Zhiliang Gao

Background/Objectives: The clinical implications of HBsAg seroreversion following HBV functional cure therapies remain unclear. In two randomized phase 2 trials, therapeutic vaccine BRII-179 or siRNA elebsiran in combination with PEG-IFNα was evaluated versus PEG-IFNα monotherapy. This pooled analysis characterized the profile of HBsAg seroreversion and explored potential predictors. Methods: Participants achieving HBsAg loss at or shortly after end of treatment (EOT) were included. Binary endpoints were summarized with two-sided 95% CIs using the Clopper–Pearson method. Time-to-event analyses used Kaplan–Meier methods and Cox regression. Longitudinal associations were evaluated using logistic mixed-effects models. Results: Among 55 participants included, 24 (43.6%) experienced HBsAg seroreversion with modest magnitude; all peak levels were p = 0.036). Sustained anti-HBs positivity during post-EOT follow-up was consistently associated with durable HBsAg loss in longitudinal analyses. Exploratory Kaplan–Meier analyses showed numerically higher HBsAg seroreversion rates among HBeAg-positive participants and those with PEG-IFNα treatment duration <12 weeks after HBsAg loss, although these findings were not statistically significant. Conclusions: HBsAg seroreversion after PEG-IFNα with or without BRII-179 or elebsiran was mild and rarely associated with clinically relevant relapse. Higher EOT anti-HBs levels and persistent anti-HBs positivity were associated with greater durability of HBsAg loss and warrant prospective evaluation as a candidate biomarker for risk-adapted off-treatment monitoring.

Background: Functional cure of chronic hepatitis B (CHB) can be achieved with appropriate antiviral treatment. However, few studies have evaluated the added benefits of achieving functional cure. We aimed to conduct a quantitative analysis of the health-related quality of life (HRQoL) of CHB patients who achieved functional cure to provide evidence for economic analysis. Methods: We conducted a cross-sectional study in five provinces in China in 2021. The study population was recruited in hospitals and divided into three groups: functional cure, antiviral treatment, and healthy control group. Data were collected through face-to-face interviews using the Short Form-36 version 2. Results: 497 participants (163 with functional cure, 192 with antiviral treatment, and 142 with healthy control) were used in this study. The eight scale scores (physical function, role physical, bodily pain, general health, vitality, social functioning, role emotional, and mental health) and two summary scores (physical composite and mental composite) in the functional cure and healthy control groups were similar. Compared to the healthy control group, the general health scores in the functional cure group were worse with −0.052 (95% CI: −0.094, −0.010), and the antiviral treatment group had significantly worse scores with −0.127 (95% CI: −0.170, −0.083). The antiviral treatment group had lower vitality scores (β = −0.048, 95% CI: −0.089 to −0.007) and MCS scores (β = −0.023, 95% CI: −0.042, −0.003, p = 0.022) compared to the healthy control. The mental composite summary scores of all groups were >50 (p > 0.05). Conclusions: Health-related quality of life decreases with CHB disease progression. The results indicate that functional cure is associated with HRQoL levels comparable to those of the healthy population, both on the physical and psychological aspect, reinforcing the clinical value of this therapeutic goal.

Hemorrhagic fever with renal syndrome (HFRS) is an acute zoonosis with a global distribution. China is one of the countries with a high incidence of HFRS, which has long endangered the lives and health of the Chinese people. The Infectious Disease Branch of the Chinese Preventive Medicine Association and the Infectious Diseases Branch of the Chinese Medical Association organized national multidisciplinary experts, based on domestic and international research results combined with experts’ practical experiences, to reach this consensus after thorough discussion. This consensus contains 17 recommendations aimed at prevention and identification of important clinical issues to further standardize the prevention, diagnosis, and treatment of HFRS.

Hepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China. In this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D. Nine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = − 0.134; 2000–4999 RMB, β = − 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.090), disease profile (cirrhosis, β = − 0.114), hyperlipidemia (β = − 0.065) and depression (β = − 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = − 0.129; 2000–4999 RMB, β = − 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.091), disease profile and depression (β = − 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D. In this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL. ClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.

To evaluate accuracy of two-dimensional shear wave elastography (2D SWE) and develop and validate a new prognostic score in predicting prognosis of acute-on-chronic liver failure (ACLF) patients.

The treatment of chronic hepatitis C has gradually entered into the era of direct-acting antiviral agents (DAAs) from the era of pegylated interferon-α combined with ribavirin, which has a high curative effect, good tolerability, and complete patient-friendly oral form of administration. Sustained virologic response (SVR) acquired by pegylated interferon-α plus ribavirin therapy has been widely recognized by scholars in reducing the recurrence of primary liver cancer and liver cancer, especially in cirrhotic patients. The clinical application time of DAAs is short and its report is inconsistent with the increase or decrease of primary liver cancer and liver cancer recurrence. Simultaneously, the effect of SVR in people with hepatocellular carcinoma on DAAs seems to be different from those in patients without hepatocellular carcinoma. This article reviews some of the existing reports in order to increase the understanding of DAAs and liver cancer and serve the long-term benefit of clinical treatment.

Liver failure has various clinical types, a complex pathogenesis, and rapid disease progression, as well as a high mortality rate. Liver failure caused by hepatitis B virus infection is the most common type in China with severe conditions, various complications, and a mortality rate as high as 40%-90%. Invasive fungal disease secondary to acute-on-chronic liver failure can affect patients' prognosis and increase mortality rate. This article introduces the research advances in hepatitis B-related liver failure, artificial liver, and invasive fungal disease secondary to acute-on-chronic liver failure in 2016.

Health-care workers’ (HCWs) exposure to bodily fluids puts them at risk of hepatitis B virus HBV infection. This study investigated HBV vaccination practices and outcomes in HCWs and assessed postvaccination seroprotection across HCWs in different departments. A survey of HCWs in a Chinese public general hospital was carried out with a retrospective cohort of 1420 hospital HCWs (458 males and 962 females). HBV vaccination status (10-μg/dose used) was investigated in the cohort from vaccination records from the period of 1988 to 2008. Blood samples were collected and tested for hepatitis B surface antigen (HBsAg) and HBV antibodies (anti-HBs). The overall vaccination (complete course) and HBsAg carrier rates among HCWs were 40.42 % (574/1420) and 6.13 % (87/1420), respectively. Vaccination rates differed by department, with HCWs in internal medicine (39.5 %) and emergency (42.0 %) departments having particularly low rates. The natural infection rate was 7.53 % (107/1420) among HCWs. HCWs in the department of infectious diseases (vaccination rate, 57.8 %) had the highest rate of antibody produced by natural infection (88.2 %). The vaccination rate was a disappointingly low among HCWs in Pearl River Delta Area of China. HCWs working in infectious diseases departments and technicians were at particularly likely to have been infected with HBV. A concerted effort is needed to bring vaccination rates up among Chinese HCWs in Pearl River Delta Area of southern China.