Jianning Jiang

Distribution and clinical correlates of viral and host genotypes in Chinese patients with chronic hepatitis C virus infection.

Chronic hepatitis C virus (HCV) infection is relatively frequent in China. This study investigated the clinical, demographic, and viral and host genetic characteristics that may influence disease manifestations and clinical management.

Real-world treatment patterns and clinical outcomes of HCV treatment-naive patients in China: an interim analysis from the CCgenos study

In China, chronic hepatitis C virus (HCV) infection represents a considerable healthcare burden. Although interferon‐based therapy has been the standard‐of‐care for many years, few long‐term, real‐life studies have assessed interferon‐based treatment in China. The objective of CCgenos follow‐up study was to analyze long‐term treatment patterns and outcomes in a cohort of treatment‐naïve, Han ethnic, patients with chronic HCV infection.

Randomized, three-arm study to optimize lamivudine efficacy in hepatitis B e antigen-positive chronic hepatitis B patients

Data about the efficacy of de novo combination therapies, or optimization strategy by adding the other drug based on the virological response at week 24 of low genetic barrier antiviral agents is still limited. This study aimed to compare the efficacy at week 104 of lamivudine monotherapy (MONO), lamivudine plus adefovir dipivoxil (ADV) combination therapy (COMBO), and lamivudine optimization strategy (OPTIMIZE).

Integration of hepatitis B virus S gene impacts on hepatitis B surface antigen levels in patients with antiviral therapy: HBV S gene integration impacts on HBsAg level

The aim of this study is to investigate the impact of hepatitis B virus (HBV) S gene integration on serum hepatitis B surface antigen (HBsAg) levels in chronic hepatitis B with long‐term nucleos(t)ide analogue (NUC) therapy.

Letter: should direct-acting antiviral drugs be used concomitantly with chemotherapeutic drugs in hepatitis C virus-infected patients with cancer?

SIR, A large number of new treatment strategies are in development for chronic hepatitis C including direct-acting antiviral drugs (DAAs), which target specific hepatitis C virus enzymes. Compared with the standard treatment of peginterferon/ribavirin, the use of DAAs to treat chronic hepatitis C has resulted in a significant increase in more than 90% sustained viral response. However, the feasibility of concomitant use of DAAs and chemotherapy in hepatitis C virus-infected patients with cancer is not well illustrated. Therefore, Economides and coworkers performed a small prospective study for the first time to examine the safety and clinically significant drug–drug interactions observed in patients who received simultaneous treatment with DAAs and chemotherapy. Although DAAs drugs were concomitant used with chemotherapeutic drugs, the overall sustained viral response was still similar with that of previous reports. And the authors found 38% (8/21) patients had grade 3 or 4 adverse events. The study by Economides and coworkers is not without limitations. First, patients who were treated with different reasons for concomitant use of DAAs and chemotherapy were included. Seven (33%) patients treated for oncologic reasons while fourteen (67%) treated for virological reasons. Different treated reasons means different disease backgrounds. For example, patients treated for virological reasons may have poorer liver function and are easy to have frequent and/or serious adverse events. It is very likely, though not certain, that the eight patients with grade 3 or 4 adverse events were treated for virological reasons. It is notable that all the two patients with grade 4 adverse events were received trastuzumab. Hepatitis B virus reactivation is easy to happen after trastuzumab treatment in hepatitis B virusinfected patients with cancer. 7 We do not know if hepatitis C virus-infected patients with cancer have similar clinical phenomenon. If univariate and multivariate analyses for the risk factors of serious adverse events were performed, drug–drug interactions will be revealed in more detail. The other limitation is lack of comparable control. Previous studies found DAAs with sofosbuvir plus ledipasvir or sofosbuvir plus daclatasvir are well tolerated with no adverse events resulting in discontinuation of treatment for treatment-na€ıve patients with hepatitis C virus and compensated cirrhosis. 8–10 The most common adverse events were headache, fatigue and asthenia, and none of them led to clinically significant symptoms. 8–10 In the study by Economides and coworkers, the mainly observed adverse events were constitutional (57%), haematological and gastrointestinal (33% each). Therefore, most of the adverse events, especially the serious adverse events, were attributed to the chemotherapeutic agents. In this regard, it may make no sense to modify anti-viral dose. If there is a control group with chemotherapy alone, the effect of drug–drug interactions about concomitant use of DAAs and chemotherapy will be more distinct and objective. While the work of Economides et al. is a laudable effort, it should be regarded as only the first step in a long process of establishing drug–drug interactions when concomitant use of DAAs and chemotherapy in hepatitis C virus-infected patients with cancer. Their conclusions must be verified in much larger studies that take into account the complex array of patientand liver function-related factors that can determine response to treatment.

Letter: hepatocellular carcinoma risk after hepatitis B surface antigen seroclearance

(5.00%) and a lower prevalence of lymphocytic gastritis (LG) (2.5%). Although mentioned but not detailed for the patients with coeliac disease in Lebwohl et al., we also noted Hp infection (13.25%), reactive gastropathy (5.00%) and intestinal metaplasia (1.25%). Overall, 25% of our cohort was on PPI at the time of the gastroscopy. As shown in Table 1, the degree of increase in tTG antibodies times upper normal limit was significantly higher in the group with gastritis (excluding Hp associated gastritis) compared to the group without gastritis. There was also a trend towards more patients with iron deficiency in this group. However, there were no significant differences in terms of GI symptomatology, PPI use and severity of villous atrophy. These results did not change after adding the individuals with Hp infection to the ‘gastritis subgroup’. The results from our newly diagnosed adult coeliac disease cohort corroborate the findings of Lebwohl et al. and Banaszkiewicz et al. that gastritis is frequent in coeliac disease, both in adult and paediatric populations. We show that the endoscopic appearance of the stomach was normal in a significant proportion of cases of gastritis. Although no difference in the severity of villous atrophy between the groups was found (possibly due to information biases), which differs from other reports of severe villous atrophy in association with gastritis, 5, 6 we feel that the increase in tTG antibodies observed in the gastritis group might indicate either a longer disease duration in these individuals or perhaps a role of the gastric mucosa in the gluten-mediated immune reaction, knowing that tTG is ubiquitous and active in gastric mucosal cells in several diseases. 8

Prevalence of abnormal glycometabolism in treatment‐naive patients with hepatitis C virus infection in a Chinese Han population

The hepatitis C virus (HCV) may promote pancreatic β‐cell apoptosis‐like cell death through a caspase 3‐dependent pathway, initiating the onset of type 2 diabetes mellitus (T2DM); however, the risk factors for development of T2DM and other abnormal glycometabolic factors in HCV patients of the Chinese Han ethnicity have been poorly explored.

Sofosbuvir plus ribavirin with or without peginterferon for the treatment of hepatitis C virus: Results from a phase 3b study in China: Sofosbuvir for Hepatitis C in China

Sofosbuvir is a nucleotide analog inhibitor of the hepatitis C virus (HCV) NS5B RNA polymerase with pangenotypic potency. This phase 3b study evaluated the safety and efficacy of sofosbuvir + ribavirin ± peginterferon in Chinese patients infected with HCV genotype 1, 2, 3, or 6.

A cross-sectional assessment of health-related quality of life in Chinese patients with chronic hepatitis c virus infection with EQ-5D

BackgroundHepatitis C virus (HCV) infection is one of the most common liver infections, with a decrement in HRQoL of HCV patients. This study aims to assess Health-related quality of life (HRQoL) in Chinese patients with chronic HCV infection, and to identify significant predictors of the HRQoL in these patients of China.MethodsIn this cross-sectional observational study, treatment-naïve Han ethnic adults with chronic HCV infection were enrolled. Adopting European Quality of Life scale (EQ-5D) and EuroQOL visual analogue scale (EQ-VAS) were used to qualify HRQoL. Results were reported in descriptive analyses to describe sociodemographic and clinical characteristics. Multiple linear regression analysis was applied to investigate the associations of these variables with HRQoL. Binary logistic regression analysis was performed to identify associations of these variables with HRQoL by dimensions of EQ-5D.ResultsNine hundred ninety-seven patients were enrolled in the study [median age 46.0 (37.0, 56.0) years; male 54.8%]. Mean EQ-5D index and EQ-VAS score were 0.780 ± 0.083 and 77.2 ± 14.8. Multiple Linear regression analysis showed that income (< 2000 RMB, β = − 0.134; 2000–4999 RMB, β = − 0.085), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.090), disease profile (cirrhosis, β = − 0.114), hyperlipidemia (β = − 0.065) and depression (β = − 0.065) were independently associated with EQ-5D index. Residence (the west, β = 0.087), income (< 2000 RMB, β = − 0.129; 2000–4999 RMB, β = − 0.052), moderate or severe symptoms of discomfort (more than one symptoms, β = − 0.091), disease profile and depression (β = − 0.316) were the influencing factors on EQ-VAS. Binary logistic regression indicated that disease profile and clinical depression were the major influencing factors on all five dimensions of EQ-5D.ConclusionsIn this cross-sectional assessment of HCV patients in China, we indicated HRQoL of Chinese HCV patients. Significant negative associations between HRQoL and sociodemographic and clinical factors such as moderate or severe symptoms of discomfort, disease profile and depression emerged. We have to focus on optimally managing care of HCV patients and improving their HRQoL.Trial registrationClinicalTrials.gov identifier NCT01293279. Date of registration: February 10, 2011.

P414 ASSESSMENT OF THE CHANGE IN ESTIMATED GLOMERULAR FILTRATION RATES IN TELBIVUDINE- OR LAMIVUDINE-BASED TRERAPY IN PATIENTS WITH CHRONIC HEPATITIS B

P414 ASSESSMENT OF THE CHANGE IN ESTIMATED GLOMERULAR FILTRATION RATES IN TELBIVUDINEOR LAMIVUDINE-BASED TRERAPY IN PATIENTS WITH CHRONIC HEPATITIS B J. Sun, J. Cheng, X. Chen, Q. Xie, D. Tan, H. Wang, S. Chen, Y. Yu, H. Tang, J. Niu, J. Sheng, Y. Sun, Q. Ning, M. Wan, X. Bai, G. Shi, H. Ren, M. Xu, X. Dou, J. Shi, J. Jiang, X. Chen, H. Long, M. Wang, H. Zhang, Z. Gao, C. Chen, J. Jiang, H. Ma, J. Jia, J. Hou. Hepatology Unit, Nanfang Hospital, Guangzhou, Beijing Ditan Hospital, Beijing Youan Hospital, Beijing, Ruijin Hospital, Shanghai, Xiangya Hospital, Changsha, Peking University People’s Hospital, Beijing, Ji’nan Infectious Diseases Hospital, Ji’nan, First Hospital of Peking University, Beijing, Huaxi Hospital, Chengdu, No. 1 Hospital Affiliated to Jilin University, Changchun, Zhejiang University 1st Affiliated Hospital, Hangzhou, Tangdu Hospital, Xi’an, Tongji Hospital, Wuhan, Changhai Hospital, Shanghai Huashan Hospital, Shanghai, Chongqing Medical University 2nd Affiliated Hospital, Chongqing, 8th People’s Hospital, Guangzhou, Shengjing Hospital, Shenyang, 6th People’s Hospital, Hangzhou, The First Affiliated Hospital of Guangxi Medical University, Nanning, Guangdong General Hospital, Guangzhou, The First People Hospital of Foshan, Foshan, 81st PLA Hospital, Guangzhou, 302nd PLA Hospital, Beijing, Sun Yat-Sen University 3rd Affiliated Hospital, Guangzhou, 85th PLA Hospital, Shanghai, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Beijing Friendship Hospital, Beijing, China E-mail: doctorsunjian@qq.com Background and Aims: Recent pooled analyses of multiple studies of telbivudine in patients with chronic hepatitis B (CHB) demonstrated that telbivudine therapy was associated with a consistent increase of estimated Glomerular Filtration Rates (eGFR). The aim of this study was to validate the effect on eGFR of telbivudineor lamivudine-based therapy in two multi-center, randomized controlled studies in Chinese CHB patients. Methods: 606 and 366 compensated HBeAg positive CHB patients were enrolled in the EFFORT (NCT00962533) and EXPLORE (NCT01088009) studies with similar study design based on ROADMAP concept, receiving telbivudine-based and lamivudinebased therapies for up to 104 weeks, respectively. Adefovir was added to patients per protocol at baseline or week 28, or at virological breakthrough. eGFR was assessed with aMDRD equation.