Trends of alkaline phosphatase to prealbumin ratio in patients with hepatitis B linked to hepatocellular carcinoma development

BACKGROUND Chronic hepatitis B often progresses silently toward hepatocellular carcinoma(HCC),a leading cause of mortality worldwide.Early detection of HCC is crucial,yet challenging.AIM To investigate the role of dynamic changes in alkaline phosphatase to prealbumin ratio(APR)in hepatitis B progression to HCC.METHODS Data from 4843 patients with hepatitis B(January 2015 to January 2024)were analyzed.HCC incidence rates in males and females were compared using the log-rank test.Data were evaluated using Kaplan–Meier analysis.The Linear Mixed-Effects Model was applied to track the fluctuation of APR levels over time.Furthermore,Joint Modeling of Longitudinal and Survival data was employed to investigate the temporal relationship between APR and HCC risk.RESULTS The incidence of HCC was higher in males.To ensure the model’s normality assumption,this study applied a logarithmic transformation to APR,yielding ratio.Ratio levels were higher in females(t=5.26,P<0.01).A 1-unit increase in ratio correlated with a 2.005-fold higher risk of HCC in males(95%CI:1.653-2.431)and a 2.273-fold higher risk in females(95%CI:1.620-3.190).CONCLUSION Males are more prone to HCC,while females have higher APR levels.Despite no baseline APR link,rising APR indicates a higher HCC risk.

Clinical features of autoimmune hepatitis patients with poor response to treatment

Objective To investigate the clinical features of autoimmune hepatitis(AIH)patients with poor response to treatment.Methods A total of 61 AIH patients were enrolled,among whom 49(80.33%)achieved complete response(good response group)and 12(19.67%)had incomplete response(poor response group).The

Alpha-fetoprotein screening in patients with hepatitis C-induced cirrhosis who achieved a sustained virologic response in the direct-acting antiviral agents era

To the Editor:Hepatocellular carcinoma (HCC) is the most common primary livertumorandthethirdcauseofcancer-relateddeathsworldwide. HCC is the consequence of malignant transformation of hepatocytes and mainly occurs in patients with cirrhosis. Hepatitis C virus (HCV) chronic infection is a leading cause of end-stage liver diseaseandHCCintheWesterncountries[1].Theapprovalof direct-acting antiviral agents (DAAs) for the treatment of HCV has revolutionized the management of the disease, as no absolute contraindication to treatment exists and sustained virological response

Knowledge levels and attitudes of health care professionals toward patients with hepatitis C infection

AIM:To study knowledge levels and attitudes of health care providers toward patients with hepatitis C virus infection in Guilan,a northern province of Iran.METHODS:This cross-sectional study was performed on 239 health care professionals from the Razi Hospital,including doctors,nurses,and operating room technicians.The questionnaires consisted of questions on demographic characteristics,knowledge levels,and attitudes toward hepatitis C patients.The questionnaire was tested in a pilot study and validated by Cronbach' s alpha coefficient.Data were analyzed using SPSS16 software.RESULTS:The mean ± SD knowledge score was 17.43 ± 2.65(from a total of 22).51.9% of the participants achieved scores higher than the mean.There was a significant relationship between knowledge score and age(P = 0.001),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.027).There was also a significant relationship between attitude level and age(P = 0.002),gender(P = 0.0001),occupational history(P = 0.0001),and educational history(P = 0.035).Physicians were significantly more knowledgeable and showed more positive attitudes.There was a positive correlation between knowledge and attitude scores(P = 0.02).CONCLUSION:Discriminatory attitudes are common among health care providers toward hepatitis C patients.It is therefore necessary to improve their knowledge level and attitude toward this disease.

Hepatic flares in chronic hepatitis C: Spontaneous exacerbation vs hepatotropic viruses superinfection

The hepatitis C virus(HCV)causes an acute infection that is frequently asymptomatic,but a spontaneous eradication of HCV infection occurs only in one-third of patients.The remaining two-thirds develop a chronic infection that,in most cases,shows an indolent course and a slow progression to the more advanced stagesof the illness.Nearly a quarter of cases with chronic hepatitis C(CHC)develop liver cirrhosis with or without hepatocellular carcinoma.The indolent course of the illness may be troubled by the occurrence of a hepatic flare,i.e.,a spontaneous acute exacerbation of CHC due to changes in the immune response,immunosuppression and subsequent restoration,and is characterized by an increase in serum aminotransferase values,a frequent deterioration in liver fibrosis and necroinflammation but also a high frequency of sustained viral response to pegylated interferon plus ribavirin treatment.A substantial increase in serum aminotransferase values during the clinical course of CHC may also be a consequence of a superinfection by other hepatotropic viruses,namely hepatitis B virus(HBV),HBV plus hepatitis D virus,hepatitis E virus,cytomegalovirus,particularly in geographical areas with high endemicity levels.The etiology of a hepatic flare in patients with CHC should always be defined to optimize follow-up procedures and clinical and therapeutic decisions.

CD55 Variant Associated with Pegylated-interferonαTherapy Response in HBeAg-positive Chronic Hepatitis B Patients

Background and Aims:Only a small percentage of chronic hepatitis B(CHB)patients effectively respond to treatment with pegylated-interferon alpha(PegIFNα)or nucleos(t)ide analogues(NUCs).We aimed to detect the correlations of complement regulators-associated single-nucleotide polymorphisms(SNPs)with treatment response of hepatitis B e antigen(HBeAg)-positive CHB patients.Methods:A total of 1,763 HBeAg-positive CHB patients were enrolled,894 received PegIFNαfor at least 48 weeks and were followed up for 24 weeks,and 869 received NUCs for 104 weeks.For each patient,nine SNPs in genes encoding for complement regulators were determined and genotyped.To assess the cumulative effect of numerous SNPs,a polygenic score(PGS)was utilized.The correlations of SNPs and PGS with the levels of combined response(CR)and hepatitis B s antigen(HBsAg)loss were also investigated.Results:In PegIFNα-treated patients,an intronic SNP of CD55,rs28371597,was strongly related to CR,and the CR rate in rs28371597_GG genotype carriers was only approximately half that of rs28371597_GT/TT genotype carriers(20.29%vs.37.10%,p=2.00×10^(−3)).A PGS incorporating CD55_rs28371597 and two additional SNPs,CFB_rs12614 and STAT4_rs7574865,which had been considered as predictors for PegIFNαtreatment response before,was strongly correlated with the levels of CR(ptrend=7.94×10^(−6))and HBsAg loss(p-trend=9.40×10^(−3))in PegIFNα-treated patients.In NUCs-treated individuals,however,none of the nine SNPs were shown to be significantly linked to CHB treatment response.Conclusions:CD55_rs28371597 is a promising biomarker for predicting CHB patients’responsiveness to PegIFNαtherapy.The updated PGS may be used for optimizing CHB treatment.

Genotyping of Hepatitis C Virus in Patients with Hepatocellular Carcinoma.

Forty-two patients with hepatocellular carcinoma（HCC）were examined for hepatitis C virus（HCV）RNA in liver tissues by reverse transcription-polymerase chain reaction（RT PCR）.Typing of HCV liver samples of 18 patientswas dependent on the amplication of NSregion gy PCR using type-specific primers.

Correlation between constitution of Yin deficiency syndrome and polymorphism of HLADQA1 / treatment response of Peg-IFNα therapy in HBeAg positive chronic hepatitis B patients

Objective To observe the correlation between constitution of yin deficiency syndrome(YDS)and polymorphism of HLA-DQA1/treatment response of Peg-IFNαtherapy in HBe Ag positive chronic hepatitis B(CHB)patients,and to explore constitution of Chinese medicine(CM)in response to interferon therapy.Methods Totally 120 HBe Ag positive CHB patients who were

The expressions and clinical significance of CD107a and CD107b in chronic hepatitis B patients with different immune status

Objective To investigate the expressions of CD107a and CD107b on CD8+T lymphocytes in chronic hepatitis B(CHB)patients with different immune status.Methods Forty-three CHB patients were collected and classified according to the immune status(23 cases of atypical status,10 cases of immune tolerance and 10 cases of immune clearance).Another 10 cases were selected

Liver injury in patients with hepatitis C virus / human immunodeficiency virus coinfection in Dehong Prefecture,Yunnan Province

Objective To evaluate liver injury in patients with hepatitis C virus(HCV)/human immunodeficiency virus(HIV)coinfection in Dehong Prefecture,Yunnan Province.Methods A total of 4 784 HIV-infected patients were enrolled in this study.Baseline aspartate aminotransferase(AST),alanine aminotransferase(ALT)

Prognostic value of keratin 18 for the patients with hepatitis B virus-related acute-on-chronic liver failure

Objective To analyze the serum keratin 18(K18)level of patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBV-ACLF)and its correlation with prognosis.Methods From December 2012 to October 2014,120 patients who visited Fuzhou Infectious Diseases Hospital and were diagnosed with HBV-ACLF were enrolled,and 20 chronic hepatitis B(CHB)pa-

The possible role and clinical implication of myeloid-derived suppressor cells in the peripheral blood of patients with hepatitis B virus-related acute-on-chronic liver failure

Objective To explore the possible role and clinical implications of myeloid-derived suppressor cells(MDSC)in the peripheral blood of patients with hepatitis B virus(HBV)-related acute-on-chronic liver failure(HBVACLF).Methods A total of 25 HBV-ACLF patients

Efficacy observation of Yiguanjian decoction combined adefovir Dipivoxil tablet in treating HBeAg negative chronic viral hepatitis B active compensated liver cirrhosis patients

Objective To explore clinical efficacy of Yiguanjian Decoction(YD)combined Adefovir Dipivoxil Tablet(ADT)in treating HBe Ag negative chronic viral hepatitis B(CVHB)active compensated liver cirrhosis(LC)patients.Methods Totally 68 HBe Ag negative CVHB active compensated LC patients initially treated were assigned to the treatment group and the control group

Effect of Telbivudine tablet combined Jianpi Bushen recipe on HBV specific cytotoxic T lymphocyte and HBe Ag seroconversion in patients with HBe Ag positive chronic hepatitis B

Objective To explore the effect of Telbivudine(LDT)Tablet combined with Jianpi Bushen Recipe(JBR)on serum hepatitis B virus(HBV)specific cytotoxic T lymphocyte(CTL)and HBe Ag seroconversion in chronic hepatitis B(CHB)patients.Methods Totally90 HBe Ag-positive and human leukocyte antigen(HLA)-A2 positive CHB patients were randomly assigned to