To investigate the demographic characteristics and clinical influencing factors which associates with the occurrence probability of persistent or intermittent hypoviremia (LLV) in patients with ...chronic hepatitis B (CHB) treated with nucleos(t)ide analogues (NAs).
A single-center retrospective analysis was performed on patients with CHB who received outpatient NAs therapy for≥48 ± 2 weeks. According to the serum hepatitis B virus (HBV) DNA load at 48±2 weeks treatment, the study groups were divided into LLV (HBV DNA < 20 IU/ml and < 2 000 IU/ml) and MVR group (sustained virological response, HBV DNA < 20 IU/ml). Demographic characteristics and clinical data at the start of NAs treatment (considered as baseline) were retrospectively collected for both patient groups. The differences in the reduction of HBV DNA load during treatment was compared between the two groups. Correlation and multivariate analysis were further conducted to analyze the associated factors influencing the LLV occurrence. Statistical analys
Background: Long-term therapy with nucleos(t)ide analogs (NAs) such as entecavir (ETV) and tenofovir disoproxil fumarate (TDF) favorably affects the incidence of hepatocellular carcinoma (HCC) on the ...basis of data from randomized or matched control studies. Recent data suggest a lower HCC incidence after 5 years of ETV or TDF therapy in chronic hepatitis B (CHB) patients, especially those with baseline cirrhosis. Summary: Three controversial issues remain to be resolved regarding hepatitis B virus (HBV) treatment and HCC. (1) The efficacy of antiviral treatment for the prevention of HCC is not established. The guidelines of the American Association for the Study of Liver Diseases (AASLD), the Asian Pacific Association for the Study of the Liver (APASL), and the European Association for the Study of the Liver (EASL) for the management of HBV infection state that antiviral treatment of HBV with interferon and NAs prevents the development of HCC. Among experts in CHB treatment, however, there is disagreement on the HCC prevention effects of antiviral treatment. (2) The rationale for antiviral management in patients with high HBV DNA and normal levels of alanine aminotransferase is unclear. The AASLD, EASL, and APASL guidelines do not recommend antiviral treatment for immune-tolerant CHB patients, and the terms and methods of treating such patients remain to be clarified. (3) The efficacy of first-line treatment with NAs, including ETV, TDF, and tenofovir alafenamide fumarate (TAF), to prevent HCC in CHB patients remains unknown. Several studies have produced controversial results regarding the effects of NAs on the risk and prevention of HCC. In the present review, we discuss these 3 issues, citing recent studies and clinical management guidelines from major international associations. Key Messages: Suggested approaches for reaching a consensus including applying the propensity score matching method, performing randomized controlled studies, and performing clinical studies with larger numbers of subjects and longer follow-up.
Hepatitis B virus (HBV) DNA integration occurs during the reverse transcription process of HBV replication, which develops in the early stages of HBV infection and accompanies the entire disease ...course. The integration of HBV DNA is detrimental to the attainment of clinical cure goals and also raises the risk of developing liver cancer. Theoretically, nucleos(t)ide analogs can reduce the synthesis of new double-stranded linear DNA, but there is no clearance function for hepatocytes that have already integrated HBV. Therefore, patients with serum HBV DNA-negative conversions still have the risk of developing liver cancer. As an immunomodulatory drug, interferon can not only inhibit viral replication but also inhibit or even eliminate existing clonally amplified hepatocytes carrying integrated HBV DNA fragments. However, there are currently few studies on the effects of nucleos(t)ide analogues and interferon therapy on HBV DNA integration. Thus, large-scale clinical studies are urgently needed for further clari
Humanoid robot represents a highly uncertain dynamic plant. Nowadays, humanoid push recovery in stepping represents a complicated and challenging task. This paper proposes a new control approach in ...order to improve the biped push recovery using flywheel-based auto-balance. The core of the proposed approach relies on the original implementation of an additional control scheme that equalizes the unexpected force acting on the humanoid during robust stepping. Our novel control approach includes an evolutionary neural (
IDE-NN: Improved Differential Evolution-Neural Networks
) controller for robust biped walking and an additional optimal Proportional Integral (PI) used to regulate the flywheel integrated to the humanoid upper body. The proposed solution helps the humanoid stepping robustly to follow the trajectory required and further empirically guarantees the small-sized experiment humanoid HUBOT-5 robot stably stepping, even in case an unexpected force acting on HUBOT-5 biped. The comprehensive benchmark tests confirm that our proposed method is initiatively efficient.
This Special Issue is dedicated to the synthesis, characterization, and application of functionalized or doped matrices (e.g., hydrogels, aerogels, or sol–gels) for environmental purposes such as the ...sensing or removal of different toxic analytes. The chemical functional groups or doping materials, such as noble metal nanostructures, quantum dots, and carbon nanotubes, play several roles, donating further features to the host matrix such as particular optical, mechanical, or electrical properties and interacting with the surrounding environment. In addition, the employment of hosting matrices increases handling and portability and opens new horizons for in situ environmental applications.
The photosynthetic apparatus accomplishes two major functions in plants — solar energy conversion and protection of the plant from photodestruction. Its highly orchestrated formation includes ...coordinated biosynthesis of chlorophyll (Chl) and of its binding to matrix proteins. Light plays here the central role driving both metabolic and regulatory processes. The regulation is achieved via operation of sophisticated photoreceptor machinery with the phytochrome system as its main component. This review concentrates on Chl
a
biosynthesis and the role of phytochrome A (phyA) in this process. The mechanism of action of phyA and the specificity of its state in the plant has been described, in particular, the existence of two native types with different modes of action. This review touches upon the dependence of the effects of phyA on tissues and organs of the plant and its species, genetic modifications, and hormonal status.
Drug resistance is a major limitation for the long‐term efficacy of antiviral therapy with nucleos(t)ide analogues (NAs) in chronic hepatitis B (CHB). Antiviral resistance mutations may pre‐exist in ...the overall viral population of untreated patients. We aimed to assess the prevalence of such hepatitis B virus (HBV) variants in a large cohort of NAs‐naïve patients with CHB and to explore possible association with viral and host variables. Serum samples from 286 NAs‐naïve consecutive patients with CHB were tested for serum HBV‐DNA, and 255 of them having HBV‐DNA > 1000 IU/mL were further analysed for drug resistance mutations by INNO‐LiPA HBV DRv2/v3. NAs‐naïve patients analysed were mainly men (73%), Caucasians (85%), hepatitis B e Antigen (HBeAg) negative (79%) and genotype D (69%), with a mean age of 43.2 ± 13.4 years. HBV mutations associated with antiviral drug resistance were detected in 13 (5%) patients: three patients infected with HBV genotype C had the rtM204V + rtL180M mutations associated with lamivudine (LMV) resistance. Four patients had the rtI233V mutation that may reduce sensitivity to adefovir, and three patients had the rtM250L/V mutation typical of entecavir resistance. LMV compensatory mutations rtL80V and rtV173L were seen in two and one patients, respectively. No relationship was seen between presence of resistant or compensatory mutations and HBV‐DNA levels, HBeAg/anti‐HBe status or previous IFN therapy. These results confirm that HBV mutations, which confer resistance against currently available anti‐HBV NAs, may already exist in patients who have never received the drug.
Significant advances have been made in nucleos(t)ideanalogue(NA) therapy to treat chronic hepatitis B,and this therapy reduces the risk of hepatitis B virus(HBV)-related hepatocellular carcinoma(HCC) ...in somepatients.However,whether NAs can also prevent recurrence after radical resection of HBV-related HCC remains controversial and is an important question,giventhat most patients will experience recurrence within afew years of curative surgery.Here we systematicallyreviewed the literature since 2004 on outcomes afteradministering NAs to patients with HBV-related HCCfollowing radical resection.We focused on treatmentindications,duration,effects on recurrence-free survivaland overall survival,and the management of NA resistance.We find that patients with HCC should stronglyconsider NA therapy if they are positive for HBV-DNA,and that the available evidence suggests that postoperative NA therapy can increase both recurrence-free andoverall survival.To minimize drug resistance,cliniciansshould opt for potent analogues with higher resistancebarriers,and they should monitor the patient carefully for emergence of NA-resistant HBV.
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