The natural history and clinical features of nonalcoholic fatty liver disease-related cirrhosis / 临床肝胆病杂志

Nonalcoholic fatty liver disease (NAFLD) is a type of metabolic liver injury closely associated with insulin resistance and genetic susceptibility and includes nonalcoholic simple fatty liver, nonalcoholic steatohepatitis, liver cirrhosis, and hepatocellular carcinoma. It has become an important public health issue nowadays. This article elaborates on the unique natural history of NAFLD and the clinical features of NAFLD-related cirrhosis. Further research on the progression of NAFLD-related cirrhosis is needed in the future to prevent the progression to liver cirrhosis, reduce liver-related death events, and relieve the economic burden for public health.

Kinetics of serum HBsAg in Chinese patients with chronic HBV infection with long-term adefovir dipivoxil treatment / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Knowledge on Hepatitis B surface antigen (HBsAg) kinetics in chronic hepatitis B (CHB) patients with long-term adefovir dipivoxil (ADV) treatment is limited. The aims of this study were to investigate HBsAg kinetics in patients with chronic hepatitis B virus (HBV) infection treated with long-term ADV and to evaluate different characteristics between patients with and without HBsAg loss.</p><p><b>METHODS</b>We retrospectively evaluated HBsAg kinetics in 24 Chinese patients with chronic HBV infection who achieved continuous virologic suppression during ADV therapy. HBV genotype was determined at baseline. Liver biochemistry, hepatitis B e antigen status, serum HBV DNA, and HBsAg levels were measured at baseline, 6 months, and once every year thereafter.</p><p><b>RESULTS</b>Of these 24 patients, 3, 1, and 20 patients were followed up for 3, 5, and 6 years, respectively. Baseline serum HBsAg level had a moderate correlation with baseline HBV DNA level (r = 0.52, P = 0.01). The median rate of HBsAg reduction during the therapy period was 0.08 lg IU × ml(-1) × y(-1). Baseline serum HBsAg level was significantly higher than other time points (P ranges from 0.046 to 0.002). The HBsAg reduction rate during the first year was similar to that in other years (P > 0.05). The HBsAg reduction rate during the first year in patients with eventual HBsAg loss was significantly faster than that in patients without HBsAg loss (P = 0.005).</p><p><b>CONCLUSIONS</b>Serum HBsAg levels in Chinese CHB patients receiving long-term ADV demonstrated a gradual reduction. Patients with eventual HBsAg loss had a significantly faster HBsAg reduction rate during the first year than those without HBsAg loss.</p>