Serum HBV DNA level at week 12 is superior to viral response at week 24 in predicting long-term treatment outcome of telbivudine for chronic hepatitis B patients / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Telbivudine, one of the five nucleos(t)ide antiviral drugs, was reported to be superior to lamivudine in a better biochemical, virological, and histological response for treatment-naive patients in the GLOBE trial. The aim of this study was to determine the antiviral potency, viral resistance, and the signifcance of early response for long-term telbivudine treatment.</p><p><b>METHODS</b>We recruited 161 patients of chronic hepatitis B (CHB) on telbivudine between January 2009 and September 2011 in Macau, China. The serum hepatitis B virus DNA levels, hepatitis B e antigen (HBeAg) seroconversion, alanine aminotransferase (ALT) normalization, and viral resistance were analyzed.</p><p><b>RESULTS</b>The median age and follow-up duration were 48 years and 16.9 months. All patients were followed up for at least 6 months, while data were collected for 132, 120, 95, and 53 patients at 12, 24, 48, and 96 weeks respectively. The cumulative HBeAg seroconversion rate was 20.8% and only three patients (1.9%) presented with telbivudine low level resistance. The ALT normalization rates were 76.9% at 48 weeks and 77.6% at 96 weeks. Undetectable HBV DNA was achieved by 1.8%, 31.6%, 60%, and 74.1% in HBeAg positive patients and 29.3%, 60.3%, 84%, and 84.6% in HBeAg negative patients at each time point. Week 12 HBV DNA level < 1000 copies/ml (< 200 IU/ml) was a better predictor of viral suppression at 2-year follow-up (P = 0.001, OR = 27.00) than undetectable HBV DNA level at week 24 (P = 0.120, OR = 4.81).</p><p><b>CONCLUSIONS</b>Two-year telbivudine treatment yielded high rates of viral suppression and ALT normalization. Serum HBV DNA level at week 12 is a superior predictor for long-term viral suppression.</p>

Effectiveness of combined therapies using two types of peginterferon and ribavirin in treating chronic hepatitis C virus genotypes 1b/6a infections / 中国医学科学院学报

<p><b>OBJECTIVE</b>To explore the effectiveness of a combined therapy using two types of peginterferon (PEG-IFN) and ribavirin in treating chronic hepatitis C virus (HCV) genotypes 1b/6a infections.</p><p><b>METHODS</b>The clinical data of 171 patients with chronic HCV genotypes 1b/6a infection in Common Hospital Centre S. Januario, Macau SAR, China, were retrospectively analyzed. Of these patients, 145 (84.8%) were infected with HCV genotype 1b and 26 (15.2%) with HCV genotype 6a. Patients were divided into two groups based on drug therapies: PEG-IFN-2b group (n=140), in which patients were treated with PEG-IFN-2b 1.5 g/kg QW plus ribavirin 800-1 200 mg/d and PEG-IFN-2a group (n=31), in which patients were treated with PEG-IFN-2a 180g QW plus ribavirin 800-1 200 mg/d. Patients was treated for 48 weeks and then followed up for 24 weeks.</p><p><b>RESULTS</b>All patients completed their therapies. The rates of early viral response (EVR) and sustained virologic response (SVR) were 78.95% and 69.59%, respectively . The two groups were not significantly different in terms of EVR P=0.091 end of treatment virological response (ETVR) (P=0.542), SVR P=0.079, relapse (P=0.497). And the two HCV genotypes patients were not significantly different in terms of EVR (P=0.268), ETVR (P=0.276), SVR (P=0.479), and relapse (P=1.000).</p><p><b>CONCLUSIONS</b>PEG-IFN combined with ribavirin can achieve high viral response in treating chronic hepatitis C. PEG-IFN-2a and PEG-IFN-2b basically are similarly effective in treating HCV genotype 1b or 6a infections.</p>

Clinical features of initial cases of 2009 pandemic influenza A (H1N1) in Macau, China / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>The first case of pandemic influenza A (H1N1) virus infection in Macau Special Administrative Region (SAR) of the People's Republic of China was documented on June 18, 2009. Subsequently, persons with suspected infection or of contact with suspected cases received screening. All the confirmed cases were hospitalized and treated with oseltamivir. Their clinical features were observed. This may help for better management for later patients and be of benefit to the government of Macau SAR to adjust its strategy to combat the pandemic influenza A (H1N1) virus infection more efficiently.</p><p><b>METHODS</b>From June to July 2009, the initial 72 cases of influenza A (H1N1) in Macau were hospitalized in Common Hospital Centre S. Januario (CHCSJ). The infection was confirmed by real-time reverse-transcriptase polymerase chain reaction (RT-PCR). The clinical features of the disease were closely observed and documented. Oseltamivir was given to all patients within 48 hours after the onset of disease and maintained for 5 days.</p><p><b>RESULTS</b>The mean age of the 72 patients was 21 years old. Forty of them were men and 32 were women. The median incubation of the virus was 2 days (1 to 7 days). The most common symptoms were fever (97.2%) and cough (77.8%). The rate of gastrointestinal symptoms including nausea, vomiting, and diarrhea was 2.8%. Fever typically lasted for 3 days (1 to 9 days). The median time from the onset to positive results of real-time RT-PCR was 6 days (3 to 13 days). After treatment with oseltamivir, most patients became afebrile within 48 hours. Only one aged patient with a history of glaucoma and hypothyroidism was found to have lung infiltration on chest X-ray.</p><p><b>CONCLUSIONS</b>The initial cases of pandemic influenza A (H1N1) virus infection in Macau SAR showed that most of the infected persons had a mild course. The virus could be detected by real-time RT-PCR within a median of 6 days from the onset. Oseltamivir was effective.</p>

Virological response of chronic hepatitis C management with peg-interferon alpha-2b and ribavirin / 中国医学科学院学报

<p><b>OBJECTIVE</b>To evaluate the virological response of managing chronic hepatitis C (CHC) with peg-interferon alpha-2b (PEG-IFN alpha-2b) and ribavirin.</p><p><b>METHODS</b>We retrospectively analyzed the virological response of 40 patients with different genotypes of hepatitis C virus (HCV) infection after anti-HCV management. Patients were given different dosages of PEG-IFN alpha-2b and ribavirin based on their weights. The duration of treatment was 48 weeks for patients infected by HCV genotype 1, and was 24 weeks for the others. HCV RNA was tested before treatment, 12 weeks post management, end of treatment, and 24 weeks after treatment stopped.</p><p><b>RESULTS</b>Data from 40 patients were collected. Among them, 24 cases experienced HCV genotype 1 infection, and 16 cases were infected with other genotypes. Between these two groups, the early virological responses were 75.0% (18/24) and 87.5% (14/16), the end-of-treatment virological responses were 80.0% (16/20) and 85.7% (12/14), and the sustained virological responses were 56.2% (9/16) and 78.5% (11/14), respectively.</p><p><b>CONCLUSION</b>Body weight-based customized PEG-IFN alpha-2b in combination with ribavirin can effectively treat patients with different genotypes of CHC.</p>