ABSTRACT
<p><b>OBJECTIVE</b>No optimal prophylactic protocol of hepatitis B immunoglobulin (HBIG) combined with nucleos(t)ide analogue for HBV recurrence has been established yet. By investigating the alterations of HBV markers in HBV related liver disease patients, recipients of a liver transplant, under lamivudine or/and HBIG prophylaxis, we aim to explore the possible HBV recurrence mechanism involved and to find a new option in the prophylaxis of HBV recurrence and to tailor individualized therapy.</p><p><b>METHODS</b>Serial liver biopsy specimens and sera were obtained intraoperationally and at definite time points during follow-up. ELISA and chemiluminescent microparticle immunoassay, HBV DNA fluorescent quantification, immunohistochemistry staining and HBV DNA in situ hybridization were performed. Alterations of HBV markers in specimens of 96 liver transplant recipients were investigated retrospectively.</p><p><b>RESULTS</b>All 17 cases had HBV recurrence (median 37 months) which occurred in the follow-up period after liver transplantation. The overall actual HBV recurrence rate at 2 years was 22% with a significant difference between that of the active and inactive groups (P<0.05); 82.4% HBV recurrence took place within the first 3 years after the operation, and the recurrence ratio of first 3 years to 3 years later after transplantation was 4.7 (P<0.01). The HBV DNA positive patients accounted for 78.6% of the total number of recurrences within the first 3 years. HBcAb and HBeAb positive rates went down with time, but their positivity remained.</p><p><b>CONCLUSION</b>HBV recurrence happens after liver transplantation. In inactive HBV replicative patients with strictly combined prophylaxis and availability of other medications and using 3 years after liver transplantation as a point of time, we think that tapering down the dosage of HBIG and tailoring individualized treatment methods based on virological and immunological situations of each recipient are worth trying.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Young Adult , Antiviral Agents , Therapeutic Uses , Hepatitis B , Drug Therapy , Immunoglobulins , Therapeutic Uses , Lamivudine , Therapeutic Uses , Liver Transplantation , Postoperative Period , Prognosis , Retrospective Studies , Secondary Prevention , Treatment OutcomeABSTRACT
<p><b>OBJECTIVE</b>To investigate the alteration of HBV markers in liver allograft of HBV related recipients pre and post liver transplantation under Lamivudine or combination of Lamivudine with HBIG prophylaxis and explore the mechanism of HBV de nova infection in liver allograft after orthotopic liver transplantation, as well as seek to establish a optimal prophylactic protocol.</p><p><b>METHODS</b>The serial liver biopsy specimens of 90 liver allograft and sera of 78 liver transplant recipients during operation and after 1 week, 1 month, 3 months, 6 months, 12 months, 24 months post transplantation have been collected and detected for HBV markers with enzyme-linked radioimmunoassay, fluorescent quantitative assay for HBV-DNA in serology and with immunohistochemistry stain, HBV-DNA in situ hybridization in histology for detection of HBV markers in liver allograft samples.</p><p><b>RESULTS</b>Whether recipients with active replicative or inactive replicative HBV preoperatively, none of positive HBV-DNA, HBsAg and HBcAg in 100% liver biopsy specimens with HBV-DNA hybridization in situ and immunohistochemistry stains in histology within 2 hours after reperfusion.</p><p><b>CONCLUSION</b>Whatever HBV replicative status the recipients have before surgery, no evidence of HBV particles direct invasion to the liver allograft from HBV related cirrhotics during operation under current prophylactic measures. However, the further supposed mechanism and its significance in HBV de nova infection of liver allograft remained to be disclosed further.</p>
Subject(s)
Adolescent , Adult , Aged , Child , Female , Humans , Male , Middle Aged , Biomarkers , Blood , DNA, Viral , Blood , Hepatitis B Antigens , Blood , Hepatitis B Surface Antigens , Blood , Hepatitis B e Antigens , Blood , Hepatitis B virus , Genetics , Hepatitis B, Chronic , Diagnosis , Drug Therapy , General Surgery , Immunization, Passive , Immunoglobulins , Lamivudine , Therapeutic Uses , Liver Transplantation , Preoperative Care , Methods , Secondary PreventionABSTRACT
Objective To study the variations of the contents of trace elements in first section of tap water stagnating in pipe over night. Methods The first and middle sections of tap water stagnating in galvanized iron pipe for water supply over night for about 10 hours flowing through an iron tap and a chromed tap were sampled and determined for the contents of copper, manganese, iron and zinc by atomic spectrophotometry. The relationship between the variations of contents of four elements and the flow capacity was analyzed also. Results The contents of copper and manganese in the first section and middle section of tap water stagnating in pipe over night accorded with the sanitary standard for drinking water (SSDW), and revealed no significant differences between the first and middle section of tap water. The contents of iron in first section of tap water flowing through an iron tap and the contents of zinc in first section of tap water flowing through a chromed tap both exceeded the SSDW and revealed higher levels respectively compared with those in the related middle section of tap water. The levels of iron and zinc negatively correlated with the flow capacity (r Zn=-0.938,P