A Prospective Multicenter Study of the Chinese Scoring System for Hepatitis B Liver Failure.

To evaluate the clinical utility of a Chinese scoring system for hepatitis B liver failure in a prospective and multicenter study. Clinical data for 1,143 patients with hepatitis B liver failure who had been followed up for a minimum of 6 months were collected from seven liver disease centers across China. The disease severity and prognosis for the patients were predicted using the Chinese scoring system and compared to those predicted with the model for end-stage liver disease (MELD) score, MELD-Na score, and Child-Turcotte-Pugh (CTP) score.

Evaluation of changes of serum hepatitis B surface antigen from a different perspective.

Aim: To investigate the dynamic changes of serum hepatitis B surface antigen (HBsAg) levels apportioned by the same hepatic parenchyma cell volume (HPCV), namely, hepatic cell quantities.

Methods: Serum HBsAg levels were detected by electrochemiluminescence and serum HBsAg levels apportioned by the same HPCV were figured out according to the theory of sphere geometry. HBsAg levels were compared among different liver inflammation grades, as well as different hepatic fibrosis stages.

[To investigate the opportunity of entecavir treatment for HBeAg-negative acute-on-chronic liver].

Objective: To explore relations between the opportunities and effects of internal general treatment added Entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B in different score ranges of acute-on-chronic liver failure severity.

Methods: A total of 108 ACLF of HBeAg-negative chronic hepatitis B patients with different ACLF severity score were treated with internal general treatment added Entecavir. The liver failure severity scores, HBV-DNA loads during the initiation of therapy, recovery phase and in deathbed phase, courses of Entecavir administration and mortalities were studied.

Serum HBsAg level and its clinical significance in lamivudine treatment for patients with HBeAg-negative acute-on-chronic liver failure.

Objectives: To investigate the dynamics and clinical significance of hepatitis B surface antigen (HBsAg) levels in hepatitis B e antigen (HBeAg)-negative acute-on-chronic liver failure (ACLF) patients receiving lamivudine.

Methods: Fifty-nine nucleoside-naïve patients with HBeAg-negative ACLF were enrolled and treated with 100mg of lamivudine daily. The dynamics of serum levels of HBsAg and HBV DNA were analyzed at baseline and at week 12, or before death if the patient died within 12 weeks.

Pretreatment HBsAg level and an early decrease in MELD score predict prognosis to lamivudine treatment for HBeAg-negative acute-on-chronic liver failure.

Background And Objective: Few data are available about the predictability of HBsAg quantification to nucleos(t)ide analogues treatment in acute-on-chronic liver failure (ACLF). The aim of this study was to investigate HBsAg level combined with the model for end-stage liver disease (MELD) score for predicting prognosis to lamivudine monotherapy in HBeAg-negative ACLF.

Methods: Fifty-seven nucleoside-naïve patients with HBeAg-negative ACLF were treated with 100mg of lamivudine daily.

Influence of chronic HBV infection on superimposed acute hepatitis E.

Aim: To investigate the influence of chronic hepatitis B virus (HBV) infection [based on the status of hepatitis B e antigen (HBeAg), HBV DNA, and cirrhosis] on superimposed acute hepatitis E.

Methods: A total of 294 patients were recruited from the Department of Infectious Diseases of the Third Affiliated Hospital, Sun Yat-sen University, from January 2003 to January 2012. The patients were classified into two groups: an HBV + hepatitis E virus (HEV) group (a group with chronic HBV infection that was superinfected with acute hepatitis E, n = 118) and an HEV group (a group with acute hepatitis E, n = 176).

[Dynamic change of hepatitis B surface antigen expression in chronic hepatitis B patients during the natural recovery course and the short-term antivirus treatment].

Objective: To investigate the dynamic quantitative changes in expression of hepatitis B virus (HBV) surface antigen (HBsAg) that occurs during the natural recovery course and the short-term antivirus treatment period of patients suffering from flares in chronic hepatitis B (CHB).

Methods: CHB patients presenting for treatment of flare-ups were randomly assigned to receive treatment with Entecavir antiviral (group A, n = 39) or to naturally resolve the acute condition (group B, n = 22). All patients MELD scores were calculated and HBsAg levels and HBV DNA loads were measured upon admission (baseline), at worst-condition stage, and end of treatment/flare-up (discharge).

Short-term entecavir versus lamivudine therapy for HBeAg-negative patients with acute-on-chronic hepatitis B liver failure.

Background: Selection of drugs for antiviral therapy of patients with hepatitis B virus (HBV)-related acute-on-chronic liver failure (ACLF) remains difficult. This study was undertaken to evaluate the short-term efficacy of entecavir versus lamivudine on hepatitis B e antigen (HBeAg)-negative patients with ACLF.

Methods: The data of 182 HBeAg-negative patients with ACLF were retrospectively collected from patient profiles of the hospital.

[Dynamic expression profile of HBsAg according to hepatic parenchyma cells' volume at different liver fibrosis stages in the immune clearance phase].

The aim of this study was to determine the dynamic expression profile of hepatitis B surface antigen (HBsAg) according to hepatic parenchyma cells' volume at different stages of liver fibrosis during the immune clearance phase. Eighty-nine patients with HBeAg-positive chronic hepatitis B (CHB) in the immune clearance stage were recruited for study. Each patient's serum HBsAg levels were detected by electrochemiluminescence.

[Dynamics of serum HBV DNA levels during the terminal phases of acute-on-chronic hepatitis B liver failure with different HBeAg status].

Objective: To investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.

Methods: One-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges, representing increasing severity of disease phases prior to death (day 0): 29-56 d, 15-28 d, and 0-14 d.

Results: In the 37 HBeAg(+) patients, HBV DNA levels at above-mentioned phases were 6.

A Novel prognostic scoring system to predict 3-month mortality risk in patients with acute-on-chronic liver failure in hepatitis B: a retrospective cohort study.

Purpose: The present study was done to establish an objective, sensitive prognostic scoring system and to determine the applicability of this model in predicting the 3-month mortality of patients with acute-on-chronic liver failure in hepatitis B (ACLFB).

Methods: We developed a novel prognostic scoring system, calculated from six clinical indices including serum total bilirubin, prothrombin activity, serum creatinine, hepatic encephalopathy, infections, and the depth of ascites from 499 patients with ACLFB. Differences in the sensitivity, specificity, and practicality of a Novel prognostic scoring system and the model of end-stage liver disease (MELD) were analyzed.

What MELD score mandates use of entecavir for ACLF-HBV HBeAg-negative patients?

Aim: To investigate optimal timing for therapeutic efficacy of entecavir for acute-on-chronic hepatitis B liver failure (ACLF-HBV) in hepatitis B e antigen (HBeAg)-negative patients.

Methods: A total of 109 inpatients with ACLF-HBV were recruited from the Department of Infectious Diseases of the Third Affiliated Hospital, Sun Yat-sen University from October 2007 to October 2010. Entecavir 0.

[The relationship of HBeAg status with HBV DNA loads, MELD scores in patients with acute-on-chronic hepatitis B liver failure during terminal phases].

Objective: To investigate the relationship and clinical significances of HBeAg status with serum HBV DNA loads, model for end-stage liver disease (MELD) scores in patients with acute-on-chronic hepatitis B liver failure during terminal phase.

Methods: 120 fatal patients were enrolled. At three phases of 0 -14 d, 15-28 d and 29-90 d before death, they were detected serum HBeAg, HBV DNA loads order meanwhile MELD scores were calculated.

[Discussion on the meaning of MELD score in the opportunity of the entecavir treatment of HBeAg-negative acute-on-chronic liver failure].

Objective: To explore the opportunity and effect of internal general treatment added entecavir on acute-on-chronic liver failure (ACLF) of HBeAg-negative chronic hepatitis B patients in different ranges of MELD score.

Methods: A total of 101 ACLF of HBeAg-negative chronic hepatitis B patients treated with internal general treatment added entecavir were divided into three groups according to the MELD score. The mortalities and HBV DNA loads during the initiation of therapy, recovery phase and in deathbed phase were studied.

Development of a sensitive prognostic scoring system for the evaluation of severity of acute-on-chronic hepatitis B liver failure: a retrospective cohort study.

Purpose: The purpose of the current study was to establish an objective, simple, and sensitive prognostic scoring system for estimating the severity of acute-on-chronic liver failure in hepatitis B (ACLFB).

Methods: A novel prognostic scoring system was calculated from six clinical indices including total bilirubin (TB), prothrombin activity (PTA), creatinine (Cr), hepatic encephalopathy (HE), infections, and the depth of ascites from 726 patients with ACLFB. Indices were scored from 1 to 4 according to their severity.

Collagen proportionate area of liver tissue determined by digital image analysis in patients with HBV-related decompensated cirrhosis.

Background: The accurate assessment of the degree of hepatic fibrosis plays a critical role in guiding the diagnosis, treatment and prognostic assessment of chronic liver diseases. Liver biopsy is currently the most reliable method to evaluate the severity of hepatic fibrosis. However, liver biopsy is an invasive procedure associated with morbidity and mortality, and has several limitations in patients with decompensated cirrhosis.

[A simple scoring system to evaluate the severity of acute-on-chronic liver failure in hepatitis B].

Objective: To establish an objective, simple and sensitive scoring system to evaluate the severity of acute-on-chronic liver failure in hepatitis B.

Methods: The clinical data of patients (194 survivals and 215 deaths) with acute-on-chronic liver failure in hepatitis B were collected and analyzed prospectively. 7 clinical indexes, including the hepatic encephalopathy, creatinine, prothrombin activity, serum total bilirubin, infection, the dimension of liver, the maximum depth of ascites, were scored objectively and simply from 0 to 4 points according to their severity.

[Association between the serum HBV DNA loads normalized to hepatic parenchyma cell volume and the liver histopathologic inflammation gradings in the immune clearance phase].

Objective: To investigate the relationship between the serum HBV DNA loads normalized to hepatic parenchyma cell volume and the liver histopathologic inflammation gradings in the immune clearance phase during the natural history of hepatitis B.

Methods: Serum HBV DNA loads were detected by fluorescence polymerase chain reaction and normalized to hepatic parenchyma cell volume. The association between normalized HBV DNA loads and liver inflammation histopathologic grade were analyzed.

[Correlation of genetic polymorphisms of beta-catenin to hepatitis B virus-related hepatocellular carcinoma].

Background And Objective: Wnt signaling pathway plays an important role in the carcinogenesis of hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). beta-catenin protein is a pivotal regulator in the pathway. Genetic mutation has been observed in the codons 32-45 at exon 3 of beta-catenin gene in HCC tissues.

Decline of serum HBV DNA and no change apportioned by the same hepatic parenchyma cell volume from hepatic fibrosis stage 1 to stage 4 during the natural history of chronic hepatitis B.

During the initial phase of chronic hepatitis B virus (HBV) infection, serum HBV DNA levels are high. Contrarily, fibrosis, cirrhosis and hepatocellular carcinoma have been found in patients with lower serum HBV DNA levels. The aim of this study is to clarify HBV DNA level dynamics of serum apportioned by the same hepatic parenchyma cell volume (HPCV) in hepatic fibrosis stages 1-4 during the natural history of chronic hepatitis B.

Portalsystemic hemodynamic changes in chronic severe hepatitis B: An ultrasonographic study.

Aim: To evaluate portalsystemic hemodynamic changes in chronic severe hepatitis B.

Methods: Hemodynamic parameters included portal vein diameter (PVD), portal vein peak velocity (PVPV), portal vein volume (PVV), spleen length (SPL), spleen vein diameter (SPVD), spleen vein volume (SPVV) and umbilical vein recanalization. They were measured by Color Doppler ultrasonography in 36 patients with chronic severe hepatitis B, compared with 51 normal controls, 61 patients with chronic hepatitis B, 46 patients with compensable cirrhosis, and 36 patients with decompensable cirrhosis.

Etiological investigation of fatal liver failure during the course of chronic hepatitis B in southeast China.

Background: The purpose of this study was to clarify the relationships between patients who had fatal liver failure during the course of chronic hepatitis B and those who were also superinfected with hepatitis A, C, D, or E virus, as well as their hepatitis B virus e system status, so that suitable measures could be adopted to decrease the mortality of patients with chronic hepatitis B.

Methods: This study detected superinfections of hepatitis A, C, D, or E virus and the hepatitis B virus e system status in cases of fatal liver failure during the course of chronic hepatitis B by enzyme-lined immunosorbent assay.

Results: The frequency of superinfections of hepatitis A, C, D, and E virus was 1.

[Relationship between fatal severe from hepatitis occurred during chronic hepatitis B and superinfections of hepatotropic B e system status].

Objective: To clarify the relationship between fatal severe form hepatitis occurred during chronic hepatitis B and superinfections of hepatitis A, C, D or E virus as well as hepatitis B e system status and to adopt corresponding measures to reduce the mortality of chronic hepatitis B.

Methods: This study detected the superinfections with hepatitis A, C, D or E virus and hepatitis B e system status in 219 patients with fatal severe form hepatitis occurred during chronic hepatitis B by enzyme linked immunosorbent assay.

Results: The superinfections with hepatitis A, C, D or E virus were found in 1.

Discriminant function for prognostic indexes and probability of death in chronic severe hepatitis B.

Background: We aimed to determine a discriminant function for prognosis in chronic severe hepatitis B (CSHB), by discriminant analysis of prognostic indexes and probability of death.

Methods: In 205 patients with chronic severe hepatitis B (101 patients in the survival group and 104 patients in the death group), we carried out discriminant analysis of serum total bilirubin, prothrombin activity, white blood cells, creatinine, maximum depth of ascites, hepatic encephalopathy, singultus, and digestive tract hemorrhage.

Results: The discriminant function was V=0.