October 2018

Monthly Archive

Epigenetic differences of chronic hepatitis B in different TCM syndromes: Protocol for a case-control, non-interventional, observational clinical…

Posted by on 17 Oct 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Epigenetic differences of chronic hepatitis B in different TCM syndromes: Protocol for a case-control, non-interventional, observational clinical study. Medicine (Baltimore). 2018 Sep;97(39):e12452 Authors: Ma L, Zheng X, Yang Y, Wang J, Xu Y, Wang B Abstract INTRODUCTION: Chronic hepatitis B is a serious disease causing serious harm to the human health. Chinese medicine has its unique advantages in the clinical prevention and treatment, while the syndrome of Chinese medicine lacks the understanding at the micro level. There are some theoretical commonalities between the epigenetics and traditional Chinese medicine (TCM) syndromes. The biological basis of chronic hepatitis B (CHB) syndrome differentiation from the perspective of epigenetics is of great significance to diagnose and prevent the diseases. METHODS: This protocol is a case-control, noninterventional, observational clinical study. Patients with CHB for spleen-stomach damp heat and liver depression and spleen deficiency, with 12 each and 11 healthy volunteers were recruited. Peripheral venous blood was collected from the participants. DNA methylated transferase, genomic DNA methylated spectrum, methylated DNA binding protein MeCP2, chronic infection of hepatitis B virus with methylated related proteins, and miRNA target genes were analyzed. OBJECTIVES: From the perspective of DNA methylation epigenetics, “DNA methylation-miRNA-Target gene” is the main line, which further reveals the essence of TCM syndrome. To improve the level of TCM clinical syndrome differentiation and the clinical efficacy of TCM, especially in the study of TCM syndromes of CHB, discovering its underlying biological signature is necessary. TRIAL REGISTRATION: Clinical Trials Registration: ChiCTR1800017365, registered 26 July 2018. PMID: 30278525 [PubMed – indexed for MEDLINE]

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Epigenetic differences of chronic hepatitis B in different TCM syndromes: Protocol for a case-control, non-interventional, observational clinical…

The prevalence and characteristics of HIV/AIDS patients presenting at a chiropractic outpatient clinic in Toronto, Ontario. A retrospective,…

Posted by on 12 Oct 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles The prevalence and characteristics of HIV/AIDS patients presenting at a chiropractic outpatient clinic in Toronto, Ontario. A retrospective, observational study. J Can Chiropr Assoc. 2018 Aug;62(2):77-84 Authors: Injeyan HS, Connell G, Foster K, Kopansky-Giles D, Sovak G, Tibbles T Abstract Objective: To determine the prevalence and presenting complaints of HIV/AIDS patients attending a chiropractic outpatient teaching clinic in downtown Toronto, and explore their self-reported comorbidities, medications used, and consumption of other complementary health care. Methods: A random sample was drawn from the entire clinic file collection spanning the years 2007 to 2013. Files were anonymized and coded to ensure confidentiality. Results: A total of 264 files were radomly pulled from approxinately 3750 clinic files. The prevalence of HIV positive patients was 5.7% (15/264), predominantly males, with 3 patients having developed AIDS. Co-infection with Hepatitis B and/or C was identified in 5/15 patients. The most common presenting complaint was neck pain (80%), followed by low back pain (47%) compared to 20% and 43% respectively for the general cohort. Eleven of 15 patients were on antiretroviral treatment (ART); The frequency of comorbidities was 8/15 (53%) however, none were identified as being dominant. In addition to chiropractic, 7/15 patients reported receiving other complementary therapies. Conclusions: A relatively small proportion of HIV/ AIDS patients were found to be receiving treatments in this downtown chiropractic clinic situated within a community health clinic setting. The principal presenting complaint was neck pain. PMID: 30305763 [PubMed]

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The prevalence and characteristics of HIV/AIDS patients presenting at a chiropractic outpatient clinic in Toronto, Ontario. A retrospective,…

HCV core antigen as an alternative to HCV RNA testing in the era of direct-acting antivirals: retrospective screening and diagnostic cohort studies.

Posted by on 03 Oct 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles HCV core antigen as an alternative to HCV RNA testing in the era of direct-acting antivirals: retrospective screening and diagnostic cohort studies. Lancet Gastroenterol Hepatol. 2018 Sep 28;: Authors: van Tilborg M, Al Marzooqi SH, Wong WWL, Maan R, Vermehren J, Maasoumy B, Mazzulli T, Bolotin S, Garber G, Guerra F, Flud CR, Kowgier M, Janssen HL, de Knegt RJ, Pawlotsky JM, Cloherty GA, Duarte-Rojo A, Sarrazin C, Wedemeyer H, Feld JJ Abstract BACKGROUND: Direct-acting antivirals for chronic hepatitis C (HCV) infection have reduced the need for on-treatment HCV RNA monitoring. We assessed the accuracy and cost implications of using HCV core antigen testing to replace HCV RNA testing for confirmation of diagnosis, on-treatment monitoring, and determination of sustained virological response (SVR). METHODS: In a retrospective screening cohort study, de-identified residual serum from unselected samples were obtained from commercial laboratories in Ontario, Canada. Samples from each 5-year age-sex band from birth years 1945-74 collected from Aug 1, 2014, to Feb 28, 2015, were included. All samples that tested positive for HCV antibodies, and 10% of samples that tested negative for HCV antibodies, were tested for HCV core antigen and HCV RNA. A retrospective clinical cohort study was also done using blood samples from patients with confirmed HCV infection collected at four tertiary academic centres: one in Canada, two in Germany, and one in the USA. For assessment of SVR, we included samples from patients who started direct-acting antiviral-based treatment (excluding telaprevir and boceprevir) with or without peginterferon, ribavirin, or both, from Jan 1, 2014, to March 31, 2015. To ensure inclusion of adequate numbers for analysis, patients who relapsed after any treatment regimen were included. Serum samples included in the study were from baseline, week 4 on-treatment (only for patients treated with direct-acting antivirals), end of treatment, and week 12 or 24 of follow-up. The sensitivity and specificity of core antigen testing as a diagnostic tool was assessed in the screening cohort, using HCV RNA as a reference. The sensitivity and specificity of core antigen testing as well as its concordance with HCV RNA testing in the clinical cohort was assessed at baseline, week 4 on-treatment, and at weeks 12 or 24 after the end of treatment in patients undergoing therapy with direct-acting antivirals. The cost-effectiveness of core antigen testing with and without confirmatory HCV RNA testing for negative samples was also assessed. FINDINGS: From 10 006 samples in the screening cohort, 75 of 80 viraemic (HCV RNA-positive) samples tested positive for HCV core antigen (sensitivity 94%, 95% CI 86-98), and none of the 993 HCV RNA-negative samples tested positive for HCV core antigen (specificity 100%, 95% CI 94-100). The five viraemic samples that tested negative for HCV core antigen had low corresponding HCV RNA concentrations. In the clinical cohort, two (1%) of 202 baseline samples tested negative for HCV core antigen; one had a low HCV RNA concentration (468 IU/mL), the other had a high HCV RNA concentration (>2 000 000 IU/mL). By week 4 of treatment, HCV core antigen concentrations decreased in all patients but were not predictive of SVR. Although there was good concordance between HCV RNA and HCV core antigen results at 12 weeks after the end of treatment (r=0·97; p<0·0001), three of the 148 patients who achieved SVR at 12 weeks tested HCV core antigen positive. 12 weeks after the end of treatment, HCV core antigen was undetectable in one (1%) of 71 samples from patients who were identified as having relapsed according to HCV RNA detection. On-treatment and end-of-treatment testing of core antigen or HCV RNA provided little clinical value. The use of HCV core antigen testing as a confirmatory diagnostic strategy was cost saving relative to HCV RNA testing, with a reduction of CAD$0·29-3·70 per patient screened depending on whether HCV RNA testing was used to confirm HCV core antigen-negative results. INTERPRETATION: These data support the use of HCV core antigen testing to document HCV viraemia in a cost-saving diagnostic algorithm. In a treatment setting, HCV core antigen testing can be used instead of HCV RNA testing for diagnosis and documentation of treatment adherence, but it might not be adequate to determine SVR. This approach might improve access to care, particularly in low-income and middle-income countries. FUNDING: Abbott Diagnostics and Toronto Centre for Liver Disease. PMID: 30274834 [PubMed – as supplied by publisher]

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HCV core antigen as an alternative to HCV RNA testing in the era of direct-acting antivirals: retrospective screening and diagnostic cohort studies.

A New ELISA to Overcome the Pitfalls in Quantification of Recombinant Human Monoclonal Anti-HBs, GC1102, by Commercial Immunoassays.

Posted by on 03 Oct 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles A New ELISA to Overcome the Pitfalls in Quantification of Recombinant Human Monoclonal Anti-HBs, GC1102, by Commercial Immunoassays. Biol Proced Online. 2018;20:18 Authors: Shin YW, Cho DH, Song GW, Kim SH Abstract Several methods for the quantification of human anti-HBs, an antibody to hepatitis B surface antigen (HBsAg), have been developed based on enzyme reaction, chemiluminescence, fluorescence, and radioactivity for application to human serum or plasma. Commercial anti-HBs immunoassay kits use a sandwich method in which a bridge is formed by the anti-HBs between a HBsAg immobilized solid matrix and the labeled HBsAg. However, this direct sandwich enzyme-linked immunosorbent assay (ELISA) is insufficient to accurately evaluate the activity of the human monoclonal anti-HBs, GC1102. As an alternative, we developed an indirect anti-HBs ELISA (anti-HBs qELISA_v.1) that improved detection of anti-HBs. In this current study, we further optimized this indirect method to minimize nonspecific binding of human serum, by employing incubation buffers containing animal serum, Tween 20, skim milk, and a low pH washing buffer. This new and improved method, termed anti-HBs qELISA_v.2, showed accurate quantification of plasma-derived hepatitis B immune globulin (HBIG) and was comparable to results obtained with commercial ELISA (r = 0.93) and RIA (r = 0.85) kits. Further, the GC1102 in human serum could be precisely measured using the anti-HBs qELISA_v.2 without limitations of nonspecific binding. PMID: 30275774 [PubMed]

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A New ELISA to Overcome the Pitfalls in Quantification of Recombinant Human Monoclonal Anti-HBs, GC1102, by Commercial Immunoassays.

Improvements in the Management of Chronic Hepatitis B Virus Infection.

Posted by on 02 Oct 2018 | Tagged as: Hepatitis B Alternative Medicine

Related Articles Improvements in the Management of Chronic Hepatitis B Virus Infection. Expert Rev Gastroenterol Hepatol. 2018 Sep 29;: Authors: Liu LZ, Sun J, Hou J, Chan HLY Abstract INTRODUCTION: The primary goals of managing chronic hepatitis B (CHB) are prevention of liver-related complications and reduction of mortality. Universal vaccination has dramatically reduced the incidence of new infection, but the management of existing CHB patients are still challenging. Areas covered: This review compares the similarities and differences among the latest published regional guidelines on the indications and choices of antiviral therapy. We have summarized advances in virological biomarkers and non-invasive tests for liver fibrosis in disease assessment. Benefits and remaining challenges of current standard of care by peginterferon and nucleos(t)ide analogues (NA) have been presented . Data on combination therapy of peginterferon and NA in seeking functional cure of the disease is also critically discussed. We have also described the improvement in the management of CHB at pregnancy and prophylaxis in patients on chemotherapy and immunosuppressants. Expert commentary: Controversies exist in the assessment of disease activity for selection patients for treatment as well as on the use of tenofovir alafenamide as a safe and cost-effective alternative to tenofovir disoproxil fumarate. Though combination therapy of peginterferon and NA has induced HBsAg seroclearance in a small proportion of patients, peginterferon is not preferred in the future trend of drug development. PMID: 30269597 [PubMed – as supplied by publisher]

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Improvements in the Management of Chronic Hepatitis B Virus Infection.