Simin Yao

The Third People's Hospital, Shen-ch’üan-shih, Zhejiang Sheng, China

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Publications (5)13.27 Total impact

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    ABSTRACT: We aimed to investigate the efficacy and safety of telbivudine (LdT) on the intervention of mother-to-child transmission (MTCT) in different trimesters of pregnant women with high viral loads. In this prospective cohort study, 160 cases of mothers with high viral loads were included. 82 subjects received 600 mg/day LdT therapy. 50 of them started LdT therapy before the third trimester of gestation, including 17 cases before pregnancy, 9 and 24 cases in the first and second trimesters of pregnancy, respectively. The other 32 cases started LdT in the third trimester of gestation. Control pregnant women (78 cases) did not take LdT therapy. MTCT rate was determined by hepatitis B surface antigen (HBsAg) and HBV DNA data of infants at the 51(st) week postpartum. Adverse events were also evaluated throughout the study. 160 infants born from 160 pregnant women. Both LdT-treated groups displayed a marked decline in HBV DNA levels from the beginning to delivery. Positive rate of serum HBsAg in infants born from above two groups mothers were 0% and 3.1% respectively, which was significantly lower than that in the untreated controls (24.4%). The incidence of detectable HBV DNA levels was significantly lower in infants born to LdT-treated mothers than in the controls (16.7%) at the 51(st) week postpartum. No infant had birth defects. No severe adverse event or complication were observed in LdT-treated mothers or infants followed until the 51(st) week postpartum. The earlier application of LdT during pregnancy, the better preventive effects it offered on MTCT. This article is protected by copyright. All rights reserved.
    Hepatology Research 04/2015; DOI:10.1111/hepr.12525 · 2.22 Impact Factor
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    ABSTRACT: In this prospective study, we aimed to evaluate the efficacy and safety of tenofovir disoproxil fumarate (TDF) in Chinese chronic hepatitis B (CHB) patients after multiple nucleoside/nucleotide analogue (NA) treatment failures. A total of 115 Chinese CHB patients with suboptimal response to two or more NA treatments were included in this study. All patients were changed to TDF (300 mg/d, oral administration) anti-viral treatment for at least 72 weeks. HBV polymerase (P) gene mutation screening for each patient was performed. In addition, virological, biochemical responses and estimated glomerular filtration rate (eGFR) of each patient at week 12, 24, 48 and 72 of TDF treatment were evaluated. 76 out of 115 patients had drug-resistance mutations (R(+) ), including 27 with adefovir (ADV)-associated mutations (35.5%) and 49 with lamivudine (LMV)-associated mutations (64.5%). For all included patients, complete viral suppression (CVR) of HBV DNA (< 100 IU/ml) was 57.4%, 69.6%, 74.8% and 86.1% at week 12, 24, 48 and 72 of TDF treatment, respectively. Alanine aminotransferase normalization and hepatitis B e antigen (HBeAg) seroclearance occurred in 77.3% and 23.2%, respectively after 72-week TDF treatment. CVR at weeks 12, 24 and 48 was observed more commonly in patients with baseline HBV DNA < 10(6) IU/ml. There was no significant reduction of eGFR induced by the TDF treatment. 72-week treatment with TDF in Chinese CHB patients with previously multiple NA treatment failures exhibited effective and safe outcomes, which were independent of baseline mutations conferring ADV or LMV resistance. This article is protected by copyright. All rights reserved.
    Hepatology Research 11/2014; DOI:10.1111/hepr.12454 · 2.22 Impact Factor
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    ABSTRACT: Background Accurate assessment of liver fibrosis in patients with chronic hepatitis B (CHB) is necessary not only to predict the long-term clinical course but also to determine an appropriate anti-viral therapy scheme. Several noninvasive approaches - serum markers and elastography - have been proposed as alternatives for the histopathologic analysis of liver biopsies.AimsThe aim of this study was to evaluate two ultrasound elastography methods (ARFI and TE) and one biochemical test (APRI), as well as their optimal linear combination, in the assessment of liver fibrosis in CHB.Methods Ninety five patients with CHB and 16 volunteers underwent ARFI, TE and APRI; and liver fibrosis was staged in the patients by a liver biopsy. An optimal linear combination of the three methods was developed, and its diagnostic performance was evaluated by a 10-fold cross-validation.ResultsThe accuracy of the linear combination was 83.86% and 91.88% for significant fibrosis (≥F2) and cirrhosis (F4), respectively, higher than those obtained for ARFI (83.50%, 88.76%), TE (75.27%, 87.61%), and APRI (73.29% and 81.67%). The combination also increased the sensitivity and the negative predictive values for the diagnosis of significant fibrosis and cirrhosis.Conclusions The optimal linear combination algorithm is effective for noninvasive staging of liver fibrosis in CHB. However, linear combination has its own limitations; nonlinear methods may eventually reveal even clearer diagnostic results.This article is protected by copyright. All rights reserved.
    Liver international: official journal of the International Association for the Study of the Liver 04/2014; 35(3). DOI:10.1111/liv.12564 · 4.41 Impact Factor
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    ABSTRACT: Background Increased numbers of Interleukin-17-producing CD4+ T cells (Th17) have been found in association with hepatitis B virus (HBV)-induced liver injury. However, the mechanism underlying the increase of Th17 responses in patients with HBV infection remains unclear. In this study, we investigate the possible regulatory mechanisms of increased Th17 responses in patients with chronic hepatitis B(CHB). Methods Th17 response and IL-6R expression on CD4+ T cells in peripheral blood samples were determined by flow cytometry. Cytokines TGF-β, IL-1β, IL-6 and IL-17 in plasma and/or supernatant samples were determined by ELISA and the IL-17 and IL-6R mRNA levels were quantified by quantitative real-time reverse polymerase chain reaction. Results All these data indicated that the frequency of periphery Th17 cells is significantly correlated with the percentage of CD4+ T cells expressing IL-6R in CHB patients. CD4+ T cells from patients with CHB, but not those from healthy donors, produced higher levels of IL-17 and had more IL-6R expression upon stimulation with the HBV core antigen (HBcAg) in vitro. The PMA/ionomycin and HBcAg -stimulated up-regulation of IL-17 production by CD4+ T cells could be reversed by a neutralizing antibody against IL-6R. Conclusion we showed that enhancement of IL-6R expression on CD4+ T cells upon HBV infection contributes to increased Th17 response in patients with CHB.
    Virology Journal 06/2011; 8(1):1-10. DOI:10.1186/1743-422X-8-270 · 2.09 Impact Factor
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    ABSTRACT: The objective of this study was to investigate the potential clinical roles of circulating soluble interleukin (IL)-6 receptor (sIL-6R) and IL-6R expression on CD4+ T cells (CD4+ IL-6R+ T cells) in chronic hepatitis B (CHB) patients. One hundred and thirty-three subjects, including 72 CHB patients, 27 asymptomatic carriers, eight acute hepatitis B (AHB) patients, and 26 healthy donors were included in this study. Plasma IL-6 and sIL-6R levels were measured by enzyme-linked immunosorbent assay (ELISA); the frequency of CD4+ IL-6R+ T cells was detected by flow cytometry analysis. Our data showed a significant increase in plasma sIL-6R levels and the frequency of CD4+ IL-6R+ T cells in peripheral blood in CHB patients compared to asymptomatic carriers and healthy controls (both p<0.05). The elevated prevalence of CD4+ IL-6R+ T cells was positively associated with increased serum alanine aminotransferase levels in CHB patients (r = 0.316, p = 0.007), but was not correlated with serum hepatitis B virus (HBV) DNA load. Moreover, CHB patients with an HBV DNA load >1.0 × 10(6) copies/ml had a lower level of plasma sIL-6R than those with an HBV DNA load <1.0 × 10(6) copies/ml. Circulating sIL-6R and CD4+ IL-6R+ T cells were increased in CHB patients. Elevated plasma sIL-6R is probably associated with HBV elimination, and CD4+ IL-6R+ T cells in peripheral blood might contribute to the pathogenesis of liver injury in CHB patients.
    International journal of infectious diseases: IJID: official publication of the International Society for Infectious Diseases 02/2011; 15(4):e267-71. DOI:10.1016/j.ijid.2010.12.008 · 2.33 Impact Factor