ABSTRACT
Chronic HBV infection can generally be divided into four stages according to the natural course of disease. Clinically, the determination of different natural stages of chronic HBV infection is crucial for patients to start antiviral therapy and to avoid missing the antiviral opportunity and progressing to cirrhosis. In particular, it is a challenge for clinicians to distinguish the immune control stage from the reactive stage. As a novel marker of HBV, the quantitative detection of HBV core-associated antigen (HBcrAg) is of value for the identification of the HBV infection stages. This article reviews the research progress of HBcrAg in the identification of different stages of chronic HBV infection.
ABSTRACT
Background:Peripheral blood mononuclear cells containing an aggregate of immune competent cells,such as T lymphocytes, B cells and natural killer cells, play an important role in control or persistence of the hepatitis B virus(HBV) infection. Similarly, the expression of hepatitis B viral antigens on the surface of infected hepatocytes can invoke a cytotoxic T–cell response.Objective:To investigate the dynamic changes in hepatitis B surface antigen (HBsAg) and peripheral lymphocyte subsets of healthy donors and chronic hepatitis B patients. Methodology:Serum HBsAg was quantified by enzyme-linked immunosorbent assayaccording to the manufacturer’s guidelines. Peripheral blood lymphocyte cell phenotyping was carried out by flow cytometry for all chronic hepatitis B patients and healthy blood donors Results:The results of this study showed a significant correlation between HBsAg level and percentage of T and NK cells (r=0.366; P=0.01, r=-0.462; P=0.01,respectively). On the other hand, significance variation in peripheral blood lymphocyte percentage of T lymphocyte subsets in patients were found to be directly proportional to T cell subsets CD4+and CD8+ (P=0.001)compared with healthy blood donor controls. Conclusion:In conclusion this study highlighted the role of the HBsAg level in supressing the immune cells of the innate and adaptive immune system. Understanding the interactions between HBsAg and peripheral blood cells serves as a basis for development of HBV therapeutic vaccines and a prognostic biomarker in persistent HBV infection
ABSTRACT
Objective To investigate the influence factors of chronic hepatitis B virus(HBV) infection complicated with chronic liver failure.Methods One hundred and eighty-six chronic HBV infection patients with chronic liver failure were selected as our subjects,who were hospitalized in the Affiliated Hospital of Hebei United University from Jul.2008 to Dec.2013 and they served as case group.Meanwhile,186 patients with chronic HBV infection were selected and served as control group,who were hospitalized during the same period.A self-mad questionnaire was used to collect the information.The influence factors related to HBV infection complicated with acute on chronic liver failure were recorded.Results Multivariate conditional Logistic regression analysis showed that 8 variables were risk factors in terms of chronic HBV infection complicated with acute on chronic liver failure and they were virus overlap infection (OR =6.523,95％ CI:2.034 -10.030),drug application (OR =9.012,95％ CI:3.018-13.241),alcohol (OR =7.2520,95％ CI:1.985 -11.247),bacterial infection(OR =4.378,95％ CI:2.032-5.648),surgical operation (OR =8.514,95％ CI:2.114-17.253),emotional stress and fatigue (OR =2.217,95％ CI:1.729-5.648),genetic (OR =11.124,95％ CI:2.168-13.429),high PCR-HBVDNA quantity (OR =1.628,95％ CI:1.504-3.282).And one protective factorwas the usage of antiviral drug(OR=0.163,95％CI:0.085-0.417).Conclusion The risk factors include virus over infection,application of hepatotoxic drugs,disease before drinking,bacterial infection,surgical operation,emotional stress and fatigue,the genetic parents and high PCR-HBVDNA quantification;and antiviral drugs application is the protective factor in terms of Chronic HBV infection complicated with acute-on-chronic liver failure.
ABSTRACT
Objective To explore the association between TNF-α gene 308 locus polymorphism and the risk of chronic HBV infection in Chinese population.Methods PubMed,Embase,CNKI and SinoMed database were searched for relevant articles published from January 2001 to May 2013.Case-control studies on TNF-α-308 polymorphism with chronic HBV infection in Chinese population were gathered with meta-analysis applied for calculation of pooled OR value (with 95％CI) after data abstraction.Results Eleven case-control studies for the TNF-α-308 polymorphism with a total of 1 872 cases and 1 471 controls were included.Results from the overall meta-analysis indicated that-308A allele had a significant decreased risk of chronic HBV infection (A vs.G:OR=0.579,95％CI:0.422-0.794; GA vs.GG:OR=0.525,95％CI:0.325-0.847; AA vs.GG:OR=0.301,95％CI:0.125-0.720; GA+AA vs.GG:OR=0.490,95％CI:0.309-0.777; AA vs.GA+GG:OR=0.542,95％CI:0.394-0.746).In subgroup analyses by region,a significantly decreased risk seemed associated with-308A allele in population from northern China.When stratified by case type,control type and genotyping methods,there apppeared no significant association between TNF-α-308A allele and chronic HBV infection in the studies when spontaneously recovered one' s were used as controls and PCR used as its methodology.Conclusion TNF-α-308A allele seemed a protective factor for chronic HBV infection in the Chinese population.
ABSTRACT
Objective To investigate hepatitis B virus surface antign (HBsAg) quantitative value quantitatively in serum of chronic hepatitis B virus (HBV) infection patients with different clinical stages,at the same time,to explore the correlation between HBV DNA,patient's age and HBsAg quantitative values.Methods Collected 774 cases without antiviral treatment of chronic HBV infection from our hospital,according to the clinical features,divided cases into six groups:chronic HBV carrier group (102 cases),inactive HBsAg carrier group (211 cases),hepativis B virus e antigen (HBeAg) positive chronic hepatitis B group (236 cases),HBeAg negative chronic hepatitis B group (114 cases),HBeAg positive hepatitis B cirrhosis group (52 cases),HBeAg negative hepatitis B cirrhosis group (59 cases).Used chemiluminescence immunoassay particles analysis to determine HBsAg quantitative value in serum in patients,used real-time fluorescent quantitative polymerase chain reaction method to determine HBV DNA quantitative value in patients,and then compared differences among groups.Results HBsAg quantitative value from high to low respectively were chronic HBV cartier group,HBeAg positive chronic hepatitis B group,HBeAg negative chronic hepatitis B group,inactive HBsAg carrier group,HBeAg negative hepatitis B cirrhosis group,HBeAg positive hepatitis Bcirrhosis group,the median quantitative value of HBsAg were [7.80 (6.69-8.32),7.11 (5.42-8.27),6.57 (5.66-7.53),6.38 (4.39-7.40),6.22 (4.84-6.91),6.13 (5.48-7.01)] ; positive correlation was found between HBsAg quantitative value and HBV DNA in HBeAg positive chronic hepatitis B group and HBeAg negative chronic hepatitis B group (r =0.714,0.390,P ＜ 0.01); negative correlation was found between HBsAg quantitative value and age in chronic HBV infection(r =-0.416,P ＜ 0.01) ; Monitored HBsAg quantitative value of inactive HBsAg carriers after the age 40 had important clinical value.Conclusions HBsAg quantitative value is different in the various phases of chronic HBV infection.HBV DNA levels and age are related with HBsAg quantitative value.HBsAg quantitative value should be monitored in inactive HBsAg carriers after the age 40.
ABSTRACT
This study was aimed to compare the effect of traditional Chinese medicine ( TCM ) treatment method of kidney-tonification, spleen-invigoration and detoxification on T lymphocytes of patients with chronic HBV infec-tion, which were mediated by peripheral blood dendritic cells (DCs). Ten patients with chronic HBV infection and eight healthy controls were included in this study. DCs were differentiated from PBMCs which were isolated from their peripheral blood, incubated and induced. Then, the DCs were interfered by plasma of medicine through the treatment methods of kidney-tonification, spleen-invigoration and detoxification. Models of interaction were estab-lished. Expressions of CD3+, CD4+, CD8+, CD8+CD28+, CD8+PD-1 of DCs and T cells were detected by FACS; and the levels of IFN-γ in supernatants were detected by ELISA. The results showed that the kidney-tonification plasma, spleen-invigoration plasma, detoxification plasma deal with HBcAg in load DCs incubated T lymphocytes. The CD3+ and CD4+ expression rate were increased; the CD8+ and CD8+PD-1 expression were reduced; IFN-γ level was increased; but only the Liuweidihuang Tang group was with significant difference compared to the model group (P < 0.05); the CD8+CD28+ expression rate was increased in the Sijunzi Tang and Liuweidihuang Tang group compared to the model group ( P < 0 . 05 ) . It was concluded that to a certain extent , the treatment method of kidney-tonification, spleen-invigoration and detoxification can restore the function of peripheral blood DCs in chronic HBV infection patients in order to restore its downstream T lymphocyte function. Among these treatment methods, the optimal method is kidney-tonification.
ABSTRACT
Objective To explore the psychological stressors of pregnant women with chronic HBV infection.Methods Using phenomenological method of qualitative study,there were 9 pregnant women with chronic HBV infection participated in the study and their mental stress was investigated by deep interview.Results Five main psychological stressors of pregnant women with chronic HBV infection emerged:fear of children being infected; anxious about giving birth in the hospital for infectious diseases; having no idea of selecting the mode of delivery and feeding pattern; worrying about their own health; to feel nervous about playing the role of mothers.Conclusions Healthcare workers should make appropriate health guidance and psychological supports to alleviate the psychological distress combined with features of pregnant women with HBV infection.At the same time,it is necessary to make change of public misunderstanding of hepatitis B,so as to create a fair and friendly social atmosphere for all the hepatitis B patients.
ABSTRACT
Objective To explore the effects of intensive health education on psychological stress of outpatients with chronic HBV infection. Methods A convenient sample of 80 patients was selected as the subjects of the study. They were randomly allocated to the control and the intervention group with 40 patients in each group. The intervention group received intensive heath education, which was designed spe-cially by researcher, while the control group just received the routine clinic health education. Demographic Data Recording Form (DDRF) and the Perceived Stress Scale specific to Hepatitis B Patients (PSSH) were used to assess the intervention effect pre-treatment and 3 months after intervention. Results The scores of PSSH were high in two groups before intervention. Compared with the control group, the intensive health education decreased the score of PSSH more significantly in the intervention group. Conclusions The intensive heath education can reduce the psychological stress of the outpatients with chronic HBV infection.
ABSTRACT
Objective To analyze of CD4+ CD25high regulatory T cells(Treg)in peripheral blood of chronic HBV patients and its correlation with multiple clinical indicators.Methods Thirty-five hepatitis B virus(HBV)infected patients in this study were divided into four different clinical types:HBsAb+group(n=5),inactive hepatitis group(n=8),chronic hepatitis group(n=12),and immune tolerance group(n=10).The number of CD4+CD25high Treg and related T cells subgroup in CD3/CD4/CD8 was thoroughly examined by flow cytometry in peripheral blood of HBV infected patients and the healthy contrast group(n=12).Serum HBV markers were determined by commercial ELISA kits.Serum HBV DNA was quantified by commercial real-time PCR kit.Statistical differences were studied to investigate the correlations between CD4+CD25high Treg and different clinical types of HBV infection and clinical indicators.Results The absolute counts of CD25high Treg and its frequency in CD4+ T cells were similar between HBV infected patients [(12.35±6.48)/μ,(1.82±0.87)%]and health controls[(8.91±3.11)/μl,(1.35±0.39)%],P＞0.05.The frequency of CD25high Treg in CD4+ T cells from the immune tolerance group was significantly higher than that of the HBsAb+ group,chronic hepatitis group,and the healthy contrast group(P＜0.05).The absolute counts of CD25high Treg from the immune tolerance group were significantly higher than the healthy control group(P＜0.05),and the frequency of CD25high Treg in CD4+ T cells is negatively correlated to the ALT level(r=-0.418,P=0.038),positively correlated to CD4/CD8 ratio(r=0.344,P=0.021),no correlation to the HBV DNA level(r=0.118,P＞0.05).The absolute counts of CD25high Treg were positively correlated to CD4/CD8 ratio(r=0.360,P=0.015),no correlation to ALT level and HBV DNA level(r=-0.211,r=0.060,P＞0.05).Conclusion CD4+ CD25high Treg may play a role in immunopathogenesis of chronic HBV infection.
ABSTRACT
No abstract available.