Background
Management of patients with CHB
Role of quantitative HBsAg in predicting HCC development and treatment response
Role of quantitative viral mutants in predicting different clinical outcomes
Nie et al. [19] | Yang et al. [20] | Tseng et al. [21] | Bayliss et al. [22] | |
---|---|---|---|---|
Quantification assay | Selective inhibitory polymerase chain reaction | Pyrosequencing | Pyrosequencing | Next generation sequencing |
Target region | PC (G1896A) & BCP (A1762T/G1764A) mutants | PC (G1896A) & BCP (A1762T/G1764A) mutants | BCP mutants (A1762T/G1764A) | HBV whole genome |
Sensitivity to detect minor strains | <1% | 10% | 10% | <1% |
Enrolled patients | 18 HBeAg-positive patients | 203 HBeAg-positive patients receiving interferon-based treatment | 151 HBeAg-negative patients with a median follow-up period of 9 years. | 157 HBeAg-positive patients receiving 4-year tenofovir treatment |
Main finding | Levels of PC and BCP mutants may predict the time of HBeAg seroconversion | Quantitative analysis of PC and BCP mutants can predict interferon-induced HBeAg seroconversion | A higher percentage of BCP mutant is associated with higher risks of cirrhosis development | Detectable BCP or PC mutants are associated with a lower probability of HBsAg loss during tenofovir therapy. |
Strategies to eliminate HBV
Combination of TDF and immunoprophylaxis to minimize mother-to-child transmission (MTCT) of HBV
Study | Chen et al. [24] | Pan et al. [25] |
---|---|---|
Study design | Prospective non-randomized control trial | Prospective randomized control trial |
No. of mother | TDF (N = 92), Control (N = 56) | TDF (N = 97), Control (N = 100) |
Intervention | TDF vs. Control | TDF vs. Control |
Time of intervention | 30–32 weeks of gestation | 30-32 weeks of gestation |
Maternal viral load | ≥20,000,000 IU/mL | ≥200,000 IU/mL |
Maternal HBeAg-positive rate | 100% | 100% |
Mother-to-infant transmission rate | TDF (1.54%) vs. Control (10.71%), P = 0.0481* | Intention-to-treat analysis: TDF (5%) vs. Control (18%), P = 0.007** Per-protocol analysis: TDF (0%) vs. Control (7%), P = 0.01 |