Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase.

Posted by on 13 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase. Chin J Integr Med. 2014 Feb;20(2):94-100 Authors: Xie HP, Yang HZ, Wu WK, Guan WB, Ke QS, Li YW, Dai M, Xiao GM, Zhang JS, Li YM Abstract OBJECTIVE: To explore Chinese medicine (CM) syndrome distribution of chronic hepatitis B virus (HBV) carriers in immunotolerant phase (ITP). METHODS: One hundred and eighty-five chronic HBV carriers in ITP, seen in the Third Affiliated Hospital of Sun Yat-sen University from May 2009 to December 2010, were admitted in an observational study under the guidance of CM. Patients’ CM symptoms and signs, demographics, liver biochemistries, and qualitative HBV DNA were recorded in the questionnaires. CM syndromes were then differentiated to 15 detailed types and analyzed by generalization. Lastly, the location, pathogenic factors and nature of the disease were also assessed. RESULTS: When CM syndrome patterns were differentiated to 15 types, there were 27 (15%) no syndrome cases, 94 (50%) single syndrome cases and 64 (35%) compound syndromes cases. The main detailed syndromes included Liver (Gan)-qi depression (LQD), Kidney (Shen)-qi deficiency (KQD), Spleen (Pi)-qi deficiency (SQD) and Kidney-yang deficiency (KYAD). After CM syndromes generalized to five types, their frequency was Spleen-Kidney deficiency (SKD)>LQD>inner dampness-heat retention (IDHR)>Liver-Kidney deficiency (LKD)>blood stasis blocking collateral (BSBC). SKD and LQD occupied 64%. The disease location included Liver, Gallbladder (Dan), Spleen, Stomach (Wei) and Kidney. The pathogenic factors were mainly qi stagnation, qi deficiency, yang deficiency, concurrently dampness-heat and blood stasis. The deficiency syndrome was more than excess syndrome in its nature. CONCLUSIONS: Most of chronic HBV carriers in ITP have their CM syndrome, and the most common types are SKAD, LQD. This study suggests that the natural history may be improved through breaking the state of immune tolerance or shorten the time of ITP by strengthening Spleen-Kidney and reliving Liver qi. PMID: 24619234 [PubMed - indexed for MEDLINE]

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Chinese medicine syndrome distribution of chronic hepatitis B virus carriers in immunotolerant phase.

Four homoisoflavonoids isolated from traditional Chinese medicine: "gan luo xin".

Posted by on 02 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Four homoisoflavonoids isolated from traditional Chinese medicine: “gan luo xin”. J Asian Nat Prod Res. 2014;16(8):813-8 Authors: Li LM, Yuan QP, Chen G Abstract Two new homoisoflavonoids, ( ± )-5,7-dihydroxy-8-methyl-3-(2′,4′-dihydroxybenzyl) chroman-4-one (1) and ( ± )-5,7-dihydroxy-6,8-dimethyl-3-(2′,4′-dihydroxybenzyl) chroman-4-one (2), along with two known homoisoflavonoids, 5,7-dihydroxy-6-methyl-3-(2′,4′-dihydroxybenzyl)chroman-4-one (3) and disporopsin (4), were isolated from the EtOAc extract of traditional Chinese medicine–”Gan Luo Xin.” Their structures were determined on the basis of spectroscopic analysis (UV, IR, HR-ESI-MS, 1D NMR, and 2D NMR). PMID: 24993400 [PubMed - indexed for MEDLINE]

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Four homoisoflavonoids isolated from traditional Chinese medicine: "gan luo xin".

Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B.

Posted by on 02 Nov 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B. PLoS One. 2014;9(10):e111641 Authors: Hong MZ, Zhang RM, Chen GL, Huang WQ, Min F, Chen T, Xu JC, Pan JS Abstract OBJECTIVES: Liver biopsy is indispensable because liver stiffness measurement alone cannot provide information on intrahepatic inflammation. However, the presence of fibrosis highly correlates with inflammation. We constructed a noninvasive model to determine significant inflammation in chronic hepatitis B patients by using liver stiffness measurement and serum markers. METHODS: The training set included chronic hepatitis B patients (n = 327), and the validation set included 106 patients; liver biopsies were performed, liver histology was scored, and serum markers were investigated. All patients underwent liver stiffness measurement. RESULTS: An inflammation activity scoring system for significant inflammation was constructed. In the training set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.964, 91.9%, and 90.8% in the HBeAg(+) patients and 0.978, 85.0%, and 94.0% in the HBeAg(-) patients, respectively. In the validation set, the area under the curve, sensitivity, and specificity of the fibrosis-based activity score were 0.971, 90.5%, and 92.5% in the HBeAg(+) patients and 0.977, 95.2%, and 95.8% in the HBeAg(-) patients. The liver stiffness measurement-based activity score was comparable to that of the fibrosis-based activity score in both HBeAg(+) and HBeAg(-) patients for recognizing significant inflammation (G ≥3). CONCLUSIONS: Significant inflammation can be accurately predicted by this novel method. The liver stiffness measurement-based scoring system can be used without the aid of computers and provides a noninvasive alternative for the prediction of chronic hepatitis B-related significant inflammation. PMID: 25360742 [PubMed - as supplied by publisher]

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Liver Stiffness Measurement-Based Scoring System for Significant Inflammation Related to Chronic Hepatitis B.

Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome.

Posted by on 24 Oct 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome. World J Gastroenterol. 2014 Oct 21;20(39):14142-14155 Authors: Ghaziani T, Sendi H, Shahraz S, Zamor P, Bonkovsky HL Abstract Hepatitis B virus (HBV) continues to be a major cause of morbidity and mortality worldwide. It is estimated that about 350 million people throughout the world are chronically infected with HBV. Some of these people will develop hepatic cirrhosis with decompensation and/or hepatocellular carcinoma. For such patients, liver transplantation may be the only hope for cure or real improvement in quality and quantity of life. Formerly, due to rapidity of recurrence of HBV infection after liver transplantation, usually rapidly progressive, liver transplantation was considered to be contraindicated. This changed dramatically following the demonstration that hepatitis B immune globulin (HBIG), could prevent recurrent HBV infection. HBIG has been the standard of care for the past two decades or so. Recently, with the advent of highly active inhibitors of the ribose nucleic acid polymerase of HBV (entecavir, tenofovir), there has been growing evidence that HBIG needs to be given for shorter lengths of time; indeed, it may no longer be necessary at all. In this review, we describe genetic variants of HBV and past, present, and future prophylaxis of HBV infection during and after liver transplantation. We have reviewed the extant medical literature on the subject of infection with the HBV, placing particular emphasis upon the prevention and treatment of recurrent HBV during and after liver transplantation. For the review, we searched PubMed for all papers on the subject of “hepatitis B virus AND liver transplantation”. We describe some of the more clinically relevant and important genetic variations in the HBV. We also describe current practices at our medical centers, provide a summary and analysis of comparative costs for alternative strategies for prevention of recurrent HBV, and pose important still unanswered questions that are in need of answers during the next decade or two. We conclude that it is now rational and cost-effective to decrease and, perhaps, cease altogether, the routine use of HBIG during and following liver transplantation for HBV infection. Here we propose an individualized prophylaxis regimen, based on an integrated approach and risk-assessment. PMID: 25339803 [PubMed - as supplied by publisher]

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Hepatitis B and liver transplantation: Molecular and clinical features that influence recurrence and outcome.

Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller.

Posted by on 30 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller. Am J Gastroenterol. 2014 Aug;109(8):1234-40 Authors: Kim JW, Kim JH, Sung KB, Ko HK, Shin JH, Kim PN, Choi HK, Ko GY, Yoon HK, Chun SY, Gwon DI Abstract OBJECTIVES: To compare the effectiveness of transarterial chemoembolization (TACE) and radiofrequency ablation (RFA) for treating small (≤2 cm) hepatocellular carcinomas (HCCs). METHODS: This retrospective study consisted of 287 patients (mean age, 57.1 years; age range, 29-84 years; 221 men, 66 women; 73.5% with HBV; 100% with liver cirrhosis) with Barcelona Clinic Liver Cancer very early-stage HCC (≤2 cm single HCC) who were initially treated with TACE (n=122) or RFA (n=165). The primary study end point was overall patient survival. Secondary study end points were time to progression and tumor response. RESULTS: The RFA and TACE groups were well balanced in terms of baseline variables. The two groups did not differ significantly in overall survival (P=0.079) or major complication (P>0.999) rates. The respective cumulative survival rates at 1, 3, 5, and 8 years were 97.6, 86.7, 74.5, and 60.0% for RFA and 93.4, 75.4, 63.1, and 51.1% for TACE. Their objective tumor regression (complete or partial response) rates were 100% (165/165) and 95.9% (117/122), respectively (P=0.013). The median times to progression for RFA and TACE were 27.0±3.8 (95% confidence intervals (CIs): 19.6-34.4) and 18.0±2.9 (95% CIs: 12.2-23.8) months, respectively. RFA yielded a significantly longer time to progression (P=0.034). CONCLUSIONS: TACE may be a viable alternative treatment for ≤2 cm HCCs when RFA is not feasible. PMID: 24935276 [PubMed - indexed for MEDLINE]

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Transarterial chemoembolization vs. radiofrequency ablation for the treatment of single hepatocellular carcinoma 2 cm or smaller.

Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection.

Posted by on 26 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection. Drug Discov Ther. 2013 Dec;7(6):212-24 Authors: Qi FH, Wang ZX, Cai PP, Zhao L, Gao JJ, Kokudo N, Li AY, Han JQ, Tang W Abstract Since the significant public health hazard of Hepatitis B virus (HBV) infection and obvious drug resistance and dose-dependent side effects for common antiviral agents (e.g., interferon α, lamivudine, and adefovir), continuous development of agents to treat HBV infection is urgently needed. Traditional Chinese medicine (TCM) is an established segment of the health care system in China. Currently, it is widely used for chronic hepatitis B (CHB) in China and many parts of the world. Over a long period of time in clinical practice and in basic research progress, the effectiveness and beneficial contribution of TCM on CHB have been gradually known and confirmed. Based upon our review of related papers and because of our prior knowledge and experience, we have selected some Chinese medicines, including Chinese herbal formulas (e.g., Xiao-Chai-Hu-Tang, Xiao-Yao-San, and Long-Dan-Xie-Gan-Tang), single herbs (e.g., Phyllanthus niruri, Radix astragali, Polygonum cuspidatum, Rheum palmatum, and Salvia miltiorrhiza) and related active compounds (e.g., wogonin, artesunate, saikosaponin, astragaloside IV, and chrysophanol 8-O-beta-Dglucoside) and Chinese medicine preparations (e.g., silymarin, silibinin, kushenin, and cinobufacini), which seem effective and worthy of additional and indepth study in treating CHB, and we have given them a brief review. We conclude that these Chinese herbal medicines exhibit significant anti-HBV activities with improved liver function, and enhanced HBeAg and HBsAg sero-conversion rates as well as HBV DNA clearance rates in HepG2 2.2.15 cells, DHBV models, or patients with CHB. We hope this review will contribute to an understanding of TCM and related active compounds as an effective treatment for CHB and provide useful information for the development of more effective antiviral drugs. PMID: 24423652 [PubMed - indexed for MEDLINE]

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Traditional Chinese medicine and related active compounds: a review of their role on hepatitis B virus infection.

Dietary Supplement Use Among Patients With Hepatocellular Carcinoma.

Posted by on 18 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

Dietary Supplement Use Among Patients With Hepatocellular Carcinoma. Integr Cancer Ther. 2014 Sep 15; Authors: Lee V, Goyal A, Hsu CC, Jacobson JS, Rodriguez RD, Siegel AB Abstract Background. More than 50% of US adults, and an even larger proportion of cancer patients, use dietary supplements. Since many supplements require hepatic metabolism, they may be particularly likely to cause toxicities in patients with hepatocellular carcinoma (HCC). However, little is known about supplement use in patients with HCC. Methods. From 2008 to 2012, we gave newly diagnosed HCC patients at our institution a standardized questionnaire about dietary supplement use, demographic factors, and clinical characteristics. We then followed patients for four years or until time to death to examine the relationship with supplement use. Results. Of 146 patients, 71% had used vitamins and 45% herbal supplements. Most commonly used supplements were antioxidants (51%), multivitamins (46%), vitamin D (25%), and milk thistle (23%). People in mid-higher income brackets were more likely to use herbal supplements (19% of those earning <$30 000, 50% of those earning $30 000-60 000, and 34% of those earning >$60 000 used supplements). Hepatitis C (HCV) patients were more likely to use milk thistle than those without HCV (30% vs 13%, P = .03), and patients with hepatitis B (HBV) were more likely than non-HBV patients to use vitamin C (32% vs 14%, P = .01). Supplement use was not associated with overall survival. Conclusions. Like cancer patients in other studies, the majority of our HCC patients used dietary supplements. Supplement use was not associated with overall survival but should be studied in larger patient samples. PMID: 25228537 [PubMed - as supplied by publisher]

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Dietary Supplement Use Among Patients With Hepatocellular Carcinoma.

A comparison of three luminescent immunoassays for HBsAg quantification during the natural history of chronic hepatitis B virus infection.

Posted by on 12 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

A comparison of three luminescent immunoassays for HBsAg quantification during the natural history of chronic hepatitis B virus infection. Clin Vaccine Immunol. 2014 Sep 10; Authors: Cheng XD, Song LW, Fang LL, Yang L, Wu Y, Ge SX, Yuan Q, Zhang J, Xia NS, Hao XK Abstract Hepatitis B surface antigen (HBsAg) quantification has garnered attention because of its high predictive value in determining treatment responses. HBsAg quantification assays, such as Architect and Elecsys, are commercially available, and more assays are in development. We aimed to compare the results of the Architect and Elecsys assays with those of a new assay, WTultra. The WTultra HBsAg assay is a sandwich chemiluminescent microplate enzyme immunoassay and provide an alternative choice which is more cost-effective and potential applicable in developing or resource-constrained countries and areas. A total of 411 serum samples were collected from patients during various phases of chronic hepatitis B (CHB) infection. The samples were assessed using the three assays, and the results were compared and analyzed. The Architect, Elecsys and WTultra assays were well correlated according to the overall results for the samples (correlation coefficients, rArchitect versus WTultra=0.936, rArchitect versus Elecsys=0.952, and rWTultra versus Elecsys=0.981) and the various infection phases (rArchitect versus WTultra range from 0.67 to 0.975, rArchitect versus Elecsys range from 0.695 to 0.982, and rWTultra versus Elecsys range from 0.877 to 0.99). Additionally, consistent results were observed according to genotype (genotype B: rArchitect versus WTultra=0.976, rArchitect versus Elecsys=0.978, rWTultra versus Elecsys=0.979; genotype C: rArchitect versus WTultra=0.950, rArchitect versus Elecsys=0.963, rWTultra versus Elecsys=0.981) and HBV DNA level (rArchitect=0.540, rWTultra=0.553, rElecsys=0.580). In conclusion, the Elecsys and WTultra assays were well correlated with the Architect assay, irrespective of the CHB infection phase or genotype. All of these assays are reliable for HBsAg quantification. PMID: 25209557 [PubMed - as supplied by publisher]

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A comparison of three luminescent immunoassays for HBsAg quantification during the natural history of chronic hepatitis B virus infection.

The immune tolerant phase of chronic HBV infection: new perspectives on an old concept.

Posted by on 02 Sep 2014 | Tagged as: Hepatitis B Alternative Medicine

The immune tolerant phase of chronic HBV infection: new perspectives on an old concept. Cell Mol Immunol. 2014 Sep 1; Authors: Bertoletti A, Kennedy PT Abstract Chronic hepatitis B virus (HBV) infection progresses through distinct disease phases that are strongly associated with patient age. The so-called immune tolerant (IT) phase represents the classical early phase of infection; it is associated with high levels of HBV replication and lack of clinical signs of liver Inflammation. Whether this phase of HBV infection is also associated with immunological features of “tolerance’ has recently been challenged. Here, we review the data that dispute this concept of immune tolerance and then propose an alternative interpretation of the immunopathological events that take place during this early phase of CHB infection.Cellular & Molecular Immunology advance online publication, 1 September 2014; doi:10.1038/cmi.2014.79. PMID: 25176526 [PubMed - as supplied by publisher]

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The immune tolerant phase of chronic HBV infection: new perspectives on an old concept.

Assessment of Bone Mineral Density in Tenofovir treated Chronic Hepatitis B patients: Can FRAX identify those at greatest risk?

Posted by on 27 Aug 2014 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Assessment of Bone Mineral Density in Tenofovir treated Chronic Hepatitis B patients: Can FRAX identify those at greatest risk? J Infect Dis. 2014 Aug 25; Authors: Gill US, Zissimopoulos A, Al-Shamma S, Burke K, McPhail MJ, Barr DA, Kallis YN, Marley RT, Kooner P, Foster GR, Kennedy PT Abstract BACKGROUND:  Tenofovir Disoproxil Fumarate (TDF) is an established nucleotide (NUC) analogue in the treatment of Chronic Hepatitis B (CHB). Bone Mineral Density (BMD) loss has been described in TDF treated Human Immunodeficiency virus (HIV) patients, but limited data exist in CHB. Dual X-ray absorptiometry (DEXA) scanning was used to determine BMD changes in TDF exposed patients; we evaluated the accuracy of the FRAX score as an alternative to DEXA in clinical practice. METHODS:  170 patients were studied; 122 exposed to TDF, 48 controls. All patients underwent DEXA scan and demographic details were recorded. FRAX scores (pre & post-DEXA) were calculated. RESULTS:  TDF was associated with a lower hip T-score (p=0.02). On univariate and multivariate analysis, advancing age, smoking, lower BMI along with TDF exposure were independent predictors of low BMD. In addition the pre-DEXA FRAX score was an accurate predictor of the post-DEXA FRAX treatment recommendation (100% sensitivity, 83% specificity), AUC 0.93 (95% CI 0.87 to 0.97, p<0.001). CONCLUSION:  TDF treated CHB patients have reduced BMD, but limited to one anatomical site. Age and advanced liver disease are additional contributing factors, underlining the importance of multifactorial fracture risk assessment. FRAX can accurately identify those at greatest risk of osteoporotic fracture. PMID: 25156561 [PubMed - as supplied by publisher]

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Assessment of Bone Mineral Density in Tenofovir treated Chronic Hepatitis B patients: Can FRAX identify those at greatest risk?

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