EASL-EORTC clinical practice guidelines : management of hepatocellular carcinoma

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.29800

Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance

This review article examines the structure and replication cycle of hepatitis B virus and discusses the natural history of primary infection, the mechanisms of clearance of the virus, and reasons for persistent infection. It concludes with a discussion of what we know about the virus and how it causes hepatitis and the implications for treatment.

http://zeus.colsanitas.com/manual_referencia/archivos/Hepatitis%20B%20Virus%20Infection%20%20Natural%20History%20and%20Clinical%20Consequences.pdf

Hepatitis B Virus Infection — Natural History and Clinical Consequences

EVOLUTION: Of Mice . . .

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

/pdf/asian-pacific-clinical-practice-guidelines-on-the-management-za5qxgu5i6.pdf

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.

Background
The human gut microbiota has profound influence on host metabolism and immunity. This study characterized the fecal microbiota in patients with nonalcoholic steatohepatitis (NASH). The relationship between microbiota changes and changes in hepatic steatosis was also studied.

/pdf/molecular-characterization-of-the-fecal-microbiota-in-xvljuud0ht.pdf

Molecular Characterization of the Fecal Microbiota in Patients with Nonalcoholic Steatohepatitis – A Longitudinal Study

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.23803

A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B.

Viral genotype and hepatitis B virus DNA levels are correlated with histological liver damage in HBeAg-negative chronic hepatitis B virus infection.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.26739

On‐treatment alpha‐fetoprotein is a specific tumor marker for hepatocellular carcinoma in patients with chronic hepatitis B receiving entecavir

Background. We studied whether quantification of serum HBsAg and HBV DNA levels could predict spontaneous HBsAg clearance in patients with negative hepatitis B e antigen (HBeAg). Methods. Serum HBsAg and HBV DNA levels were measured at baseline among a longitudinal cohort of 103 HBeAg-negative patients recruited since 1997. Results. Twelve (12%) patients developed HBsAg seroclearance after 88 6 26 months (range, 21–139) of followup. At baseline, the serum HBsAg level among patients who cleared HBsAg (1.30 6 1.27 log IU/mL) was significantly lower than those who did not clear HBsAg (2.96 6 0.84 log IU/mL; P , .001). The area under receiver operating characteristics (ROC) curve for serum HBsAg to predict HBsAg seroclearance was 0.90 (95% confidence interval [CI], 0.83–0.97; P , .001). Nine (75%) of 12 patients who had HBsAg seroclearance versus 8 (9%) of 91 who remained HBsAg-positive had serum HBsAg #100 IU/mL at the baseline (P , .001). An HBsAg cutoff of #100 IU/mL had 75% sensitivity and 91% specificity to predict HBsAg seroclearance. Baseline serum HBV DNA could not predict HBsAg seroclearance; the area under ROC curve was 0.64 (95% CI, 0.46–0.81; P 5 .13). Conclusions. Single-point serum HBsAg level can predict the chance of HBsAg seroclearance in chronic hepatitis B patients with negative HBeAg.

/pdf/viral-determinants-of-hepatitis-b-surface-antigen-zizph3rmlm.pdf

Chi-Hang Tse

Papers

Molecular Characterization of the Fecal Microbiota in Patients with Nonalcoholic Steatohepatitis – A Longitudinal Study

A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B.

Viral genotype and hepatitis B virus DNA levels are correlated with histological liver damage in HBeAg-negative chronic hepatitis B virus infection.

On‐treatment alpha‐fetoprotein is a specific tumor marker for hepatocellular carcinoma in patients with chronic hepatitis B receiving entecavir

Viral Determinants of Hepatitis B Surface Antigen Seroclearance in Hepatitis B e Antigen–Negative Chronic Hepatitis B Patients