Models for predicting hepatitis B e antigen seroconversion in response to interferon-α in chronic hepatitis B patients

AIM:To develop models to predict hepatitis B e antigen(HBe Ag)seroconversion in response to interferon(IFN)-αtreatment in chronic hepatitis B patients.METHODS:We enrolled 147 treatment-nave HBe Agpositive chronic hepatitis B patients in China and analyzed variables after initiating IFN-α1b treatment.Patients were tested for serum alanine aminotransferase(ALT),hepatitis B virus-DNA,hepatitis B surface antigen(HBs Ag),antibody to hepatitis B surface antigen,HBe Ag,antibody to hepatitis B e antigen(anti-HBe),and antibody to hepatitis B core antigen(anti-HBc)at baseline and 12 wk,24 wk,and 52 wk after initiating treatment.We performed univariate analysis to identify response predictors among the variables.Multivariate models to predict treatment response were constructed at baseline,12 wk,and 24 wk.RESULTS:At baseline,the 3 factors correlating most with HBe Ag seroconversion were serum ALT level>4×the upper limit of normal(ULN),HBe Ag≤500 S/CO,and anti-HBc>11.4 S/CO.At 12 wk,the 3 factors most associated with HBe Ag seroconversion were HBe Ag level≤250 S/CO,decline in HBe Ag>1 log10 S/CO,and anti-HBc>11.8 S/CO.At 24 wk,the 3 factors most associated with HBe Ag seroconversion were HBe Ag level≤5 S/CO,anti-HBc>11.4 S/CO,and decline in HBe Ag>2 log10 S/CO.Each variable was assigned a score of1,a score of 0 was given if patients did not have any of the 3 variables.The 3 factors most strongly correlating with HBe Ag seroconversion at each time point were used to build models to predict the outcome after IFN-αtreatment.When the score was 3,the response rates at the 3 time points were 57.7%,83.3%,and 84.0%,respectively.When the score was 0,the response rates were 2.9%,0.0%,and 2.1%,respectively.CONCLUSION:Models with good negative and positive predictive values were developed to calculate the probability of response to IFN-αtherapy.

Genetic variation of occult hepatitis B virus infection

Occult hepatitis B virus infection(OBI), characterized as the persistence of hepatitis B virus(HBV) surface antigen(HBs Ag) seronegativity and low viral load in blood or liver, is a special form of HBV infection. OBI may be related mainly to mutations in the HBV genome, although the underlying mechanism of it remains to be clarified. Mutations especially within the immunodominant "α" determinant of S protein are "hot spots" that could contribute to the occurrence of OBI via affecting antigenicity and immunogenicity of HBs Ag or replication and secretion of virion. Clinical reports account for a large proportion of previous studies on OBI, while functional analyses, especially those based on full-length HBV genome, are rare.

Roles of Kallikrein-Related Peptidase in Epidermal Barrier Function and Related Skin Diseases

Introduction The skin barrier usually refers to the physical barrier formed by the cuticle and sebum membrane of the skin.This barrier not only protects against the onslaught of microorganisms and percutaneous penetration of chemicals and allergens but also prevents the loss of nutrients and moisture from the body.Corneodesmosomes play an important role in maintaining the function of the keraphyllous skin barrier.Desmogleins,desmocollin,and corneodesmosin are examples of corneodesmosomes.

A case of hepatocellular carcinoma diagnosed as facial cutaneous metastasis survives for 18 months

To the Editor: Cutaneous metastasis of an internal malignancy is uncommon. Its clinical presentation is variable, although it is rarely seen in hepatocellular carcinoma (HCC).[1] For patients with HCC, the presence of cutaneous metastases is associated with a dismal prognosis.

Real-world investigation of the efficacy and safety of secukinumab for psoriasis treatment in a Chinese population

To the Editor:Psoriasis is a chronic inflammatory proliferative disease mediated by T lymphocytes under a multi-gene genetic background.[1]Moreover,its pathogenesis is not fully understood.Recent research shows that T cell-mediated immune inflammation plays a key role in the pathophysiology of psoriasis,and its most common downstream mediator,interleukin(IL)-17,is the primary effector cytokine in this condition.Secukinumab is a high-affinitive,fully humanized,G1κmonoclonal antibody that can simultaneously block IL-17A from multiple sources.[2]In a global,core,phase III trial,secukinumab was confirmed to rapidly improve psoriasis symptoms;however,the efficacy of its use in Chinese population remains unknown.This study was performed in a Chinese population for a period of 16 weeks to explore the efficacy and safety of secukinumab after its introduction in clinical settings in May 2019.