Current trends in management of hepatitis B virus reactivation in the biologic therapy era

Hepatitis B virus (HBV) reactivation represents an emerging cause of liver disease in patients undergoing treatment with biologic agents. In particular, the risk ofHBV reactivation is heightened by the use monoclonalantibodies, such as rituximab (anti-CD20) and alemtuzumab (anti-CD52) that cause profound and longlasting immunosuppression. Emerging data indicatethat HBV reactivation could also develop following theuse of other biologic agents, such as tumor necrosis factor (TNF)-α inhibitors. When HBV reactivation is di-agnosed, it is mandatory to suspend biologic treatmentand start antiviral agents immediately. However, preemptive antiviral therapy prior to monoclonal antibodyadministration is crucial in preventing HBV reactivationand its clinical consequences. Several lines of evidencehave shown that risk of HBV reactivation is greatlyreduced by the identifi cation of high-risk patients andthe use of prophylactic antiviral therapy. In this article, we discuss current trends in the management of HBV reactivation in immunosuppressed patients receiving biologic therapy, such as rituximab, alemtuzumab and TNF-α antagonists.

Woodchip-sulfur packed biological permeable reactive barrier for mixotrophic vanadium(V)detoxification in groundwater

Groundwater vanadium(V)(V(V))contamination is ubiquitous in vanadium mining/smelting region and development of novel strategy for its remediation is of particular significance.Herein woodchip-sulfur packed biological permeable reactive barrier(bio-PRB)is established towards successful V(V)bio-detoxification.V(V)removal was accelerated under such mixotrophic condition,compared with heterotrophic and autotrophic V(V)reductions.The performance of bio-PRB was relatively steady with V(V)removal efficiency of 68.5%–98.2%under fluctuant geochemical and hydrodynamic conditions.Microbial community analysis indicated that heterotrophic Geobacter was the main reducer to convert V(V)to insoluble V(IV),by consumption of organic source attributed to woodchip hydrolysis and sulfur anabolism of autotrophs(e.g.,Sulfuricurvum and Thiobacillus).V(V)reduction and elemental sulfur oxidation were regulated by genes as omcA,omcB and mtrC and soxB,respectively.The elevated contents of cytochrome c and nicotinamide adenine dinucleotide implied that improved electron transfer facilitated V(V)reduction.This study provides a cost-effective,robust and sustainable route for V(V)-polluted aquifer remediation.