends and approaches

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World Journal of Gastroenterology 2021年第23期27卷 3279-3289页

作者： Maria Belopolskaya Viktor Avrutin Olga Kalinina Alexander Dmitriev Denis Gusev Polyclinical Department Botkin's Infectious Disease HospitalSt-Petersburg 195067Russia Chronic Viral Infectious Disease Lab Institute of Experimental MedicineSt-Petersburg 197376Russia Institute for Systems Theory University of StuttgartStuttgart 70569Baden-WurttembergGermany Faculty of Biomedical Sciences Almazov National Medical Research CentreSt-Petersburg 197341Russia Department of Molecular Microbiology Institute of Experimental MedicineSt-Petersburg 197376Russia Botkin's Infectious Disease Hospital St-Petersburg 195067Russia

Chronic hepatitis B(CHB)is a significant public health problem worldwide.The aim of the present review is to summarize the actual trends in the management of CHB in pregnant women.The prevalence of hepatitis B virus(HBV)infection in pregnant women is usually comparable to that in the general population in the corresponding geographic area.All women have to be screened for hepatitis B surface antigen(HBsAg)during pregnancy.Additional examinations of pregnant women with CHB may include maternal hepatitis B e antigen,HBV viral load,alanine aminotransferase level,and HBsAg level.The management of pregnancy depends on the phase of the HBV infection,which has to be determined before pregnancy.In women of childbearing age with CHB,antiviral therapy can pursue two main goals:treatment of active CHB,and vertical transmission prevention.During pregnancy,tenofovir is the drug of choice in both cases.A combination of hepatitis B immunoglobulin and vaccine against hepatitis B should be administered within the first 12 h to all infants born to mothers with CHB.In such cases,there are no contraindications to breastfeeding.

关键词： Chronic hepatitis B Hepatitis B viral load Pregnancy antiviral treatment Newborns Mother-to-child transmission

HIV screening and retention in care in people who use drugs in Madrid, Spain: a prospective study

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Infectious Diseases of Poverty 2021年第4期10卷 77-85页

作者： Pablo Ryan Jorge Valencia Guillermo Cuevas Jesus Troya Juan Torres-Macho Maria Jose Munoz-Gomez Nuria Munoz-Rivas Isabel Canorea Sonia Vazquez-Moron Salvador Resino Hospital Universitario Infanta Leonor MadridSpain Universidad Complute nse de Madrid(UCM) MadridSpain Instituto de Investigacion Sanitaria Gregorio Maranon(liSGM) MadridSpain Unidad de Reduccion de Darios"SMASD"Madrid Spain Unidad de Infeccion Viral e Inmunidad Centro Nacional de MicrobiologiaInstituto de Salud Carlos IIICarretera Majada-honda-PozueloKm 2.228220 MajadahondaMadridSpain

Background::The burden of human immunodeficiency virus(HIV)infection in people who use drugs(PWUD)is significant.We aimed to screen HIV infection among PWUD and describe their retention in HIV care.Besides,we also screen for hepatitis C virus(HCV)infection among HIV-seropositive PWUD and describe their linkage to care.Methods::We conducted a prospective study in 529 PWUD who visited the"Ca?ada Real Galiana"(Madrid,Spain).The study period was from June 1,2017,to May 31,2018.HIV diagnosis was performed with a rapid antibody screening test at the point-of-care(POC)and HCV diagnosis with immunoassay and PCR tests on dried blood spot(DBS)in a central laboratory.Positive PWUD were referred to the hospital.We used the Chi-square or Fisher’s exact tests,as appropriate,to compare rates between groups.Results::Thirty-five(6.6%)participants were positive HIV antibodies,but 34 reported previous HIV diagnoses,and 27(76%)had prior antiretroviral therapy.Among patients with a positive HIV antibody test,we also found a higher prevalence of homeless(P<0.001)and injection drug use(PWID)(P<0.001),and more decades of drug use(P=0.002).All participants received HIV test results at the POC.Of the 35 HIV positives,28(80%)were retained in HIV medical care at the end of the HIV screening study(2018),and only 22(62.9%)at the end of 2020.Moreover,12/35(34.3%)were positive for the HCV RNA test.Of the latter,10/12(83.3%)were contacted to deliver the HCV results test(delivery time of 19 days),5/12(41.7%)had an appointment and were attended at the hospital and started HCV therapy,and only 4/12(33.3%)cleared HCV.Conclusions::We found almost no new HIV-infected PWUD,but their cascade of HIV care was low and remains a challenge in this population at risk.The high frequency of active hepatitis C in HIV-infected PWUD reflects the need for HCV screening and reinforcing the link to care.

关键词： HIV Point-of-care Screening People who use drugs Retention in care Hepatitis C Dried blood spot antiviral treatment

Genotype 3-hepatitis C virus’last line of defense

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World Journal of Gastroenterology 2021年第11期27卷 1006-1021页

作者： Dorota Zarębska-Michaluk Department of Infectious Diseases Jan Kochanowski UniversityKielce 25-369ŚwiętokrzyskiePoland

Chronic infection with hepatitis C virus(HCV)is one of the leading causes of liver disease globally,affecting approximately 71 million people.The majority of them are infected with genotype(GT)1 but infections with GT3 are second in frequency.For many years,GT3 was considered to be less pathogenic compared to other GTs in the HCV family due to its favorable response to interferon(IFN)-based regimen.However,the growing evidence of a higher rate of steatosis,more rapid progression of liver fibrosis,and lower efficacy of antiviral treatment compared to infection with other HCV GTs has changed this conviction.This review presents the specifics of the course of GT3 infection and the development of therapeutic options for GT3-infected patients in the era of direct-acting antivirals(DAA).The way from a standard of care therapy with pegylated IFNalpha(pegIFNα)and ribavirin(RBV)through a triple combination of pegIFNα+RBV and DAA to the highly potent IFN-free pangenotypic DAA regimens is discussed along with some treatment options which appeared to be dead ends.Although the implementation of highly effective pangenotypic regimens is the most recent stage of revolution in the treatment of GT3 infection,there is still room for improvement,especially in patients with liver cirrhosis and those who fail to respond to DAA therapies,particularly those containing inhibitors of HCV nonstructural protein 5A.

关键词： Hepatitis C virus Genotype 3 antiviral treatment Interferon Direct-acting antivirals Pangenotypic