Liu Y.,Beijing Institute of Infectious Diseases |
Liu Y.,Beijing 302 Hospital |
Wang C.,Beijing Institute of Infectious Diseases |
Wang C.,Beijing 302 Hospital |
And 16 more authors.
Antiviral Therapy | Year: 2010
Here, we report a case of multidrug resistance in a patient with chronic hepatitis B. The patient sequentially received lamivudine, adefovir dipivoxil and entecavir, and subsequently developed single-, double- and triple-drug-resistant HBV strains. We consider this case report important because it documents, for the first time, that triple-drug-resistant HBV strains identified in a clinical setting were suppressible by lamivudine add-on adefovir dipivoxil when tenofovir disoproxil fumarate was not available. ©2010 International Medical Press.
Association of hepatitis B virus mutations in basal core promoter and precore regions with severity of liver disease: An investigation of 793 Chinese patients with mild and severe chronic hepatitis B and acute-on-chronic liver failure
Xu Z.,Beijing Institute of Infectious Diseases |
Xu Z.,Beijing 302 Hospital |
Ren X.,Beijing Institute of Infectious Diseases |
Ren X.,Beijing 302 Hospital |
And 22 more authors.
Journal of Gastroenterology | Year: 2011
Objective: To investigate the features of hepatitis B virus (HBV) basal core promoter/precore (BCP/PC) mutations and genotypes in a large number of mild/severe chronic hepatitis B (CHB-M/CHB-S), and acute-on-chronic liver failure (ACLF) patients and analyze the clinical implications of the virologic features. Patients and methods: Sera of 793 (325 CHB-M, 170 CHB-S, and 298 ACLF) patients admitted to or who had visited Beijing 302 Hospital from January 2005 to December 2008 were collected and successfully amplified for the HBV BCP/PC and a 1225-bp-long S/Pol (nt 54-1278) gene regions. Biochemical and serological parameters and HBV DNA level were routinely performed. Viral DNA was extracted and subjected to a nested PCR. Genotypes/subgenotypes were determined based on complete genomic sequence or on analysis of the 1225-bp-long S/Pol-gene sequence. HBV genotyping was performed by direct PCR sequencing followed by molecular evolutionary analysis of the viral sequences. A P value of <0.05 (two-sided) was considered to be statistically significant. Conclusions: Our findings suggest that CHB patients infected with BCP/PC mutant viruses are more susceptible to severe hepatitis and ACLF than those with the BCP/PC wild-type virus and that ACLF patients with PC mutant viruses have an increased risk of death. As such, the HBV PC mutation is a potential predictive indicator of ACLF outcome. © 2010 Springer.
Yang Y.,Beijing 302nd Hospital |
Yang Y.,Beijing Institute of Infectious Diseases |
Lu Y.,Beijing 302nd Hospital |
Wang C.,Beijing 302nd Hospital |
And 10 more authors.
Experimental and Therapeutic Medicine | Year: 2012
Sorafenib may prolong survival in patients with advanced hepatocellular carcinoma (HCC), but with limited efficacy. The present study aimed to assess the safety and efficacy of sorafenib combined with cryotherapy (cryoRx) for the treatment of advanced HCC. A total of 104 patients met the following criteria: advanced HCC without distant metastasis, presence of portal vein thrombosis, Child-Pugh class A or B and life expectancy of at least 12 weeks. All patients were randomly assigned to sorafenib and cryoRx (n=52) or sorafenib-alone (n=52) treatment groups. The primary end-point of the study was overall survival (OS). The secondary end-points included time to progression (TTP) and tolerability. Microvessel density (MVD) was assessed following immunostaining for CD34. In a median of 10.5 (4-26) months follow-up, the median OS was 12.5 months (95% CI 10.6-16.4) in the combination therapy vs. 8.6 months (7.3-10.4) in the sorafenib-alone (P=0.01) group. The median TTP was 9.5 months (8.4-13.5) in the combination therapy vs. 5.3 months (3.8-6.9) in the sorafenib alone (P=0.02) group. CryoRx was an independent factor associated with improved clinical outcomes of sorafenib for the treatment of advanced HCC. Patients with low intratumoral MVD receiving the combination therapy exhibited a significantly longer median TTP and OS compared to those receiving sorafenib. High intratumoral MVD was an independent predictor of poor responses to sorafenib for advanced HCC. Compared with previous reports of sorafenib-related adverse drug reactions (ADRs), cryoRx did not further increase the frequency and degree of sorafenib-related ADRs. In conclusion, compared to sorafenib alone, the addition of cryoRx to sorafenib significantly improves the clinical outcomes of sorafenib for the treatment of advanced HCC with acceptable tolerance and similar safety profiles as previously reported. High intratumoral MVD is predictive of poor responses to sorafenib in advanced HCC patients.
PubMed | Beijing Institute of Infectious Diseases
Type: Case Reports | Journal: Antiviral therapy | Year: 2010
Here, we report a case of multidrug resistance in a patient with chronic hepatitis B. The patient sequentially received lamivudine, adefovir dipivoxil and entecavir, and subsequently developed single-, double- and triple-drug-resistant HBV strains. We consider this case report important because it documents, for the first time, that triple-drug-resistant HBV strains identified in a clinical setting were suppressible by lamivudine add-on adefovir dipivoxil when tenofovir disoproxil fumarate was not available.