Rapidly decreased HBV RNA predicts responses of pegylated interferons in HBeAg-positive patients: a longitudinal cohort study.

BACKGROUND: As an important anti-HBV drug, pegylated interferon α (PegIFNα) offers promising clinical efficacy, but biomarkers that accurately forecast treatment responses are yet to be elucidated. Here, we evaluated whether HBV RNA could act as an early monitor of pegylated interferon responses. METHODS: We analyzed a phase 3, multicenter, randomized cohort of 727 HBeAg-positive non-cirrhotic patients receiving a 48-week treatment of PegIFNα-2a or PegIFNα-2b and a 24-week treatment-free follow-up. Serum levels of HBV RNA, HBV DNA, HBeAg, and HBsAg were measured at weeks 0, 12, 24, 48, and 72. RESULTS: HBeAg seroconversion and HBsAg loss at week 72 were observed in 217 (29.8%) and 21 (2.9%) patients, respectively. During the 48-week treatment, HBV RNA decreased more rapidly than HBV DNA and HBsAg, but HBV RNA and HBeAg shared similar dynamics with positive correlations. Multivariate regression analyses consistently revealed the significance of HBV RNA at weeks 0, 12, 24, and 48 to monitor HBeAg seroconversion but not HBsAg loss. Although baseline HBV RNA only showed a modest AUC performance, HBV RNA with a significant increase of AUC at week 12 outperformed other HBV biomarkers to forecast HBeAg seroconversion (p value < 0.05). HBV RNA ≤ 1000 copies/mL was an optimized cutoff at week 12 that offered better prediction than other HBV biomarkers. This optimized cutoff plus patient age, HBV genotype B, and HBeAg offered a strong estimation of HBeAg seroconversion (accuracy 95.2%, true negative rate 99.8%). CONCLUSION: HBV RNA at week 12 is an effective monitor of HBeAg seroconversion in HBeAg-positive patients treated with pegylated interferons.

Pilot-scale experiment on thermally hydrolyzed sludge liquor anaerobic digestion using a mesophilic expanded granular sludge bed reactor.

A pilot process of thermal hydrolysis combined with an expanded granular sludge bed reactor (EGSB) was carried out to evaluate pretreated sludge liquor into biogas conversion, process stability, and energy input/output balance. Approximately 25% of suspended solids of sludge were liquefied into aqueous phase during thermal hydrolysis pretreatment, which resulted in chemical oxygen demand (COD) concentration of 20.0 to 35.0 g/L. A mesophilic EGSB reactor was operated for 206 days treating pretreated liquor. Under an organic loading rate of 11.0 kg COD/(m(3)·d) and hydraulic retention time of 60 h, COD conversion efficiency was maintained at 63%. The energy from biogas provided 80% of that demand for heating pretreatment. Dewatered sludge after thermal hydrolysis could be incinerated with municipal solid waste in an industrial-scale incinerator. Total energy production from combined biogas anaerobic digestion and sludge incineration, treating 1.0 kg raw sludge with moisture content of 82%, was 2419 kJ. The energy demand of thermal hydrolysis pretreatment was 340 kJ.