ROG,GATA3 and T-bet mRNA levels in peripheral blood mononuclear cells in patients with chronic hepatitis B / 南方医科大学学报

<p><b>OBJECTIVE</b>To investigate the role of ROG, GATA3 and T-bet in the progression of chronic hepatitis B (CHB).</p><p><b>METHODS</b>The mRNA levels of ROG, GATA3 and T-bet in peripheral blood mononuclear cells (PBMCs) from 135 patients with CHB (including 45 mild cases, 42 moderate cases, and 48 severe cases) and 15 healthy control subjects were detected by real-time quantitative PCR.</p><p><b>RESULTS</b>The levels of T-bet mRNA in the PBMCs were significantly higher in CHB patients than in the healthy controls (P<0.05), and also differed significantly between the 3 groups of CHB patients (P<0.05). ROG mRNA levels were significantly higher in severe cases of CHB than in the healthy controls and mild and moderate CHB cases (P<0.05), but were similar among the latter 3 groups (P>0.05). The mRNA level of GATA3 in the PBMCs were significantly higher in moderate and severe CHB cases than in the healthy controls and mild CHB cases (P<0.05). The T-bet/GATA3 ratio was significantly greater in the 3 CHB groups than in the control group (P<0.05) but comparable between the 3 CHB groups (P>0.05). ROG levels were not correlated with GATA3 levels or T-bet/GATA3 ratio in the CHB cases.</p><p><b>CONCLUSIONS</b>The mRNA levels of ROG, GATA3 and T-bet in the PBMCs are obviously up-regulated in CHB patients and these 3 genes may participate in the progression of CHB. ROG plays an important role in correcting and maintaining the new balance of Th1/Th2.</p>

Comparative study on the clinical characteristics of HBV infection patients with different pathologic inflammation grade / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>The aim of this study was to compare the biochemical and virological characteristics among patients infected with hepatitis B virus (HBV) according to pathologic inflammation grade.</p><p><b>METHODS</b>428 patients with chronic HBV infection accept liver biopsy, liver function test, HBeAg detection and HBV DNA levels detection. They were studied and subdivided into four groups according to pathologic inflammation grade. The biochemical and virological characteristics were studied. Univariate analysis was performed with the SPSS 16.0.</p><p><b>RESULTS</b>In different inflammation grading group, mean age and sex composition were no difference. Serum levels of ALT was highest in group G3 and lowet in group G0-1, there was statistically significant among groups (P = 0.005); AST and TBil were all highest in group G4 and lowest in group G0-1, statistically significant also found among groups (P = 0.000 & 0.004). Serum levels of ALB and PTA were all highest in group G0-1 and lowest in group G4, had statistically significant among groups (P = 0.000 & 0.000). There was no difference of HBV DNA level and percentage of HBeAg (+) among four groups (P = 0.565 & 0.065).</p><p><b>CONCLUSIONS</b>The serum AST, TBil, ALB and PTA were different and can partly reflect the inflammation degree of liver damage in patients with HBV infection. ALT and PTA can reflect the inflammation degree of G0-1, G2 and G3; AST, TBil, ALB and PTA reflect the G3 and G4. HBV DNA level and HBeAg status can not indicate the inflammation degree in HBV infection patients.</p>

Correlation between serum macrophage migration inhibitory factor and regulated on activation normal T cell expressed and secreted cytokines in patients with chronic hepatitis B / 中国医师进修杂志

Objective To investigate the serum levels and correlation between macrophage migration inhibitory factor (MIF) and regulated on activation normal T cell expressed and secreted cytokines (RANTES) in patients with chronic hepatitis B (CHB).Methods Forty-four CHB patients (CHB group)and 30 healthy controls (control group) were enrolled in this study.The venous blood was collected and serum MIF and RANTES levels were detected by enzyme-linked immunosorbent assay.Correlation between MIF and RANTES was analyzed in CHB group.Results The serum MIF and RANTES levels in CHB group were significantly higher than those in control group [(8.48 ± 1.70) μ g/L vs.(1.99 ± 2.38) μ g/L,(3.94 ±2.38) μ g/L vs.(0.33 ± 0.15) μ g/L,P =0.000].There was no correlation between MIF level and RANTES level(r =0.212,P＞ 0.05).Conclusions The serum MIF and RANTES levels are significantly increased in patients with CHB,but there is no correlation.The participation pathogenesis way of CHB is different.

Interleukin-32 expression is induced by hepatitis B virus / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate whether hepatitis B virus (HBV) can induce the expression of the host-encoded cytokine interleukin-32 (IL-32) and its effects on host signaling mechanisms related to HBV pathogenesis.</p><p><b>METHODS</b>A eukaryotic expression vector harboring an enhanced green fluorescent protein was constructed with HBV genomic sequences (pIRES2-HBV-EGFP) and transfected into HepG2 cells. In addition, the nuclear factor-kappa B (NF-kB) subunits, p50 and p65, were transfected respectively into HepG2 cells. In both cases, 48 hrs after transfection, IL-32 expression was determined at the mRNA and protein levels using real-time PCR and ELISA and western blot, respectively. The HepG2 cells transfected with pIRES2-HBV-EGFP were also treated with the NF-kB inhibitor SN50 at various concentrations, and the effects on IL-32 protein expression 48 hrs later were evaluated by western blot. Significance of between-group differences was assessed by the Student's t-test.</p><p><b>RESULTS</b>Transfection with pIRES2-HBV-EGFP led to significantly higher IL-23 expression than transfection with empty vector (mRNA: 2.8-fold higher and protein: 4.5-fold higher; both P less than 0.05). Transfection of p50 and p65 proteins led to significantly higher IL-32 expression (both P less than 0.05), and NF-kB activation was found to be required for HBV-induced IL-32 expression.</p><p><b>CONCLUSION</b>IL-32 expression is induced by HBV in HepG2 cells. This host-encoded cytokine, and its downstream activation of NF-kB, may be involved in the pathogenesis of HBV, especially in the subsequent liver inflammation that accompanies HBV infection.</p>

Interleukin-21 expression in serum of patients with acute-on-chronic liver failure and its significance / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the level of the serum IL-21 and its correlation with serum biochemical indices of liver function test in patients with acute-on-chronic liver failure.</p><p><b>METHODS</b>Sixty patients with acute-on-chronic liver failure (severe hepatitis group) and 18 normal cases (control group) were enrolled in the study. Peripheral blood lymphocytes were isolated and total RNA of lymphocytes was extracted by using Trizol. Real-time PCR was used to assay IL-21 mRNA level. The serum IL-21 expression level was detected by ELISA method. The correlation between IL-21 and ALT, AST, TBiL, ALB was analyzed using Pearson's correlation analysis, respectively.</p><p><b>RESULTS</b>Serum IL-21 expression level in severe hepatitis group was higher than that of control group. Moreover, the difference between them was statistically significant (P < 0.05). Serum IL-21 level was positively correlated with serum ALT, AST, TBil, respectively (P < 0.05), but was negatively correlated with ALB, respectively (P < 0.05).</p><p><b>CONCLUSION</b>Serum IL-21 expression level was increased in patients with acute-on-chronic liver failure and was associated with the severe of inflammation. We, therefore, believe that IL-21 might be involved in the pathogenesis of acute-on-chronic liver failure and might be an index of the severity of liver inflammation.</p>

Dynamics of serum HBV DNA levels during the terminal phases of acute-on-chronic hepatitis B liver failure with different HBeAg status / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.</p><p><b>METHODS</b>One-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges, representing increasing severity of disease phases prior to death (day 0): 29-56 d, 15-28 d, and 0-14 d.</p><p><b>RESULTS</b>In the 37 HBeAg(+) patients, HBV DNA levels at above-mentioned phases were 6.10+/-1.63, 5.61+/-1.50, and 5.29+/-1.96 log10 copies/mL. In the 70 anti-HBe(+) patients, HBV DNA levels were 4.63+/-1.82, 5.81+/-1.78, and 4.93+/-1.73 log10 copies/mL. Phase to phase comparisons revealed that the HBV DNA level in the HBeAg(+) group was significantly higher than that in the anti-HBe(+) group at 29-56 d (P less than 0.05), and that 15-28 d and 0-14 d were not significantly different (P more than 0.05). Intragroup comparisons of phases revealed no significant differences in the HBeAg(+) group (P more than 0.05), but a significant difference between 15-28 d and 0-14 d (P less than 0.05) for the anti-HBe(+) group.</p><p><b>CONCLUSION</b>Serum levels of HBV DNA in patients with HBeAg positivity are higher than those in patients with anti-HBe positivity as the disease phase of ACLF nears fatality. Following the deterioration to liver failure, the HBV DNA load in HBeAg(+) patients remains stable while that in anti-HBe(+) patients decreases.</p>

Adenoviruses mediated BCL-X1 overexpression protects mice from fulminant hepatic failure / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To indentify the relation between hepatic cells apoptosis and the lesion of liver tissue in acute toxic lethal hepatitis.</p><p><b>METHODS</b>60 Wistar mice were randomly divided into normal control, model group and treatment group. Normal control and model group were pretreated by portal vein injection of normal saline, the treatment group was pretreated by portal vein injection of BCL-X1 adenoviruses. The mice of model group and treatment group were received an injection of D-galn and LPS to establish fulminant hepatic failure models 7 days after pretrement. To observe BCL-X1 expression, serum ALT, AST, hepatocyte apoptosis rate, and mortality rate of the three groups.</p><p><b>RESULTS</b>The BCL-X1 expression was higher in treatment group than in model group; 6 hours after fulminant hepatic failure models were established,the serum ALT, AST level of treatment group was lower than model group;The hepatocyte apoptosis rate of treatment group was lower than model group. The death rate of treatment group was lower than model group.</p><p><b>CONCLUSION</b>In fulminant mice hepatic failure models, the hepatocyte apoptosis rate has a positive correlation with death rate, the overexpression of BCL-X1 can decrease the hepatocyte apoptosis rate and the death rate.</p>

The levels of HBsAg can predict the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil, in HBeAg-positive chronic hepatitis B patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the levels of HBsAg in predicting the efficacy of peglated interferon-alpha 2a combined with adefovir dipivoxil (ADV), in HBeAg-positive chronic hepatitis B patients.</p><p><b>METHODS</b>This trial enrolled 62 HBeAg-positive chronic hepatitis B patients with detectable HBsAg for at least 6 months prior to screening, serum HBV DNA levels of at least 100 000 IU/ml. The efficacy assessment: viral suppression below 100 IU/ml. The patients with HBV DNA < or = 100 IU/ml after 24 weeks therapy were divided into group A, in which monotherapy continued; While the rest were divided into group B, in which ADV was combined until week 48. In group B, at the end-of-treatment, the patients with HBV DNA < or = 100 IU/ml were divided into group B1, the rest were divided into group B2.</p><p><b>RESULTS</b>There was no significant difference on the baseline characteristics of patients between B1 and B2. There was significant difference on the levels of HBsAg at 12-week and 24-week between B1 and B2; while there was no significant difference on the levels of HBeAg.</p><p><b>CONCLUSIONS</b>The levels of HBsAg at 12-week and 24-week would be predictors to evaluate the efficacy of combined therapy in HBeAg-positive chronic hepatitis B patients.</p>

Analysis of clinical features of hepatitis B virus/hepatitis C virus coinfected patients with different virological profiles / 中华传染病杂志

Objective To understand the clinical features of hepatitis B virus(HBV)/hepatitis C virus(HCV)coinfected patients with different virological profiles.Methods The clinical data of 186 patients with HBV/HCV coinfection from May 1999 to May 2010 in the Third Affiliated Hospital of Sun Yat-Sen University were analyzed retrospectively.The demographic data,epidemiological data,laboratory results and pathological index were analyzed.The statistical analysis was done using t test and chi square test.Results A total of 186 patients were divided into 4 groups:66(35.5%)in HBV DNA(-)/HCV RNA(-)group,8(4.3%)in HBV DNA(+)/HCV RNA(+)group,68(36.6%)in HBV DNA(+)/HCV RNA(-)group and 44(23.7%)in HBV DNA(-)/HCV RNA(+) group.The gender composition,complication incidence,transmission among drug users,alanine aminotransferase(ALT)level,total bilirubin(TBil)level,prothrombin activity(PTA)and hapatitis B e antigen(HBeAg)negative rate were all significantly different among four groups(F or x2=11.578,8.451,11.738,2.669,5.102,4.254 and 18.413,respectively;all P0.05).The HBeAg negative rate in HBV DNA(-)patients was 85.5%,which was higher than that in HBV DNA(+)patients(59.2%)(x2=16.393,P<0.05).Conclusions HBV DNA(+/-)/HCV RNA(-)profile were major components in HBV/HCV confection.HBV DNA level is related to disease progression and prognosis,but not relate to disease severity.Liver function damage and disease severity are aggravated with HCV RNA level decreases.HBV DNA level is related to HBeAg negative rate,while HCV RNA level is not related to HBeAg seroconversion rate.

Detection of core antigen of hepatitis virus C in patients infected with hepatitis virus C and B / 中华肝脏病杂志

<p><b>OBJECTIVE</b>To observe the effect of hepatitis virus B on the detection rate of core antigen of hepatitis virus C in sera of chronic hepatitis C patients.</p><p><b>METHOD</b>HCVcAg and HCV RNA in sera were detected in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV. At the same time, HBV DNA and HBeAg in sera were detected in 62 patients infected with HCV and HBV. Then we analyzed the correlation between HCVcAg and HBeAg/HBV DNA. The detection rates of HCVcAg in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV were 72.7% (64/88) and 38.7% (24/62), respectively (x2 = 17.358, P less than 0.01).</p><p><b>RESULTS</b>The detection rates of HCV RNA in 88 patients with chronic hepatitis C and 62 patients co-infected with HCV and HBV was 81.8% (72/88) and 53.2% (33/62)respectively (x2=20.110, P less than 0.01). In 62 patients infected with HCV and HBV, the detection rate of HCVcAg in HBeAg positive patients and HBeAg negative patients were 28.6% (12/42) and 60% (12/20), respectively (x2 = 7.547, P = 0.011). Moreover, the positive rates of HBV DNA in HBeAg positive patients and HBeAg negative patients were 42.9% (18/42) and 80% (16/20), respectively (P more than 0.05). The detection rates of HCVcAg in HBV DNA positive patients and HBV DNA negative patients were 39.1% (18/46) and 37.5% (6/16), respectively (x2 = 0.013, P = 0.908). Compared with the detection rates of HCVcAg in patients only infected with HCV, the detection rate of HCVcAg in HBeAg or HBV DNA negative patients infected with HCV and HBV were 60% (12/20) (x2 = 1.266, P = 0.261) and 37.5% (6/16) (x2 =7.635, P less than 0.01), respectively.</p><p><b>CONCLUSION</b>The detection rate of HCVcAg in patients infected with HCV and HBV is relatively low. The reason is possibly that HBeAg inhibits duplication of HCV and decreases the expression of HCVcAg.</p>

Comparative study on the clinical characteristics of HBV/HCV co-infection patients with different HCV contaminnation mode / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>The purpose of this study was to compare the epidemiological, biochemical and virological characteristics among patients co-infected with hepatitis B virus (HBV) and hepatitis C virus (HCV) according to the mode of HCV contamination.</p><p><b>METHODS</b>The study included 133 patients with chronic HBV/HCV co-infection. They were studied and subdivided into two groups (drug addicts group and Blood transfusion group) according to the mode of HCV contaminnation. The epidemiological, biochemical and virological characteristics were collected. Univariate analysis was performed with the SPSS 16.0.</p><p><b>RESULTS</b>78 patients were infected by the mode of drug addicts (IDU), whereas 55 were infected by the mode of blood transfusion( PTCH). Patients in drug addicts group had yonger age, shorter HBV and HCV infection history, and lower cirrhosis percentage than those of patients in PTCH group (P <0.05). However,serum levels of ALT (t =4.760, P =0.000), AST (t = 3.798, P = 0.000), TBil (t = 4.274, P = 0.000) of IDU patients were higher than those of PTCH patients. There was difference of sex composition between two groups (chi2 = 18.706, P = 0.000).</p><p><b>CONCLUSIONS</b>The clinical characteristics of patients with HBV/HCV coinfection were significantly different among different HCV contamination mode. PTCH patients have the characteristics of older age, more cirrhosis and mild degree of liver injury; IDU patients have the characteristics of yonger age,fewer cirrhosis and severe liver injury.</p>

Detection of hepatitis C core antigen in intravenous drug addictions / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the status of detection of hepatitis C core antigen in intravenous drug addictions, and discuss the foreground of the hepatitis C core antigen ELISA test system.</p><p><b>METHODS</b>HCV core antigen, HCV RNA quantity, anti HCV-IgG, HBsAg were analysis in all the plasma samples taken from 93 cases of intravenous drug users.</p><p><b>RESULTS</b>The specialty and sensitivity of HCV core antigen in intravenous drug addictions 100% -54% separately. When HBsAg were positive, the sensitivity of HCV core antigen was 38%, while HBsAg negative, the sensitivity of HCV core antigen was 69% (P < 0.01).</p><p><b>CONCLUSION</b>The detections of HCV core antigen showed high specialty but low sensitivity in intravenous drug addictions. The positive rate has positive relation with HCV RNA virus logarithm quantity. Coinfection with HBV are the interfere factor of HCV core antigen detection. In screening experimentations, the detection of HCV core antigen in plasma may be applied as supplement method for anti-HCV-IgG. It can also be used to monitor viremia in HCV infection.</p>

A clinical study on the efficacy of HBeAg-positive chronic hepatitis B patients treated with adefovir dipivoxil for 4 years / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To observe the efficacy and safety on the efficacy of HBeAg-positive chronic Hepatitis B patients treated with adefovir dipivoxil for 4 years.</p><p><b>METHODS</b>Ninety-five patients with HBeAg-positive chronic hepatitis B were treated with adefovir dipivoxil 10 mg per day orally. The patients were observed before and after treatment for their serum levels of ALT and HBV DNA, the new increasing rates of serum ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and adverse drug events.</p><p><b>RESULTS</b>At 4 years on study, the rates of ALT normalization, HBV DNA clearances, HBeAg loss, HBeAg seroconversion and HBV DNA rebound were 89.5%, 63.2%, 47.4%, 41.1% and 8.0%, respectively. No drug related to renal function impairment was found during the treatment, eight patients had adverse drug events but all were mild.</p><p><b>CONCLUSION</b>Adefovir dipivoxil could effectively inhibit HBV replication, normalize ALT and enhance transformation from HBeAg to HBeAb for cases with naive and treated-first patients. The efficacy were increased with prolongation of the treatment period. It is safe and has a good tolerance.</p>

MiR-196a-2 gene polymorphism and the antiviral therapy of chronic hepatitis C / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the relationship between the SNP rs11614913 on miR196a-2 gene and the treatment effects of Peg-IFN-a plus Ribavirin on chronic hepatitis C patients.</p><p><b>METHODS</b>The total 139 patients of chronic hepatitis C infection who received the treatment of Peg-IFN-alpha-2a or Peg-IFN-alpha-2b plus Ribavirin were enrolled in this study. The patients were divided into two groups: sustained virological response (SVR) (n = 82) group and non virological response (NVR) or recurrence (n = 57) group. Blood samples were collected and chromosomal DNA was extracted. The miR-196a-2 polymorphism was determined with the method of polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP).</p><p><b>RESULTS</b>In our study, there was statistically association between miR-196a-2 polymorphism and the antiviral therapy efficacy of hepatitis C patients. There was statistically significance in the CT genotype and the TT genotype of miR-196a-2 between the two groups [P = 0.009, A = 2.924 (1.285 -6.652)]. There was statistically significance in the CC genotype and the TT genotype between the two groups [P = 0.036, A = 3.091(1.052 -9.078)]. There was statistically significance in the C allele and the T allele between the two groups [P = 0.036, A = 3.091 (1.052 - 9.078)].</p><p><b>CONCLUSION</b>These findings suggested that the rs11614913 SNP in miR - 196a-2 be associated with the antiviral therapy efficacy of hepatitis C patients, and the TT genotype or T alleles be associated with the SVR while the CC genotype or C allele could be related to the NVR or recurrence.</p>

Short-term efficacy of adefovir dipivoxil as an add-on therapy in the pegylated IFNalpha-2a treatment for HBeAg positive chronic hepatitis B patients / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate whether the combination therapy of pegylated IFNalpha-2a plus adefovir dipivoxil (ADV) improve the efficacy of the treatment in CHB patients with HBeAg positive or not.</p><p><b>METHODS</b>57 CHB patients with HBeAg positive received 48-week pegylated IFNalpha-2a therapy were enrolled into this study. If serum HBV DNA levels exceeded 1000 copies/ml at week 24, the patients were assigned to group A (pegylated IFN-alpha2a plus ADV, 21 cases) or group B (pegylated IFNalpha-2a only, 14 cases); otherwise, they received the unceasing monotherapy of pegylated IFNalpha-2a (group C, 22 cases).</p><p><b>RESULTS</b>At week 48, HBeAg seroconversion rates were 23.8%, 28.6% and 63.6% (A vs C,P = 0.014), but rates of aminotransferases normalization and HBV DNA suppression (< 1000 copies/ml) were not statistically significant among three groups. But during week 24 to week 48, rates of HBeAg seroconversion, aminotransferases normalization and HBV DNA suppression were also not statistically significant between group A and B. But amplitude of DNA drop in group A was much more than that in group B (2.60 +/- 1.37 vs 0.86 +/- 2.09, P = 0.005).</p><p><b>CONCLUSION</b>An ADV add-on therapy in pegylated IFNalpha-2a treatment seems able to improve the inhibition of HBV DNA in chronic hepatitis B patients with HBeAg positive. It requires a large, double-blind, randomized clinical trial to further provent.</p>

The effect of antiviral therapy for patients with HBeAg-negative cirrhosis / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of nucleot(s)ide analogues therapy in patients with HBeAg-negative cirrhosis in China.</p><p><b>METHODS</b>111 patiens with HBeAg-negative cirrhosis were divided into antiviral group (58 cases, 25 entecavir, 19 adefovir dipivoxil, 13 lamivudine, 1 telbivudine) and control group (53 cases, supportive and symptomatic treatment). These two groups were matched for demography, liver function and Child-Pugh score.</p><p><b>RESULTS</b>At the 96th week, the rate of ALT normalization and HBV DNA drop (1g copies/ml) in antiviral group were higher than those in control group (P < 0.05). The rates of HBV DNA negative (< 500 copies/ml) were 88.7% (47/53) and 32. 5% (13/40), respectively (P < 0.05 ). There were no differences in the rates of developing HCC and undergoing variceal bleeding between antiviral group and control group (P > 0.5). 15.4% patients with lamivudine treatment emerged YMDD mutations. 10.5% patients with adefovir dipivoxil treatment emerged virologic breakthrough and hepatitis flare during the second year. 2 patients (3.5%) in treatment group and 6 patients (11.5%) in control group died of liver failure or variceal bleeding or HCC ( P > 0.05 ).</p><p><b>CONCLUSIONS</b>Neucleot(s)ide analogues are effective in suppressing HBV replication in patients with HBeAg-negative cirrhosis, but the impact of which on the mortality and complications of cirrhosis should be prolongly observed. For continuing treatment, the neucleot(s)ide analogues with strong effective and low resistance are the first choices to prevent viral mutation and drug resistance.</p>

The relationship of expression of BMP-7 in the liver and hepatic inflammation and fibrosis in patients with chronic HBV infection / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To evaluate the relationship of the expression of bone morphogenefic protein-7 (BMP-7) in the liver and the liver fibrosis and inflammation in patients with chronic hepatitis B virus (HBV) infection, to explore the role of BMP-7 in the fibrogenesis of chronic hepatitis B.</p><p><b>METHODS</b>81 patients chronically infected with HBV were enrolled. Liver biopsy were performed in all these patients. The hematoxylin staining and reticular fiber staining were performed for the grading of inflammation and staging of fibrosis, respectively. The patients were divided into different groups by the inflammatory grade or fibrosis stage (8, 14, 19, 22, 18 patients with inflammatory grade of G0, G1, G2, G3, G4, respectively; 8, 16, 21, 24, 12 patients with fibrosis stage of S0, S1, S2, S3, S4, respectively ). Then the immunohistochemical staining by BMP-7 were performed. The expression of BMP-7 in the liver was evaluated by digital image quantitative analysis system. We compared the expression of BMP-7 in the liver with different inflammatory grade and fibrosis stage.</p><p><b>RESULTS</b>The expression of BMP-7 in the liver tissue increased with the increase of hepatic inflammatory grade and fibrosis. When liver biopsy showed a severe intrahepatic inflammation, the expression of BMP-7 significantly increased, regardless the intrahepatic fibrosis stage. Similarly, when liver biopsy showed a severe intrahepatic fibrosis, the expression of BMP-7 also significantly increased, regardless the intrahepatic inflammatory grade.</p><p><b>CONCLUSION</b>BMP-7 may play an important role as anti-inflammatory and anti-fibrogenic effect in the fibrogenesis of chronic hepatitis B.</p>

Efficacy of antiviral treatment on patients with acute-on-chronic hepatitis B liver failure with low viral load / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To investigate the efficacy of antiviral treatment on patients with acute-on-chronic hepatitis B liver failure with low viral load.</p><p><b>METHODS</b>352 patients with acute-on-chronic hepatitis B liver failure including 175 cases of low HBV viral load and 177 cases of high HBV viral load were enrolled into this study. The patients were divided into the antiviral group which received antiviral therapy (Lamivudine, Entecavir or Telbivudine) plus routine supportive therapy and the control group which received supportive therapy only. The clinical features and the 24-week short-term efficacy of antiviral therapy were assessed.</p><p><b>RESULTS</b>At week 24,total survival rate in antiviral group was higher than that in control group (P = 0.010). The survival rate of patients with low viral load in the antiviral group was higher than that in the control group (P = 0.001). But there was no significant difference between the antiviral group and the control group with high viral load (P = 0.856). But in the antiviral group, there was no significant difference in survival rate between the patients with high HBV viral load and those with low viral load (P = 0.755).</p><p><b>CONCLUSIONS</b>Antiviral therapy can significantly improve survival rate of patients of acute-on-chronic hepatitis B liver failure with low viral load. Liver failure;</p>

Pathological study of liver biopsy from 156 patients clinically diagnosed with mild chronic hepatitis B based on current guideline / 中华实验和临床病毒学杂志

<p><b>OBJECTIVE</b>To study the pathological features of liver tissues from patients clinically diagnosed with mild chronic hepatitis B based on current guideline and emphasize the important significance of liver puncture and biopsy for these patients.</p><p><b>METHODS</b>Totally 156 patients clinically diagnosed with mild chronic hepatitis B based on current guideline received liver puncture under the real-time Doppler ultrasonographic guiding. Pathological diagnosis was made after microscopic examinations of the liver tissue specimens stained with hematoxylin-eosin (HE) and reticular fiber staining. The differences between clinical and pathological diagnosis for these patients were analyzed.</p><p><b>RESULTS</b>Finally, 105 (67.3%) patients were pathologically diagnosed with mild chronic hepatitis B; 28 (18.0%), 3 (1.9%) and 20 (12.8%) patients were pathologically diagnosed as moderate, severe chronic hepatitis B and cirrhosis, respectively. Forty-eight (30.8%) and 39 (25.0%) patients of non-mild chronic hepatitis B were found to have G3-4 inflammation and S3-4 fibrosis, respectively. Differences in serum alanine aminotransferase, aspartate aminotransferase, total bilirubin or albumin between mild and non-mild chronic hepatitis B based on pathological diagnosis were not statistically significant (t-test, P > 0.05).</p><p><b>CONCLUSIONS</b>Accurate pathological diagnosis is helpful to guiding an antiviral therapy.</p>

The efficacy of entecavir treatment on acute-on-chronic liver failure in patients with hepatitis B / 中华传染病杂志

Objective To evaluate the efficacy of entecavir treatment on hepatitis B patients with acute-on-chronic liver failure. Methods Eighty-four hepatitis B patients with acute-on-chronic liver failure were treated with entecavir 0.5 mg daily and Other routine drugs. Another 99 hepatitis B patients with acute-on-chronic liver failure were treated with only routine drugs as control. The survival, liver functions, hepatitis B virus (HBV) DNA level, prothrombin time (PT) were observed. The survival rates of patients with early, middle or late stage of liver failure were analyzed. The comparison of rates were done using chi-square test. The numeration data were compared by t test. The survival rates were compared using Kaplan-Meier method. Results Among patients with early stage of acute-on-chronic liver failure, the survival rate in treatment group was 63.3% (31/49), which was significantly higher than that in control group (39.7%, 23/58) (χ2=5.923, P=0.015). Among patients with middle stage of acute-on-chronic liver failure, the surviral rate in treatment group was 63.0% (17/27), which was significantly higher than that in control group (35.1%, 13/37) (χ2=4.854, P=0.028). Among patients with late stage of acute-on-chronic liver failure, four out of eight cases survived in treatment group, while one out of four cases survived in control group. In patients with serum total hilirubin (TBil) level > 342 μmol/L, the survival rate was 56.0% in treatment group, which was significantly higher than that in control group (26.8%) (χ2=9.351,P=0.002). At week 4 of the treatment, the HBV DNA reduction in treatment group was 3. 95 lg copy/mL, which was higher than that in control group (1.78 lg copy/mL) (t=5.847, P=0.001). Conclusions Entecavir treatment could improve the survival rate of hepatitis B patients with early or middle stage of acute-on-chronic liver failure. And the further study with larger population is needed in patients with late stage of liver failure. In addition, entecavir therapy could also improve the survival rate of patients with TBil >342 μmol/L.