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Context and objectives As the global epidemic of obesity and metabolic syndrome progresses, the coexistence of fatty liver disease in patients with chronic viral hepatitis B (VHB) becomes significant. The objective of this work was to determine the frequency of hepatic steatosis assessed by Fibroscan/CAP (Controlled Attenuation Parameter) in patients with chronic VHB in Côte d'Ivoire. Methods. The study included 83 patients with chronic VHB. These were black patients who had performed a Fibroscan/CAP during the recruitment period and were willing to participate in the study. Patients with significant alcohol consumption, a secondary cause of hepatic steatosis, another liver disease regardless of the etiology associated with VHB were not included. Results. The frequency of hepatic steatosis in chronic HBV carriers assessed by CAP in our study population was 48.19 %, including 24.10 % of severe steatosis. Obesity was statistically correlated with the presence of steatosis in our patients. Patients who had steatosis on ultrasound were 5 times more likely to have steatosis on CAP. Significant fibrosis was insignificantly associated with steatosis. Conclusion. The frequency of fatty liver disease detected by fibroscan/CAP is high in patients with chronic VHB.
Contexte et objectifs Avec la progression de l'épidémie mondiale d'obésité et du syndrome métabolique, la coexistence d'une stéatose hépatique chez les patients porteurs d'une hépatite virale B chronique devient non négligeable. L'objectif de ce travail était de déterminer la fréquence de la stéatose hépatique chez les patients porteurs d'une hépatite virale B (HVB) chronique. Méthodes. Il s'agissait d'une série des cas de HVB de race noire, ayant réalisé un Fibroscan/CAP pendant la période du recrutement et consentants à participer à l'étude. Les patients ayant une consommation d'alcool significative, une cause secondaire de stéatose hépatique, une autre hépatopathie quelle que soit l'étiologie associée à l'hépatite B n'ont pas été inclus. Résultats. Quatre-vingt-trois patients porteurs d'une HVB ont été inclus. La fréquence de la stéatose hépatique chez les porteurs du VHB chronique était de 48,19 % dont 24,10 % de stéatose sévère. L'obésité était statistiquement corrélée à la présence d'une stéatose chez nos patients. Les patients qui avaient une stéatose à l'échographie étaient 5 fois plus à risque d'avoir une stéatose au CAP. La fibrose significative était associée de façon non significative à la stéatose. Conclusion : Près de la moitié des patients porteurs d'une hépatite virale B chronique présente une stéatose hépatique.
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Humans , Male , Female , Fatty LiverABSTRACT
Objective@#To understand the epidemiological characteristics of viral hepatitis B in Shaoxing from 2008 to 2018,so as to provide basis for formulating the viral hepatitis B prevention and control strategy. @*Methods@#The data of viral hepatitis B cases in Shaoxing from 2008 to 2018 were collected from infectious diseases reporting and management system. Descriptive epidemiological method was employed to analyze the time,place and population characteristics of viral hepatitis B cases in Shaoxing. Annual percentage change（APC）was calculated to analyze the development trend of viral hepatitis B.@*Results @#From 2008 to 2018,a total of 22 764 cases of viral hepatitis B were reported in Shaoxing,with an average annual incidence rate of 42.24/100 000 and a standardized incidence rate of 39.19/100 000. The incidence rate of viral hepatitis B decreased from 2008 to 2018,among which the APC from 2012 to 2018 was -18.00% with a significantly downward trend（P<0.05）. Six counties,cities or districts in Shaoxing reported cases of viral hepatitis B,of which Zhuji（49.40/100 000）,Yuecheng（44.17/100 000）and Xinchang（43.28/100 000）ranked top three in average annual incidence rate. The incidence rate of viral hepatitis B in men was 57.07/100 000,which was higher than 27.33/100 000 in women（P<0.05）.The age of onset was mainly 25-59 years old,with 16 941 cases（74.42%）reported. The top three occupations were farmers,workers and migrant workers,with 15 013（65.95%）,2 730（11.99%）and 1 121（4.92%）cases reported,respectively. @*Conclusions@#The incidence of viral hepatitis B in Shaoxing from 2008 to 2018 showed a downward trend. Farmers,workers and migrant workers aged 25-59 years were at high risk of hepatitis B infection.
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Objective@#To investigate the correlation between serum chemokine CXCL13 (CXCL-13), interleukin-1beta (IL-1beta), interleukin-6 (IL-6) levels and liver function damage and hepatitis B virus replication in patients with chronic hepatitis B (CHB).@*Methods@#Eighty patients with CHB who were treated in Jiyuan People′s Hospital of Henan Province from January 2016 to December 2018 were selected as the study subjects. According to the severity of the disease, the patients were divided into mild group (34 cases), moderate group (26 cases) and severe group (20 cases). Eighty healthy people in the same period were selected as control group, and the serum levels of CXCL-13, IL-1β and IL-6 were detected and compared. Spearman correlation analysis was used to analyze the relation between CXCL-13, IL-1β, IL-6 and ALT, AST, HBV-DNA.@*Results@#The levels of ALT, AST, serum CXCL-13, IL-1β and IL-6 in patients with CHB were significantly higher than those in control group (P=0.000 for all comparisons); the levels of ALT, AST, HBV DNA and serum CXCL-13, IL-1β and IL-6 in patients with CHB were significantly higher than those in control group (P=0.000 for all the comparisons). Serum CXCL-13, IL-1β, IL-6 were positively correlated with ALT and AST (P=0.000, P=0.006, P=0.003, P=0.000, P=0.000, P=0.001), CXCL-13 level was positively correlated with HBV DNA (P=0.014), IL-1β and IL-6 were not correlated with HBV DNA. There were positive correlations among CXCL-13, IL-1β and IL-6 (P=0.012, P=0.019, P=0.008).@*Conclusions@#Serum CXCL-13 and IL-1β, IL-6 were closely related to the degree of liver function damage and disease progression in CHB patients. The level of CXCL-13 is positively correlated with the amount of hepatitis B virus. Therefore, close monitoring of serum CXCL-13, IL-1β and IL-6 in CHB patients is of clinical reference value for judging the patient′s condition.
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Objective To study the recurrence risks of viral hepatitis B (VHB) after liver transplantation for hepatitis B virus (HBV)-related liver diseases.Methods A total of 599 patients undergoing liver transplantation due to HBV-related liver disease [hepatic cellular cancer (HCC),decompensated liver cirrhosis (DLC),acute liver failure (ALF)] were included in this study.All patients included in this study have been followed up for at least 12 month for liver biochemistry and HBV testing,altogether with the clinic presentation and outcomes.Treatment protocols about prevention of VHB recurrence in perioperative period and after liver transplantation,the time interval and influence factors of VHB recurrence,and the disease prognosis were analyzed.Results Of the 599 patients,36 cases of VHB recurrence were observed.The rate of VHB recurrence was 7.2％ (23/319),5.6％ (13/232) and 0 (0/48) for HCC,DLC and ALF,respectively.The rates of VHB recurrence were 2.3％,5.5％,6％ for 1 year,5 years and 8 years,respectively.The rate of VHB recurrence in the lamivudine group was significantly higher than in enticavir group and combination therapy group [16.5％ (22/133),2.9％ (8/280),and 3.2％ (6/186),respectively,P＜0.05 for all].Conclusion HCC and DLC as liver transplant indications are independent risk factors for VHB recurrence after liver transplant.For liver transplant patients with HBV-related liver disease,entecavir monotherapy and combination therapy (lamivudine and adefovir,or tenofovir) are both more effective on the prophylaxis of VHB recurrence than lamivudine monotherapy.
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Objective To study the effect and safety of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis.Methods100 cases with hepatitis B cirrhosis in Zhejiang Taizhou hospital from June 2014 to December 2016 were selected as the research object in this study which were randomly divided into the control group and the experimental group 50 cases in each group.The control group were given entecavir, the experimental group were given compound Biejiaruangan tablets combined with entecavir.The clinical effect and the adverse reaction in the two groups were compared.ResultsThe effective rate was 90.0% in the experimental group, which was significantly higher than 72.0% in the control group(P<0.05).There were 2 patients vomiting in the experimental group, the adverse reaction rate was 4.0%.There were 9 cases of vomiting and headache in the control group, the adverse reaction rate was 18.0%.T,he adverse reaction rate(in the experimental group was significantly lower than that in the control group(P<0.05).ConclusionThe clinical effect of compound Biejiaruangan tablets combined with entecavir on the treatment of viral hepatitis B cirrhosis is better, which can reduce the rate of adverse reactions in a certain extent, is high safety, and worth popularizing.
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Objective To explore the application value of real-time shear wave elastography (SWE) technique in diagnosing and staging of chronic viral hepatitis B and hepatic fibrosis and to establish Young's modulus reference range for diagnosing and staging of hepatic fibrosis.Methods Forty-eight patients with chronic hepatitis B and fifty-eight healthy adults were enrolled and their Young's modulus values of S5 and S6 segments of liver were measured.Histopathologic examination was performed on 48 patients with chronic hepatitis B.Comparative analysis was conducted between the pathological findings and Young's modulus values,by means of which Young's modulus reference range for diagnosis and staging of hepatic fibrosis was obtained.Results There was significant difference in Young's modulus values of S5 and S6 segments of liver between chronic hepatitis B group and the normal control group (P＜0.05).Young's modulus values of S5 and S6 segments of liver in chronic hepatitis B group were (11.7 ± 2.9) kPa and (12.1 ± 3.2) kPa respectively,which were significantly higher than those in the normal control group,(5.7 ± 1.1) kPa and (5.8 ± 1.3) kPa respectively.Significant differences of Young's modulus values were detected in every staging of hepatic fibrosis (P＜0.05).S5 segment of liver Young's modulus values in S0-S4 stages were (5.8 ± 2.2) kPa,(7.3 ± 1.9) kPa,(10.3 ± 2.8) kPa,(10.3 ± 2.8) kPa,and (25.3 ± 3.6) kPa,respectively.S6 segment of liver Young's modulus values in S0-S4 stages were (5.7 ± 2.3) kPa,(9.2±2.1) kPa,(10.5±2.1) kPa,(14.7±4.5) kPa,and (26.1 ±2.1) kPa,respectively.Young's modulus value of the liver rose with the increase of S stage.Conclusion SWE technique can establish the Young's modulus reference range for hepatic fibrosis stage.Besides,it features high sensitivity,specificity and accuracy.
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Objective:To research the number and function of monocyte-macrophages in patients with chronic active hepatitis B. Methods:The 51 chronic viral hepatitis B( CHB) patients were selected randomly,which consisted of 20 cases of mild-moderate,31 cases of severe group and 13 cases of healthy controls. PBMCs were separated by percoll. Monocytes were tagged by CD14,the molecules CD80,CD86,HLA-DR and CD163 were detected by flow cytometry which expressed on the surface of PBMCs. Serum cytokine were detected for IL-10, IL-12 and IL-23 by ELISA. The distribution of CD68 was detected in the liver by immunohistochemical staining. Results:The expressions of CD80 for all chronic hepatitis B patients were lower than the controls respectively,no matter mild-moderate or even severe group. Similarly,the HBV patients expressed lower level of CD86 in the peripheral blood mononuclear cells when compared with the control group. Furthermore, there was statistically difference between the levels of CD86 in severe group compared with control group (P<0. 01). As the expression of CD80 and CD86,the levels of HLA-DR in the patents had also declined when compared with controls. While the HLA-DR levels in both the mild-moderate HBV hepatitis groups were statistically significant higher than the severe group (P<0. 01). Different from the above all,the expression of CD163 in all chronic HBV hepatitis was higher than the control group. The CD68 positive cells in chronic HBV patients were observed and infiltrated increasingly in portal area and hepatic lobules (P<0. 05). There were statistically significant differences of IL-10 levels between the mild-moderate group,severe group and the control group,respectively (P<0. 01). Conclusion:Macrophages have participated in the pathological lesions of liver in CHB patients,among peripheral blood mononuclear cells,the phenomena of imbalance between type M1/M2 and polarization to type M2 have been observed,which participated in the development of the chronicity of CHB.
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Objective To observe the clinical curative effect of combination of traditional Chinese and western medicine for treatment of patients with hepatitis B virus (HBV) related acute-on-chronic (subacute) liver failure (ACLF). Methods A prospective randomized controlled trial was conducted; 66 cases of HBV-ACLF patients were randomly divided into two groups: a test group (44 cases) and a control group (22 cases). Conventional western medicine treatment was given to both groups; the patients in test group additionally received the traditional Chinese medicine (TCM) in accord to the principles of differentiation of syndromes in TCM, in cases with damp-heat and blood stasis syndrome with yellow appearance, Liangxue Jiedu Huayu decoction (Paeoniae Radix Rubra 60 - 150 g, Artemisiae Scopariae Herba 30 - 90 g, Gardeniae Fructus 9 - 12 g, Hedyotis diffusa Willd 20 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Bletillae Rhizoma 15 g ) was given, in cases with Qi deficiency and blood stasis with yellow appearance, Yiqi Jiedu Huayu decoction (Astragali Radix Preparata Cum Melle 30 g, Pseudostellariae Radix 15 g, Artemisiae Scopariae Herba 30 - 60 g, Polygoni Cuspidati Rhizoma et Radix 15 - 30 g, Salviae Miltiorrhizae Radix et Rhizoma 30 g, Aconiti Lateralis Radix Preparata 10 - 15 g, Atractylodis Macrocephalae Rhizoma 30 g, Rubiae Radix et Rhizoma 30 - 45 g, Siegesbeckiae Herba 30 - 45 g, Gigeriae Galli Endothelium Corneum 20 g) was given, the dosage in both groups being 1 dose daily, one dose was prepared to a water decoction 250 - 300 mL which was divided into two parts, one part taken twice a day; the control group received only western medicine treatment. After 2 weeks of treatment, the clinical comprehensive curative effect, the syndrome score efficacy, and the changes of main indexes of liver function,cholinesterase (ChE), albumin (Alb), prothrombin activity (PTA) were observed in the two groups.Results The clinical total efficacy in the test group was significantly higher than that in the control group [75.0% (33/44) vs. 45.5% (10/22),P 0.05). After treatment, the alanine aminotransferase (ALT), aspartate aminotransferase (AST), total bilirubin (TBil) and direct bilirubin (DBil) were all lower than those before treatment in both groups, while the ChE, Alb and PTA were higher than those before treatment, and the degree of changes was more significant in the test group [test group: ALT (U/L): 63.28±99.28 vs. 574.58±571.08, AST (U/L): 86.84±92.88 vs. 438.20±482.74, TBil (μmol/L): 161.90±178.34 vs. 269.46±95.10, DBil (μmol/L): 115.32±126.51 vs. 209.12±79.78, ChE (U/L): 4 239.14±1 505.00 vs. 3 341.49±1 609.40, Alb (g/L): 32.65±4.77 vs. 29.73±3.31, PTA: (69.69±44.92)% vs. (32.84±7.47)%; control group: ALT (U/L): 93.28±93.86 vs. 365.24±376.98, AST (U/L): 126.26±121.35 vs. 287.17±301.04, TBil (μmol/L): 226.80±187.38 vs. 281.02±103.73, DBil (μmol/L): 172.50±147.32 vs. 227.96±87.20, ChE (U/L): 4 484.66±1 886.53 vs. 3 918.77±1 417.77, Alb (g/L): 33.17±4.76 vs. 30.47±3.03, PTA: (63.80±36.80)% vs. (33.96±6.32)%,P < 0.05 orP < 0.01].Conclusion The combination of TCM and western medicine for treatment of HBV-ACLF can improve liver function, and the prognosis is superior to using western medicine treatment alone.
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Objective To investigate the incidence of familial hepatitis B viral (HBV ) infection in the southeast part of Chongqing ,and provide information for its prevention and treatment .Methods 295 patients with HbsAg positive came from 110 families were selected and divided to different groups by gender and marital status .We investigated the infections of HBV in three generations of the immediate families .This research focused on the difference between mother-to-child transmission and father-to-child transmission ,the status of receiving HBV vaccine ,the morbidity and mortality of cirrhosis and hepatic carcinoma ,the cause of death ,and the impact of gender in three generations .Results Of the 110 cases ,the HBsAg positive rate for children with HBsAg positive mothers (more than 66 .7% ) was significantly higher than that with positive father (less than 1 .1% ) ,while there was no significant difference between male spouses and female spouses (22 .2% versus 20 .5% ,P>0 .05) .Only 23 .2% received HBV vac-cine and 2 .7% got immune globulin of HBV .8 .5% of the 295 persons had cirrhosis and 4 .4% of them had primary hepatocellular carcinoma (HCC);19 patients from 16 families died of liver diseases .39 cases of 110 patients got antiviral treatment regularly .Con-clusion As well as father-to-child transmission and close contact ,mother-to-child transmission contributed to familial HBV infec-tion ,and even more common .The high rate of familial HBV infection in this area was associated with low rate of vaccination and immune globulin of HBV .The leading cause of the high incidence of hepatocellular carcinoma and hepatic cirrhosis was substandard treatment .
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Vitiligo universalis is an uncommon variant that is rarely seen. Interestingly, vitiligo universalis often accompanies systemic diseases such as endocrinopathies. A 43-year-old man presented with whole body depigmentation and poliosis affecting most of his scalp and body hair. He had undergone a liver transplant 2 years ago due to liver cirrhosis from a chronic hepatitis B infection and has been treated for diabetes mellitus for several years. Histopathology showed no melanocytes and an absence of epidermal pigmentation on the skin. We herein report a rare case of vitiligo universalis associated with chronic viral hepatitis B.
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Adult , Humans , Diabetes Mellitus , Hair , Hepatitis B , Hepatitis B, Chronic , Hepatitis, Chronic , Liver , Liver Cirrhosis , Melanocytes , Pigmentation , Scalp , Skin , Transplants , VitiligoABSTRACT
El objetivo de este trabajo consiste en resaltar el diagnóstico serológico de un agente viral de gran interés en Salud Pública, como lo es el Virus de la Hepatitis B por su capacidad de inducir hepatitis crónica, su evolución a cirrosis y carcinoma hepático. Se consideran los diferentes marcadore serológicos virales empleados en el laboratorio clínico, según los estadios de la infección y el posible pronóstico, los cuales son de gran utilidad en los programas de control y prevención que han permitido disminuir la morbilidad y mortalidad de la hepatitis B. Además, se discuten algunos aspectos tales como inmunización por la vacuna y la ubicación geográfica de los laboratorios para el diagnóstico serológico en la Caja Costarricense de Seguro Social.
The objective of this overview is tohighlight the serological diagnosis ofthe hepatitis B virus, agent of greatimportance for Public Health due to itscapacity to induce chronic hepatitis, cirrhosis and hepatic carcinoma.It consider different viral serologicmarkers used in clinical laboratoriesaccording to the phase of the infectionand the probable prognostic, wichare very useful in the prevention andcontrol programs that have allowedreduced morbidity and mortality fromhepatitis B. Moreover, are discussed inthis document some aspects such asimmunization with the vaccine and thegeographical location of laboratoriesof the Caja Costarricense de SeguroSocial, for the diagnosis of the virus.
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Humans , Diagnosis , Hepatitis B , Hepatitis B virus , Biomarkers , Serologic Tests , Costa RicaABSTRACT
OBJECTIVE To survey the therapeutic effect of lamivudine alone or in combination with bicyclol on chronical viral hepatitis B.METHODS Ninety patients with chronic viral hepatitis B were divided into 3 groups: A,B and C.Patients of group A(n=30) were given each 100mg lamivudine po qd,and 25 mg(bicyclol) po,tid,and the course of treatment lasted 72 weeks.Patients of group B(n=30) were subjected to(lamivudine) treatment alone at the same dosage as that of patients in group A.Patients of group C(n=30) were treated with(conventional) hepatinica and symptomatic therapeutic measures,serving as controls.Changes in serum HBV DNA and liver functions and YMDD mutant were dynamically monitored.RESULTS At the end of the 24,48 and 72 weeks of treatment,the rates of sera to turn negative for HBV DNA were 90.0%,(86.7%,) and(83.3%),(respectively),in patients of group A,and 86.7%,83.3%,and 76.7%,respectively,in patients of group B.The rates of sera to turn negative for HBV DNA,in patients of groups A and B were significantly higher than those in patients of group C(P0.05);at the end of 72 weeks,the rates of YMDD mutant were 16.7% in group A and 36.7% in group B,the rates in group A were significantly higher than in group B((P
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0.05).Conclusion Coverage of medical insurance and effective antiviral therapy for the patients with CHB could affect their QOL.
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OBJECTIVE:To evaluate the economic burden of chronic hepatitis B(CHB)and its complications,and to e-valuate the benefits of treatment with interferon-?.METHODS:The components of the economic burden of disease included direct medical costs and non-medical costs as well as indirect economic loss per patient-year in patients with chronic hepatitis B virus infections,including chronic hepatitis B,compensated and decompensated cirrhosis,and hepatocellular carcinoma.Net cost savings due to treatment of CHB with interferon-?were estimated using clinical data from2therapeutic schemes used in hospital.RESULTS:For the patients at different stages of hepatopathy,the direct medical cost and economic burden per year were different:9000yuan,11362yuan(CHB);13865yuan,19412yuan(compensated cirehosis);25678yuan,36979yuan(decompensated cirrhosis);26501yuan,40264yuan(liver cancer),Compared with conrentional therapy against CHB,the direct medical cost and total cost were reduced following4months treatment of interferon-?after5-year follow-up.The reduced amounts were831yuan,2038yuan per person,respectively.The surrival rate rised by2.8%.CONCLUSION:CHB infections create a heavy economic burden on the society,as well as patients and their families.We have seen the potential cost-savings due to treatment with interferon-?.
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Objective To assess the differences in the specificity and the sensitivity in detecting specific IgM by indirect ELISA and capturing-ELISA methods,and to analyze the possible causes of those differences.Methods The HBc-IgM and EHF-IgM level in serum samples from activity Hepatitis B patients and hemorrhagic fever patients with renal syndrome were determined by both indirect-ELISA and capturing-ELISA methods,and the differences in the positive rate,positive threshold value and the specificity between those two methods were compared. Results Specific murine IgM diluted in PBS were detected by indirect-ELISA and capturing-ELISA,and the specificity and sensitivity of those two methods were similar.Results showed that sensitivity of indirect-ELISA was lower than capturing-ELISA in detecting specific IgM in serum from patients with activity Hepatitis B and hemorrhagic fever patients with renal syndrome.The IgM level in hepatitis B and hemorrhagic group treated with thioglycol became negative detected by those two methods,suggesting that both of them have the anti-IgM epitope-specificity.Cross reaction results demonstrated that the reagent detecting IgM from the two methods had the specificity to the specific antigen. Conclusion It is recommended to detect IgM level by capturing-ELISA method for the early diagnosis of acute infectious disease,pathological changes,immune reaction and prognoses of chronic continuous infectious disease.Applying the indirect-ELISA method to detect IgM level to diagnose acute infectious disease is to discuss in the future.
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BACKGROUND/AIMS: Long-term treatment with lamivudine causes breakthrough, but the clinical course after lamivudine breakthrough is not well known. The aims of this study were to evaluate the clinical course in lamivudine after breakthrough, and to identify predictive factors of breakthrough. METHODS: 124 patients with chronic hepatitis B infection, who represented viral breakthrough during lamivudine therapy, were included. The mean duration of lamivudine therapy and additional lamivudine therapy after breakthrough was 30.5 months and 12.5 months, respectively. RESULTS: The cumulative breakthrough rates at 12, 18, 24 and 36 months were 8, 24, 36 and 52%, respectively. After viral breakthrough, only 4 patients maintained normal ALT levels. 120 patients showed ALT elevation. The number of patients with ALT levels greater than 5 times, and greater than 10 times, the upper normal limit were 67 (56%) and 29 (24%), respectively. While still on lamivudine therapy after breakthrough, 98 patients presented ALT elevation. Only 22 had normalized ALT levels. Hepatic decompensation developed in 2 patients. HBeAg seroconversion after breakthrough occurred in 10 patients. The changing pattern of quantitative HBeAg levels during lamivudine therapy was the only predictive factor associated with viral breakthrough. The mean time of turning points in decrescendo-crescendo patterns of HBeAg levels during lamivudine therapy was earlier than viral breakthrough (9 months vs. 17 months). CONCLUSIONS: These results suggested that deterioration of hepatic function can usually be observed after breakthrough. The serial monitoring of serum quantitative HBeAg levels may allow an early recognition of viral breakthrough.
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Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , DNA, Viral/blood , English Abstract , Hepatitis B e Antigens/blood , Hepatitis B virus/isolation & purification , Hepatitis B, Chronic/drug therapy , Lamivudine/therapeutic use , Prognosis , Reverse Transcriptase Inhibitors/therapeutic useABSTRACT
BACKGROUND/AIMS: The post-treatment relapse patterns and efficacy of lamivudine re-treatment for relapsed patients have not been clarified. The aims of this study were to evaluate the relapse patterns after discontinuing therapy and the effects of lamivudine re-treatment for relapsed patients after HBeAg seroconversion. METHODS: Therapy was discontinued after HBeAg seroconversion in 121 patients. Sixty-six patients were relapsed and included in this study. The duration of lamivudine re-treatment therapy was from 6-35 (mean: 16) months. Post-retreatment monitoring continued for 1-40 (mean: 8.9) months. RESULTS: Among the relapsed 66 patients, 50 (75.8%) had HBeAg reappearance while 16 (24.2%) remained HBeAg negative and anti-HBe positive. The cumulative relapse rates at 3, 6, 12 and 24 months were 27%, 47%, 60% and 66%, respectively. Forty-two relapsers received lamivudine re-treatment. Among them, 33 were HBeAg positive and 9 were HBeAg negative and anti-HBe positive, Response was achieved in 31 of the 42 patients (73.8%). The cumulative response rates at 6, 9 and 12 months were 62%, 69% and 72%, respectively. Six patients (14.3%) developed viral breakthrough. All patients were HBeAg positive chronic hepatitis B. The duration of lamivudine re-treatment was the only predictable factor for response of lamivudine re-treatment. Therapy was discontinued after response in 21 patients. Eleven patients were relapsed, including 6 who were HBeAg positive and 5 who were HBeAg negative. Predictive factors for post-retreatment relapse were age and the duration of additional lamivudine therapy after response. CONCLUSIONS: The response rate of lamivudine re-treatment was significantly higher than in initial lamivudine treatments. The breakthrough and relapse rates, however, were similar in both initial and retreated lamivudine therapy.
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Adult , Female , Humans , Male , Antiviral Agents/therapeutic use , Hepatitis B e Antigens/blood , Hepatitis B, Chronic/diagnosis , Lamivudine/therapeutic use , Recurrence , RetreatmentABSTRACT
The study has determined the seroprevalence and the risk factors of C and B hepatitis virus infection among cambodian patients visited to HCM city University Medical Centre. Results found an endemic prevalence of 19.74% of anti HCV(+) serum, anti-HBC(+) 74.84%, 15.84% HBsAg(+). 3.04% of anti-HCV(+) and HBsAg. Risk factors for HCV infection are concentration campain staying, traditional acupuncture, multiple sex partners injecting glass syringes.
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Hepatitis C , Hepatitis B , Risk Factors , EpidemiologyABSTRACT
Objective To explore the relationship among HBV load ,IFN-? and IL-4 in sera from patients with CHB.Methods Fluorescence quantitative PCR(FQ-PCR) was used to detect quantity of HBV DNA,and ELISA was used to determine contents of IFN-? and IL-4.According to HBV DNA quantity(copies/ml),the patients with chronic hepatitis B(CHB) were divided into high(≥10 7/ml),middle(10 6～10 5/ml) and low (
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To explore the changes in blood levels of lipopolysaccharide(LPS), lipopolysaccharide-binding protein(LBP),and soluble CD14 (sCD14), and their clinical significance in patients with severe chronic viral hepatitis B. blood levels of LPS were determined with chromogenic limulus amebocyte lysate assay, and LBP and sCD14 were assayed with ELISA in 24 patients of severe chronic viral hepatitis B. 10 normal subjects and 16 patients with chronic hepatitis B were also enrolled as controls. The results showed that the blood levels of LPS, LBP and sCD14 were significantly higher in patients with the early stage, midterm, late periods of severe chronic viral hepatitis B than in normal subjects and in those with chronic hepatitis B. The blood levels of LPS, LBP and sCD14 were also significantly higher in patients who died of severe chronic viral hepatitis B than in survivors of the same disease. It suggested that when patients with severe chronic viral hepatitis B were complicated by intestinal endotoxemia (IETM), the sensitivity of Kupffer cells to endotoxin was significantly increased, resulting in hepatocyte injury by TNF ?,even in the presence of very low endotoxin concentration .