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Objective To investigate the immune regulation and prognosis of hepatitis B virus (HBV) infection in infected patients, and to analyze the relationship between immune regulation and clinical outcome. Methods The data of 633 cases of HBV infection in Huhhot from January 2015 to December 2018 were retrospectively analyzed. At the same time, healthy people from the Affiliated Hospital of Inner Mongolia Medical University were selected as the control group. Immune cell regulatory factors and lymphocyte subsets in blood of HBV infected and healthy people were tested. The results of one-year clinical outcomes were calculated. The relationship between immune cell regulatory factors and lymphocytes and the clinical outcomes of patients was analyzed by multiple logistics regression. Results The levels of CD4+T cells, CD8+T cells, NK cells, IL-2, and IL-12 in the blood of patients with HBV infection were significantly lower than those in the control group, and decreased as the patients’ clinical outcome deteriorated (P0.05). Low CD4+ T cells, low CD8+ T cells, low NK cells, low IL-2, low IL-12, high IL- 4 and high IL-10 were independent risk factors leading to the deterioration of clinical outcomes (P<0.05). Conclusion The immune regulation of patients with HBV infection is in a state of suppression, which is an independent factor affecting the clinical outcome of patients.
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Background@#Few data are available regarding the progression of liver disease and therapeutic efficacy in chronic hepatitis B virus (HBV) carriers infected by mother-to-child transmission (MTCT). This study aimed to investigate these two aspects by comparing the adult chronic HBV carriers in MTCT group with those in horizontal transmission group.@*Methods@#The 683 adult chronic HBV patients qualified for liver biopsy including 191 with MTCT and 492 with horizontal transmission entered the multi-center prospective study from October 2013 to May 2016. Biopsy results from 217 patients at baseline and 78 weeks post antiviral therapy were collected.@*Results@#Patients infected by MTCT were more likely to have e antigen positive (68.6% vs. 58.2%, χ2 = -2.491, P = 0.012) than those with horizontal transmission. However, in patients with MTCT, levels of alkaline phosphatase (ALP) (P = 0.031), Fibroscan (P = 0.013), N-terminal propeptide of Type III procollagen (PIIINP) (P = 0.014), and Laminin (LN) (P = 0.006) were high, in contrast to the patients with horizontal transmission for whom the levels of albumin (ALB) (P = 0.041), matrix metalloproteinase-3 (MMP-3) (P = 0.001) were high. The 47.2% of patients with MTCT and 36.8% of those with horizontal transmission had significant liver fibrosis (P = 0.013). Following antiviral therapy for 78 weeks, 21.2% and 38.0% patients with MTCT and horizontal transmission acquired hepatitis B e antigen (HBeAg) clearance, respectively (P = 0.043), and the virological response rates were 54.7% and 74.1% in the MTCT and horizontal groups, respectively (P = 0.005). MTCT was a risk factor for HBeAg clearance and virological response.@*Conclusion@#Adult patients with MTCT were more prone to severe liver diseases, and the therapeutic efficacy was relatively poor, which underlined the importance of earlier, long-term treatment and interrupting perinatal transmission.@*Trial Registration@#NCT01962155; https://clinicaltrials.gov.
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BACKGROUND/AIMS: The objective of our study was to determine the epidemiological, laboratory, and serological characteristics of patients with chronic hepatitis B virus (HBV) infection and normal transaminases. The study also aimed to evaluate liver damage by measuring the liver fibrosis (LF) grade and to identify possible factors associated with the presence of fibrosis. METHODS: A retrospective observational study was conducted in patients with chronic HBV infection and classified as inactive carriers or immune-tolerant. Epidemiological variables of age, sex, immigrant, alcohol consumption, and body mass index (BMI), as well as virological variables (HBV DNA) and transaminase level were collected throughout the follow-up. The LF grade was evaluated by transient elastography. The cutoff value for significant fibrosis (SF) was liver stiffness ≥7.9 kPa. RESULTS: A total of 214 patients were included in the analysis, and 62% of them had a BMI ≥25 kg/m². During follow-up, 4% of patients showed transaminase elevation ( < 1.5 times normal). Most patients had a viral DNA level < 2,000 IU/mL (83%). Data on LF were available in 160 patients; of these, 14% had SF, 9% F3, and 6% F4. The variables associated with the presence of SF were transaminase alteration during follow-up, as 23% of patients with SF had elevated transaminases versus 3% of patients without SF (P < 0.005), and BMI, as the vast majority of patients with SF (88%) had a BMI ≥25 kg/m² versus 56% of patients without SF (P < 0.05). CONCLUSIONS: In patients with chronic HBV infection and normal transaminases, liver damage does not seem to be related to DNA levels, alcohol consumption, or immigrant status. SF seems to be associated with transaminase alteration during follow-up and elevated BMI. It is therefore recommended to measure LF grade with validated non-invasive methods in such patients.
Subject(s)
Humans , Alcohol Drinking , Body Mass Index , DNA , DNA, Viral , Elasticity Imaging Techniques , Emigrants and Immigrants , Fibrosis , Follow-Up Studies , Hepatitis B e Antigens , Hepatitis B, Chronic , Hepatitis, Chronic , Liver Cirrhosis , Liver , Observational Study , Retrospective Studies , TransaminasesABSTRACT
Objective · To investigate the correlation between proportion of natural killer (NK) cells and dendritic cells (DCs) and liver injury in patients with chronic hepatitis B virus (HBV) infection. Methods · Peripheral blood samples were collected from 65 patients with chronic HBV infection and 10 healthy volunteers (HCs group). Flow cytometry was used to detect the proportion of peripheral NK cells and DCs. The patient were divided into asymptomatic HBV carrier (AsCs) group, chronic hepatitis B in low or moderate grade (CHB-LM) group, and chronic severe hepatitis B (CSHB)group.The relationship of the proportion of NK cells, the proportion of DCs, and the ratio of NK/DC with the degree of liver injury was analyzed. Results · The proportion of peripheral NK cells was significantly lower in CHB-LM group (9.29%±1.20%) and CSHB group (3.60%±0.79%) than that in HCs group (14.77%±2.90%) and AsCs group (14.05%±2.32%) (P=0.000). And the proportion of peripheral DCs was significantly higher in CHB-LM group (4.10%±1.18%) than that in HCs (1.67%±0.31%), AsCs (2.05%±0.46%) and CSHB groups (2.08%±0.41%) (P=0.000). The ratio of NK/DC was decreased in CSHB and CHB-LM groups compared to that in HCs and AsCs groups (P=0.000). The correlation analysis indicated the proportion of NK cells was negatively correlated with the levels of ALT, AST, TB and DB (r=-0.50, r=-0.49, r=-0.53, r=-0.51, P=0.000 for all) in patients with chronic HBV infection. Conclusion · The proportion of peripheral NK cells and the ratio of NK/DC in patients with chronic hepatitis B were decreased. The decrease of the frequency of NK cells and the ratio of NK/DC were associated with liver injury in patients with chronic HBV infection.
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Objective To investigate hospital acquired infections in patients with liver cirrhosis caused by relevant factors.Methods From July 2008 to June 2013,the clinical data of 470 cases of hospital acquired infections patients with chronic hepatitis B virus (HBV) infection were retrospectively analyzed by case-control study for the effective factors.Results Hospital acquired rate was 29.1％ (137/470).By logistic regression analysis,the effective factors were length of stay (OR =27.824,95％ CI 7.187-98.386),invasive operation (OR =17.201,95％ CI 4.245-71.303),a complication (OR =2.138,95％ CI 1.030-4.377),preventive use of antibiotics(OR =2.741,95％CI 1.816-4.010),drinking history(OR=34.248,95％CI 13.045-82.328),serum albumin(OR =17.258,95％ CI 6.242-53.162),quantitative PCR-HBVDNA (OR =4.859,95％ CI 3.214 -7.625),white blood cell (OR =4.271,95 ％ CI 1.520-12.157),c holinesterase (OR =2.761,95 ％ CI 1.523 -3.787) and anti virus medicine(OR=0.128,95％CI 0.041-0.375) (P＜0.05).Conclusion This study shows that length of stay,invasive operation history,complications,low white blood cell,low serum protein,low cholinesterase,the prophylactic use of antibiotics,hormone,high PCR-HBVDNA quantitative and drinking are the important risk of hospital acquired infections infection factors of patients of impact chronic HBV infection.Applications of antiviral drugs are effective in the prevention of chronic HBV infection protection factors of hospital acquired infections infection patients.
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Objective To determine the expression of interleukin-21 (IL-21) in patients infected with hepatitis B virus (HBV) and its association with HBV-DNA and ALT. Methods Clinical dates and blood specimen were collected from 25 unrelated healthy controls (HC) and 101 independent chronic HBV infected patients, including 25 patients in immune tolerant phase (IT), 25 in immune clearance phase (IC), 26 patients in inactive HBV carrier state (IA) and 25 patients in immune reactive phase (IR). Serum IL-21 levels were measured by Cytometric Bead Array (CBA). IL-21 mRNA and IL-21 receptor mRNA were measured by real-time PCR. Results Chronic HBV-infected patients had higher levels of serum IL-21 and IL-21 mRNA , with P <0.001 for both. In subgroup analysis, both serum IL-21 and IL-21 mRNA levels in IC, IR were higher than those in IT, IA and HC (all P < 0.001). Serum IL-21 level in IA was higher than that in HC and IT (P <0.001, P = 0.036). IL-21R mRNA levels were different between groups. Serum IL-21 level was associated with HBV-DNA (r = -0.472, P < 0.001), but not with ALT. Conclusion IL-21, up-regulated in chronic HBV infection, is associated with immune activity and may play a key role in HBV control.
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BACKGROUND/AIMS: The clinical effects of clevudine have been reported in patients with chronic hepatitis B virus infections (CHIs). In this investigation, we assessed whether clevudine induced biochemical and virological improvements in hepatocellular carcinoma (HCC) patients with CHI. METHODS: Fifty-four patients who received 30 mg clevudine for more than 24 weeks between 2007 and 2009 at the National Cancer Center Hospital, Korea, were enrolled. Among these cases, 39 had HCC (CHI/HCC group) and 15 did not (CHI group). RESULTS: In relation to the CHI group, the CHI/HCC group was older (55.5 years.) and had a higher liver cirrhosis rate (79.5%) (p0.05). Liver function was preserved with clevudine treatment in patients displaying response or stable disease under anti-cancer therapy. Four patients (7.4%) developed viral resistance during clevudine therapy. Among these, one was naive, and three had previously received antiviral therapy. One CHI/HCC patient (1.9%) discontinued clevudine treatment due to symptomatic myopathy. CONCLUSIONS: Our findings clearly indicate that clevudine has comparable antiviral and biochemical effects in patients with CHI and with CHI/HCC and preserves the underlying liver function in HBV-related HCC patients.