Hepatitis B virus resistance to nucleos(t)ide analogues.

Significant advances in vascular disease medical intervention since large randomized trials for asymptomatic severe carotid stenosis were conducted (1983–2003) have prompted doubt over current expectations of a surgical benefit. In this systematic review and analysis of published data it was found that rates of ipsilateral and any-territory stroke (+/−TIA), with medical intervention alone, have fallen significantly since the mid-1980s, with recent estimates overlapping those of operated patients in randomized trials. However, current medical intervention alone was estimated at least 3 to 8 times more cost-effective. In conclusion, current vascular disease medical intervention alone is now best for stroke prevention associated with asymptomatic severe carotid stenosis given this new evidence, other cardiovascular benefits, and because high-risk patients who benefit from additional carotid surgery or angioplasty/stenting cannot be identified.

Medical (nonsurgical) intervention alone is now best for prevention of stroke associated with asymptomatic severe carotid stenosis: results of a systematic review and analysis.

Hepatitis B virus infection represents a major global health problem. Currently, there are more than 240 million chronically infected people worldwide. The development of chronic hepatitis B virus-mediated liver disease may lead to liver fibrosis, cirrhosis and eventually hepatocellular carcinoma. Recently, the discovery of the viral entry receptor sodium taurocholate cotransporting polypeptide has facilitated new approaches for a better understanding of viral physiopathology. Hopefully, these novel insights may give rise to the development of more effective antiviral therapy concepts during the next years. In this review, we will discuss the natural history of hepatitis B virus infection including the viral biology, the clinical course of infection and the role of the immune response.

Natural history of chronic hepatitis B virus infection

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.21698

Antiviral drug-resistant HBV: standardization of nomenclature and assays and recommendations for management.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.23571

Serum hepatitis B surface antigen and hepatitis B e antigen titers: disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers

BACKGROUND
Chronic hepatitis B virus (HBV) infection is a major health problem for all Indigenous Australians. Post-2000, HBsAg prevalence has decreased, although remaining four times higher in Indigenous compared with non-Indigenous people.


AIMS
This study aimed to characterise the HBV from Indigenous populations in Queensland and the Torres Strait Islands.


METHODS
Serum samples were collected, with consent, from people within Queensland Indigenous communities prior to 1990 as part of the Queensland Health vaccination program. Ethics approval was subsequently obtained to further characterise the HBV from 93 of these stored samples. HBV DNA was extracted and genotype obtained from 82 samples. HBV full genome sequencing was carried out for a subset of 14 samples.


RESULTS
78 samples were identified as genotype C (2xC12, 3xC13, and 73xC14), one sample as genotype A (A2) and three samples as genotype D (1xD2, 1xD3, 1xD4). The HBV/C sequences identified were most closely related to sequences isolated from Papua New Guinea and Indonesia (Papua Province).


CONCLUSIONS
The HBV isolated from the Torres Strait Islanders was notably different to the HBV/C4 strain isolated from Indigenous people of mainland northern Australia, with no evidence of recombination. This reflects the differences in culture and origin between Torres Strait Islanders, and mainland Indigenous people. This article is protected by copyright. All rights reserved.

Molecular epidemiology of Hepatitis B among Indigenous Australians in Queensland and the Torres Strait Islands.

Load Assay in Clinical Specimens Targeted by the Abbott RealTime HBV Viral Sequence Conservation of the Region

Despite the existence of vaccines, the Hepatitis B virus (HBV) is still a serious global health concern. HBV targets liver cells. It has an unusual replication process involving an RNA pre-genome that the reverse transcriptase domain of the viral polymerase protein translates into viral DNA. The reverse transcription process is error prone and together with the high replication rates of the virus, allows the virus to exist as a heterogeneous population of mutants, known as a quasispecies, that can adapt and become resistant to antiviral therapy. This study presents an individual-based model of HBV inside an artificial liver, and associated blood serum, undergoing antiviral therapy. This model aims to provide insights into the evolution of the HBV quasispecies and the individual contribution of HBV mutations in the outcome of therapy.

Lilly Yuen

Papers

Molecular epidemiology of Hepatitis B among Indigenous Australians in Queensland and the Torres Strait Islands.

Load Assay in Clinical Specimens Targeted by the Abbott RealTime HBV Viral Sequence Conservation of the Region

Modelling Hepatitis B Virus Antiviral Therapy and Drug Resistant Mutant Strains