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<p><b>OBJECTIVE</b>To explore the changes in HBsAg titer and HBV DNA load and their correlation in patients with chronic hepatitis B (CHB) and HBV-related liver cirrhosis (HBV-LC).</p><p><b>METHODS</b>Forty-six patients with mild to moderate CHB (CHB-LM), 24 patients with severe CHB (CHB-S), and 28 patients with HBV-LC at admission, and 51 patients with HBV-LC at 4.08 ± 3.06 months during antiviral treatment were tested for serum HBsAg titer and HBV DNA load using Abbott chemiluminescence and fluorescence quantitative PCR, respectively.</p><p><b>RESULTS</b>The serum HBsAg titer and HBV DNA load gradually decreased with increased disease severity (from CHB-LM, CHB-S to HBV-LC; χ(2)=12.537 and 8.381, respectively, P<0.05). HBsAg titer and HBV DNA load were significantly higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05), but comparable between CHB-LM and CHB-S groups (Z=-0.649 and 0.032, respectively, P>0.05). Among HBeAg-positive patients, HBsAg titer and HBV DNA load tended to decrease with increased disease severity (from CHB-LM, CHB-S to HBV-LC; χ(2)=6.146, P=0.046 and χ(2)=1.017, P>0.05; respectively), and CHB-LM group had significantly higher HBsAg titer than HBV-LC group (Z=-2.247, P=0.025). Among the HBeAg-negative patients, serum HBsAg and HBV DNA load gradually declined with the disease severity (χ(2)=8.660 and 13.581, respectively, P<0.05), and were obviously higher in CHB-LM and CHB-S groups than in HBV-LC group (P<0.05). Positive correlations were found between serum HBsAg and HBV DNA levels in CHB-LM (r=0.389, P=0.009) and HBV-LC groups (r=0.431, P=0.022), but not in CHB-S group (r=0.348, P=0.104). After antiviral therapy, the serum HBsAg titer was slightly decreased (Z=-1.050, P=0.294) while HBV DNA load markedly reduced (Z=-5.415, P<0.001), showing no correlation between them (r=0.241, P=0.111) or between the measurements before and after treatment (r=0.257, P=0.085).</p><p><b>CONCLUSION</b>Serum HBsAg titer and HBV DNA load decreases progressively from CHB-LM to CHB-S and HBV-LC in both HBeAg- positive and -negative patients. The serum HBsAg titer is positively correlated with HBV DNA load, but their levels are not consistently parallel.</p>
Subject(s)
Humans , Antiviral Agents , Therapeutic Uses , DNA, Viral , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B, Chronic , Blood , Liver Cirrhosis , Blood , Virology , Viral LoadABSTRACT
Objective To investigate the hepatitis B liver cirrhosis complicated with hepatic encephalopathy (HE),relevant risk factors in the development of strategies for the prevention and treatment of the disease,and make for the clinical experience accumulation.Methods A retrospective analysis of 64 cases of liver cirrhosis patients complicated with HE,for the observation group.In addition,53 patients of hepatitis B cirrhosis without HE patients were selected as control group.The two groups of patients with objective physiological indicators were recorded and compared.Results (1) Compared with the control group,blood ammonia,serum total bilirubin,blood urea nitrogen level and infection,incidence of digestive tract hemorrhage of the study group increased,blood sodium,alanine amin otrans ferase,decrease the serum albumin level,the differences were statistically significant (t =3.0 8 5,5.5 2 8,x2 =9.174,7.126,t =4.102,4.337,8.675,5.323,all P ＜0.05).(2) For the patients in the study group,age,more than 3 kinds of incentives and C grade of liver function were the high risk factors of death.(3) In the cause of deaths in the study group,the infection was the most common,the incidence rate was 75.9%,the second above digestive rare tract hemorrhage,the incidence rate was 65.5%.Conclusion The elderly,the number of risk factors and severity of liver function are the occurrence and development of related risk factors of hepatitis B related cirrhosis with hepatic encephalopathy,to remove the incentive is the key of HE with prevention and treatment of hepatitis B cirrhosis.
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OBJECTIVE To study the antimicrobial susceptibility and distribution of the ?-lactamases producing Escherichia coli from hepatopathy patients.METHODS Thirty-six ?-lactamases producing E.coli strains from hepatopathy patients were detected with a multi-disk test(synergy test,antagonized test for the inducible AmpC ?-lactamases(IABLs)),AmpC ?-lactamases(ABLs)phenotype test and extended-spectrum ?-lactamases(ESBLs) comfirmation test,and the susceptibility of antimicrobial agents with K-B test.RESULTS Twenty-six strains of 38 strains produced the ?-lactamases(68.4%),13(34.2%)strains produced penicillinases,5(13.2%)strains produced broad-spectrum ?-lactamases or penicillinases and 8(21.1%)strains produced ESBLs alone.All were not detected out to produce ABLs and carbapenem-hydrolyzing ?-lactamases(CHBLs);All nonnproducing ?-lactamases strains were sensitive to 9 kinds of antimicrobial agents;but in the 26 strains producing ?-lactamases,the resistant rate to AMP,KZ,FTX,IMP,AK,CN,CIP,SXT and TET were 100.0%,50.0%,30.8%,0,61.5%,15.4%,73.1%,61.5%,and 69.2%,respectively.CONCLUSIONS The rate of ?-lactamases producing E.coli from hepatopathy patients is high.The main types of ?-lactamases are penicillinases and ESBLs.Most strains producing ?-lactamases are susceptible to imipenem and amikacin.
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Objective To investigate the significance of the expression of interleukin-10(IL-10),interleukin-13(IL-13)and interleukin-15(IL-15)in serums of patients with hepatitis B.Methods The expression of IL-10,IL-13 and IL-15 in serums of 109 patients was measured by ELISA.Results The serum levels of IL-10,IL-13 in patients with moderate degree chronic hepatitis B(CHB)group were significantly higher than that in patients with chronic severe hepatitis group,severe degree CHB group,acute hepatitis group and normal group.The serum level of IL-15 was increased in patients with acute hepatitis、moderate degree CHB group,severe degree CHB group and chronic severe hepatitis compared with normotensives.The proportion of IL-15/IL-10 and IL-15/IL-13 in patients with chronic severe hepatitis group,severe degree CHB group and acute hepatitis group were higher than that in patients with moderate degree CHB group and normotensives.The serum level of IL-15 and the proportion of IL-15/IL-10 and IL-15/IL-13 in dead group were significantly higher than that in improving group with chronic severe hepatitis.Conclusion There is an abnormal cell-mediated immune response in patients with hepatitis B.Combining detection on the levels of serum IL-10,IL-13 and IL-15,and the proportion of IL-15/IL-10 and IL-15/IL-13 would nicely show the cellular active status and be helpful to the prediction of prognosis and direction of therapy in patients with hepatitis B of different kinds of clinical type.
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Objective To evaluate the effectiveness of prophylactic antibiotic therapy on nosocomial infection in patients with severe viral hepatitis,and inquire into its applied mechanism.Methods 159 cases of severe viral hepatitis were divided into groups according to clinical stage and the applied circumstance of antibiotic medicine;Group A:receiving no prophylactic antibiotics therapy,Group B intravenous injection of the third generation cephalosporins and Group C intravenous injection of the semisymthetic penicillins.All cases had no infection on admission and received no antibiotics for 7 days before entering hospital and had stayed in hospital over 72 hours.Results Nosocomial infection occurred in 76 patients among the 159 selected cases.The incidence of nosocomial infection of Group A,Group B and Group C was 56.16%(41/73),34.0%(17/50) and 50.0% (18/36),respectively.The occurring time of nosocomial infection of Group B in early,middle and late stage patients with severe viral hepatitis was significantly later than Group A.The incidence of nosocomial infection in middle and later stage patients was significantly lower,and the mortality was significantly decreased in middle stage patients.There was significantly difference between group A and B(P0.05).Conclusion Prophylactic usage of antibiotics of third generation cephalosporins can not only delay nosocomial infection but also decrease the incidence of nosocomial infection in middle and late stage patients and mortality in middle stage patients with severe viral hepatitis.
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Objective To investigate the relationship between lipopolysaccharide binding protein(LBP) in serum and degree of hepatic inflammation. Methods The levels of LBP in serum of 99 patients with chronic viral hepatitis (CVH) were detected by ELISA. The levels of LBP in 33 of all patients with chronic severe viral hepatitis were further detected 2～4 weeks after treatment. Results The serum levels of LBP in patients with chronic viral hepatitis were higher than that in normal patients [(79.62?45.52) ng/ml vs (50.22?31.44) ng/ml, P=0.001]. The serum levels of LBP in patients with chronic severe viral hepatitis were significantly higher than that in patients with moderate degree CVH group, severe degree CVH group, and normal group (P