Clinical features and long-term prognosis of primary biliary cholangitis in patients with past hepatitis B virus infection / 中华肝脏病杂志

Objective: To investigate the clinical features and long-term prognosis of primary biliary cholangitis (PBC) in patients with past hepatitis B virus (HBV) infection. Methods: 353 cases with PBC who visited the Liver Disease Center of Beijing Friendship Hospital Affiliated to Capital Medical University between January 2000 and January 2018 were retrospectively analyzed and were divided into the past HBV infection group (156 cases) and the no HBV infection group (197 cases). The two groups' baseline clinical features were compared. Ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, and long-term liver transplantation-free survival rate were compared through outpatient and telephone follow-up. Results: PBC with past HBV infection had a significantly reduced female proportion compared to the no HBV infection group (91.9% vs. 79.5%, P = 0.001). However, there were no statistically significant differences in age, biochemical indices, immunological indicators, platelet count, cirrhosis proportion, and others. Ursodeoxycholic acid biochemical response rate was reduced in patients with past HBV infection at the end of one year of treatment, but the difference was not statistically significant (65.8% vs. 78.2%, P = 0.068). In addition, there were no statistically significant differences between the GLOBE score (0.57 vs. 0.59, P = 0.26) and UK-PBC 5-year (2.87% vs. 2.87%, P = 0.38), 10-year (9.29% vs. 8.2%, P = 0.39) and 15-year liver transplantation rates (16.6% vs. 14.73%, P = 0.39). Lastly, the overall 5-year liver transplantation-free survival rate had no statistically significant difference between the two groups of patients (86.4% vs. 87.5%, P = 0.796). Conclusion: Primary biliary cholangitis had no discernible effect in terms of age at onset, biochemical indices, immunological indicators, cirrhosis proportion, ursodeoxycholic acid response rate after one year, GLOBE score, UK-PBC score, or overall liver transplantation-free survival rate in patients with past hepatitis B virus infections.

Analysis of peripheral blood lymphocyte status in low-level-viremia patients with chronic hepatitis B virus infection after nucleos(t)ide analogue treatment / 中华微生物学和免疫学杂志

Objective:To evaluate the status of T, B and NK lymphocytes in peripheral blood of patients with chronic hepatitis B virus(HBV) infection and low-level viremia after nucleos(t)ide analogue (NA) treatment and to provide ideas for solving low-level viremia.Methods:This retrospective study involved 344 patients with chronic HBV infection who had been treated with NAs. They were divided into two groups: low-level viremia group (LLV group) and complete virological response group (CVR group). Clinical data including basic information, biochemistry and coagulation test results, HBV DNA, peripheral blood lymphocyte counts, PD1 and CD28 expression by T lymphocytes, and perforin and granzyme B expression by NK lymphocytes were collected and compared between the two groups. Propensity matching analysis was performed to verify the accuracy of the results.Results:Among the 344 cases, 162 were in the LLV group and 182 in the CVR group. There were no significant differences in disease diagnosis, alanine aminotransferase (ALT), aspartate aminotransferase (AST) or albumin (ALB) level between the two groups ( P>0.05), but the differences in gender and age were statistically significant ( P<0.05). The differences in the counts and percentages of peripheral blood CD3 +, CD4 + and CD8 + T lymphocyte and CD4 + /CD8 + ratios between the two groups were not statistically significant ( P>0.05), but the expression of PD1 and CD28 by peripheral blood CD3 +, CD4 + and CD8 + T lymphocytes was higher in the LLV group than in the CVR group ( P<0.05). The count of peripheral blood CD19 + B lymphocytes in the LLV group was higher than that in the CVR group ( P>0.05), and the percentage of peripheral blood CD19 + B lymphocytes was also higher in the LLV group ( P<0.05). The count of peripheral blood CD16 + CD56 + NK lymphocytes and the expression of perforin in the LLV group were lower than those in the CVR group ( P>0.05). The percentage of peripheral blood CD16 + CD56 + NK lymphocytes and the expression of granzyme B in the LLV group were lower than those in the CVR group ( P<0.05). After propensity score matching, 108 cases in the LLV group and 108 cases in the CVR group showed no significant differences in basic information ( P>0.05); the percentage of CD4 + T lymphocytes and CD4 + /CD8 + ratio in peripheral blood T lymphocyte subsets were higher in the LLV group than in the CVR group, while the percentage of CD8 + lymphocytes was lower in the LLV group ( P<0.05); the expression of PD1 and CD28 by CD3 +, CD4 + and CD8 + T lymphocytes remained higher in the LLV group ( P<0.05); the differences in the counts and percentages of peripheral blood CD19 + B lymphocytes as well as CD16 + CD56 + NK lymphocytes between the two groups were not statistically significant ( P>0.05); no significant difference in the expression of perforin by CD16 + CD56 + NK lymphocytes was found between the two groups ( P>0.05), and the expression of granzyme B remained lower in the LLV group ( P<0.05). Conclusions:Abnormal number and function of T lymphocytes and decreased function of NK lymphocytes might be related to the development of LLV in patients with chronic HBV infection after treatment. Therefore, in addition to adjusting NAs, targeting of T and NK lymphocytes might also be a feasible measure for future LLV treatment.

Progress in application of hepatitis B virus core-associated antigen in differentiating natural stages of chronic HBV infection / 中华临床感染病杂志

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.

Serological and molecular characterization of HBV infection with HBsAg reactive and HBV DNA non-reactive / 中国输血杂志

【Objective】 To investigate the serological and molecular characteristics of HBsAg+ /HBV DNA non-reactive (NR) infections. 【Methods】 Samples tested as HBsAg+ and HBV DNA NR were confirmed by individual NAT repeat testing, viral particle concentration by PEG precipitation combined with in-house nested PCR and real-time quantitative PCR, anti-HBc testing, and HBsAg quantification. HBV sequences were compared with those from donors with chronic and occult infection as controls. 【Results】 A total of 792 195 samples were screened between January 2011 and December 2020, of which 53 (1: 14 947) were confirmed HBsAg+ /HBV DNA NR. HBV DNA was detected further in five (9.4%) samples; three S sequences and four Pre Core/Core sequences were obtained. Unique amino acid substitutions (P130T, P135Q/S, R151Q, G153S and S155F) were found in the Core protein that may affect virus packaging and replication. 【Conclusion】 Extremely low HBV DNA level was detected in plasmas of HBsAg+ /HBV DNA NR donors. Barely detectable HBV DNA might be associated with unusual mutations in the Pre Core/Core protein affecting viral replication. More sensitive HBV DNA and/or HBsAg assays may be considered to further reduce the potential HBV transfusion-transmission residual risk.

Investigation and analysis of HBV infection and related cirrhosis in a certain area / 公共卫生与预防医学

Objective To investigate and analyze the incidence of hepatitis B virus (HBV) infection and related cirrhosis in a certain area. Methods A retrospective investigation was performed on 365 patients with HBV infection in a certain area from October 2018 to October 2020. The relevant data of the patients and the incidence of HBV infection-related cirrhosis were analyzed to explore the influencing factors for liver cirrhosis caused by HBV infection. Results The age of patients with HBV infection was mainly 31-50 years old (61.92%), who were mainly males (80.00%). The symptoms included yellow urine (66.30%), loss of appetitte (57.53%) and fatigue (46.85%). There was abnormal increase of aspartate aminotransferase and alanine aminotransferase, and hyperbilirubinemia in patients. 35 patients developed liver failure, of whcih 31 patients survived and were discharged, 3 patients underwent liver transplantation and 1 patient died after discharge. Among the 365 patients, there were 82 cases with HBV-related cirrhosis, mainly aged between 31 and 50 years old (63.41%), who were mainly males (80.00%). The main symptoms included abdominal distension (46.34%), liver palm (39.02%) and jaundice (34.15%), and all were accompanied with abnormal liver function indexes. Of the 365 patients, 35.37% of them were complicated with primary peritonitis, and 25.61% with electrolyte imbalance. In addition, 87.80% of the patients improved and were discharged. The incidence rates of upper gastrointestinal bleeding, hepatic encephalopathy and death were 7.32%, 3.66% and 1.22%, respectively. The results of univariate and multivariate analysis showed that drinking history, HBV-DNA level and exercise were the influencing factors of HBV-related cirrhosis (P<0.05). Conclusion Patients with HBV infection and related cirrhosis are mostly middle-aged men. Drinking history, HBV-DNA level and exercise are important influencing factors for HBV infection progression to cirrhosis.

Prevalence of Hepatitis B among jaundiced cases in paediatric age group

Background: Hepatitis B virus (HBV) infection is a global health problem. Over two billion people have been infected with hepatitis B virus globally, of whom over 350 million are chronic carriers. Vertical (mother to child) and horizontal early childhood transmission are the main routes of HBV transmission and are responsible for most chronic infections. The aim of this study was to study the role played by different modes of transmission of HBV and to study the burden of hepatitis B in pediatric age group.Methods: All children below 12 years of age, admitted for jaundice, of both sexes, during one year study period were included. 50 patients (control) who were not suffering from jaundice or known liver disease were also included.Results: Prevalence of HBsAg positivity among jaundiced children was 15.24%. There was increase in HBsAg positivity with increase in the age signifying role of horizontal mode of transmission in Hepatitis B virus infection.Conclusions: HBV infection is an important health problem in paediatric age group. Horizontal mode of transmission plays important role in the spread of HBV infection among children.

Dynamics of Hepatitis B Virus Surface Antigen Level with Peripheral Blood Lymphocytes in Chronic Hepatitis B Infection

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

Awareness and Attitude towards Hepatitis B Infection among Medical and Dental Students in Lucknow

Health professionals, especially physicians, medical and dental students are always in direct contact with patients and are vulnerable to the acquisition of infections like hepatitis B.4 Moreover, graduates in dentistry also require advanced health care training, clinical knowledge on infection control.5 Therefore, the current study was conducted to assess and compare the level of awareness and attitude towards hepatitis B infection among medical and dental students of Lucknow. Methods: The present cross-sectional study was conducted among 200 medical and dental students of King George Medical University, Lucknow using a self-structured questionnaire, over the time period of 3 months. This selfadministered questionnaire comprised of 24 closed-ended questions to assess the awareness and attitude of students regarding HBV infection. 100 medical and 100 dental students were selected using simple random sampling method. Results: The study was conducted among 200 medical and dental students. Majority 99(99%) medical students and 98(98%) dental students had heard about hepatitis B infection. 97(97%) medical students thought it was blood borne infection and 93(93%) dental students thought it was a blood borne infection. 99 (99%) medical and 100(100%) dental students thought it was transmitted by all the given routes. It was noticed that only 5(5%) medical and only 4(4%) dental student checked their antibody status after vaccination. It was also noticed that 61(61%) medical and 47 (47%) dental students thought dentist or physician infected with HBV should avoid patient treatment especially surgery. 56(56%) medical and 61 (61%) dental students thought infection of Hep B can be prevented by Hep B Vaccine completely. Conclusion: Majority of medical and dental students have heard about HBV infection, they know about modes of transmission and vaccination schedule. It was noted that, majority of medical and dental students undergo vaccination for hepatitis B, but all of them have not completed all three doses of vaccination. The reason behind this attitude was lack of motivation or they never thought of it. Most of them acknowledged that dentists are at high risk of exposure and every patient undergoing surgical procedure should go for HBV investigation. A significant fraction of medical and dental students infected with HBV did not avoid working on the patients even during surgery. Hence, a regular awareness program for all the students would be very beneficial.

HBV epidemiology and genetic diversity in an area of high prevalence of hepatitis B in southern Brazil

ABSTRACT Background Hepatitis B virus (HBV) infection is a major public health problem in Brazil. HBV endemicity is usually moderate to low according to geographic regions, and high prevalence of this virus has been reported in people of some specific Brazilian counties, including those with a strong influence of Italian colonization in southern Brazil. Analysis of HBV diversity and identification of the main risk factors to HBV infection are necessary to understand hepatitis B epidemiology in these high prevalence regions in southern Brazil. Objective To investigate epidemiological characteristics and HBV genotypes and subgenotypes circulating in a specific city with high HBV prevalence. Methods A cross-sectional study was performed with 102 HBV chronically infected individuals, recruited in reference outpatient clinics for viral hepatitis in a city of high HBV prevalence (Bento Gonçalves) in Rio Grande do Sul state, Brazil between July and December 2010. Socio-demographic, clinical and behavior-related variables were collected in a structured questionnaire. HBV serological markers (HBsAg, anti-HBc), viral load, genotypes/subgenotypes and drug resistance were evaluated and comparatively analyzed among all patients. Results The HBV infected subjects had a mean age of 44.9 (±12.2) years, with 86 patients (84.3%) reporting to have a family history of HBV infection, 51 (50.0%) to share personal objects, and were predominantly of Italian descendants (61; 64.9%). There was a predominance of genotype D (49/54; 90.7%), but genotype A was also detected (5/54; 9.3%). Subgenotypes D1 (1; 4.7%), D2 (3; 14.3%), and D3 (17; 81.0%) were identified. LAM-resistant mutation (rtM204I) and ADV-resistant mutations (rtA181V) were detected in only one patient each. Conclusions These results demonstrate a pivotal role of intrafamilial transmission for HBV spreading in this population. Furthermore, there is a high prevalence of HBV genotype D in this region.

Analysis of HBV infection and risk factors among Li minority in Hainan / 中国免疫学杂志

Objective:To investigate the HBV infection and analyze the related risk factors among Li minority in Baisha county,Hainan Province. Methods: A total of 1 595 individuals of Li minority in Baisha county,were enrolled by random sampling method from July 2014 to October 2015. Epidemiological data including baseline characteristics and risk factors were obtained. HBcAb was detected by chemiluminescence method. The difference in age between HBcAb positive and negative group was analyzed by t test. The effects of age,gender and related risk factors on HBcAb were analyzed by univariate chi-square test and multivariate Logistic regression. Results: The positive rate of HBcAb was 71. 8% (1 145/1 595) and no significant difference between male and female was observed(x2=0. 134,P=0. 715). The difference of HBV infection among age groups was statistically significant (F=540. 769,P＜0. 001). The HBV infection rate was 11. 9% in the 12-17 year group,which was significantly lower than the others. The rate in the 18-23 year group (28. 0% ) was significantly higher than that in the 12-17 year group,but significantly lower than the other groups (＞85% ). Multivariate Logistic regression analysis showed that alcohol consumption and tattoo were independent risk factors associated with HBV infection (x2=169. 833,P＜0. 001;x2=11. 354,P=0. 001). Conclusion: The rate of HBV infection of Li minority in Baisha county,Hainan Province is high. The age,alcohol consumption and tattoo are the independent risk factors for infection.

Clinical observation of influences of donor HBV infection on allogeneic hematopoietic stem cell transplantation recipients / 西安交通大学学报(医学版)

Objective To investigate the influences of donor HBV infection on allogeneic hematopoietic stem cell transplantation recipients.Methods We made a retrospective analysis of data of four patients without HBV infection who underwent allogeneic hematopoietic stem cell transplantation from January 2015 to December 2016. Among them donors of these patients all had HBV infection.We then observed the influences of HBV infection on hematopoietic reconstruction,hepatic vein occlusive disease and HBV infection.Results HBV serological conditions of two donors were HbsAb,HbeAb and HbcAb positive,and quantitative of HBV-DNA was negative;the donor and the recipient did not use anti-HBV drugs.One donor was HbsAg,HbeAb and HbcAb positive,and the quantitative of HBV-DNA was also positive.Another donor was HbsAg and HbcAb positive,and the quantitative of HBV-DNA was also positive.These two donors received oral nucleoside therapy one month before stem cell collection and the recipients of these two donors also took nucleoside drugs one week before the conditioning.Hepatitis B immune globulin was given after transfusion of stem cells and the third day and seventh day after transplantation.Quantitative of HbsAb was detected each month and if it was less than 150 IU,hepatitis B immune globulin would be given.All the recipients had hematopoietic reconstruction and no VOD or hepatitis B virus infection occurred.Conclusion Oral administration of nucleoside drugs combined with hepatitis B immunoglobulin can effectively prevent HBV infection in recipients with HBV infection donors.

Viral Outcome in Patients with Occult HBV Infection or HCV-Ab Positivity Treated for Lymphoma

ABSTRACT HBV and HCV reactivation has been widely reported in patients undergoing immunosuppressive therapy for oncohaematological diseases. We aimed to evaluate the HBV and HCV reactivation events in patients with non-Hodgkin lymphoma (NHL) or Hodgkin lymphoma (HL) underwent cytotoxic chemotherapy containing or not rituximab. This is a retrospective observational study, including all patients with NHL and HL attending an Italian tertiary referral hospital, the University of Naples "Federico II". A total of 322 patients were enrolled. We evaluated serum HBV and HCV markers. A total of 47 (38%) patients with occult HBV infection were enrolled. Seven/47 were treated with therapeutic cytotoxic schedule containing rituximab. Of them, 6/7 received prophylaxis with lamivudine. HBV reactivation was observed in two patients treated with rituximab. A reactivation was observed in the only patient (HBcAb+/HBsAb+) not receiving lamivudine prophylaxis, and the other one was observed in 1 patient with isolated HBcAb positivity during lamivudine prophylaxis. Moreover, 8 patients with HCV-Ab positivity were enrolled. No viral reactivation was observed in these patients. In conclusion, patients with occult HBV infection receiving chemotherapy containing rituximab for lymphoma without antiviral prophylaxis are at risk of viral reactivation. On the contrary, there is no risk of reactivation in patients undergoing rituximab-free schedule. Our findings suggest that there is also very low risk of HCV reactivation. This preliminary report underlines the concept that HBV reactivation is strongly related to the type of immunosuppressive therapy administered and that antiviral prophylaxis needs to be tailored.

Clinical value of liver transplantation for intrahepatic cholangiocarcinoma / 中华器官移植杂志

Objective To investigate the clinical value of liver transplantation for intrahepatic cholangiocarcinoma (ICC).Methods A retrospective analysis was performed on 68 patients with ICC who underwent hepatic resection or liver transplantation between January 2007 and September 2013.In the surgical treatment of ICC,overall survival and prognostic risk factors were analyzed to determine the clinical value of liver transplantation for ICC compared with hepatic resection.Results Of the patients with ICC,55 underwent hepatic resection and 13 were given liver transplantation.The 1 and 3-year survival rate was significantly higher in the liver transplantation group than in the hepatic resection group (76.9％ versus 52.7％,and 61.5％ versus 27.3％,P＜0.05).In addition,liver transplantation resulted in higher tumor recurrence-free survival rate than hepatic resection (69.2％ versus 41.8％,and 61.5％ versus 20.0％,P＜0.05).The multivariate analysis showed that tumor size larger than 5 cm was an independent risk factor and HBV infection was an independent protective factor of ICC.Conclusion The prognosis of patients who underwent liver transplantation was better than hepatic resection,suggesting that liver transplantation is perhaps a prior treatment in strictly selected and unresectable patients with ICC.

Detection of occult HBV infection and probably window period infection among single NAT reactive blood donors / 国际检验医学杂志

Objective To analyze hepatitis B virus(HBV) infection stage in single nucleic acid test(NAT)reactive blood donors.Methods Blood donor samples were screened routinely for HBV DNA by using transcription-mediated amplification(TMA) NAT and quantitative polymerase chain reaction(PCR).Then serum markers of HBV were also detected.The HBV infection stage was analyzed.Results Among the 225 single NAT reactive samples,78(34.67%) were identified to be reactive for HBV DNA by TMA NAT discrimination test and/or PCR test,of which 63(82.89%) were occult HBV infection(OBI),13(17.11%) were probably window period infection(pWP),and 2 cases could not be classified for infection stage.Among the OBI samples,49 samples(77.78%) were with HBV DNA concentration less than 20 IU/mL,whereas,there were only 4 samples(30.77%) in pWP samples.The 225 samples were classified into three groups according to the S/CO of NAT, including 1-<6 group,6-<10 group and 10-17 group, the confirmed HBV DNA positive rates of which were 13.11%,13.64% and 47.18%,and the positive rate of 10-17 group was higher than 1-<6 group and 6-<10 group(P<0.05).In all 63 OBI samples,there were 8(12.70%),3(4.76%) and 52(82.54%) samples were classified into S/CO 1-<6,6-<10 and 10-17,respectively.All of the 13 pWP samples were with NAT S/CO of 10-17.Conclusion Part of single NAT reactive blood donors could be with HBV infection,of which OBI might be popular than pWP, with very low concentration of HBV DNA.Deferral of single NAT reactive blood donors could reduce transfusion-transmitted HBV infection.

Role of TLR5 in infectious diseases / 中华微生物学和免疫学杂志

Toll-like receptor 5 (TLR5) is one of the pattern recognition receptors and recognizes the flagellin protein of bacteria.It activates innate immune responses and induces production of a series of cytokines.TLR5 functions as a bridge linking innate and adaptive immunities.It is known that TLR5 plays an important role in the occurrence and development of certain infectious diseases.This review summarizes the relationships of TLR5 polymorphisms with the development of infectious diseases and discusses the possible pathogenesis.

A case-control study on risk factors of hepatitis B infection in Karamay / 中华实验和临床病毒学杂志

Objective@#To investigate the main risk factors of hepatitis B virus (HBV) infection in Karamay, to provide scientific basis for hepatitis B prevention and control.@*Methods@#Hepatitis B patients treated in Karamay Central Hospital in 2014 were selected as the case group, and the HBsAg negative cases were selected as control group by case control study method according to the same hospital, gender, age and other factors. Questionnaire survey was conducted and serological markers of HBV infection were detected.@*Results@#Multivariate analysis showed that family members of patients with HBV infection, HBV infection markers detection, aesthetic treatment caused trauma history (e.g., eyebrow tattoo, Tattoo, eyeliner tattoo, piercing ears), and no hepatitis B vaccination history were the main risk factors of HBV infection in Karamay currently.@*Conclusions@#The risk factors of HBV infection in Karamay population still exist. The propaganda and education of hepatitis B prevention knowledge in the public should be improved in the future. Changing adverse lifestyle and the timely initiatiation of hepatitis B vaccination are important measures to control HBV infection.

Changes and clinical correlation of serum IL-4 level for patients with chronic hepatitis B / 国际检验医学杂志

Objective To investigate the changes and clinical correlation of IL-4 in patients with HBV infection.Methods Sixty cases with chronic asymptomatic HBV carriers,60 cases with chronic hepatitis B,60 cases with liver cirrhosis,60 cases with hepato-cellular carcinoma and 50 healthy controls were collected for serum.ELISA was used for detection of cytokine IL-4 levels;The a-mount of HBV DNA was measured by fluorescence quantitative PCR;Liver function was tested by automatic biochemical analyzer. Results Compared with the healthy controls[(1.64±0.17)ng/mL],IL-4 levels of patients with CHB,LC and HCC were signifi-cantly increased[(4.18±0.48),(4.71±0.42),(3.62±0.31)ng/mL,P <0.05].LC group have the highest IL-4 levels,while ASC was the lowest.Compared with the ASC group,IL-4 levels of patients with CHB,LC and HCC were significantly increased(P <0.05).Compared with the HCC group,IL-4 levels of patients with LC were significantly increased(P <0.05).IL-4 level was posi-tively correlated with TBIL levels in LC patients(r=0.529,P <0.01),while the IL-4 level was positively correlated with ALT and TBIL level in HCC patients(r=0.263,0.323,P <0.05).Conclusion IL-4 may play an important role in chronic HBV infection, the levels of IL-4 can be used as an important indicator to assess the severity of chronic hepatitis B.

Occult HBV among Anti-HBc Alone: Mutation Analysis of an HBV Surface Gene and Pre-S Gene

PURPOSE: The aim of this study is to investigate the molecular characteristics of occult hepatitis B virus (HBV) infection in ‘anti-HBc alone’ subjects. MATERIALS AND METHODS: Twenty-four patients with ‘anti-HBc alone’ and 20 control patients diagnosed with HBV were analyzed regarding S and pre-S gene mutations. All specimens were analyzed for HBs Ag, anti-HBc, and anti-HBs. For specimens with an anti-HBc alone, quantitative analysis of HBV DNA, as well as sequencing and mutation analysis of S and pre-S genes, were performed. RESULTS: A total 24 were analyzed for the S gene, and 14 were analyzed for the pre-S gene through sequencing. A total of 20 control patients were analyzed for S and pre-S gene simultaneously. Nineteen point mutations of the major hydrophilic region were found in six of 24 patients. Among them, three mutations, S114T, P127S/T, M133T, were detected in common. Only one mutation was found in five subjects of the control group; this mutation was not found in the occult HBV infection group, however. Pre-S mutations were detected in 10 patients, and mutations of site aa58–aa100 were detected in 9 patients. A mutation on D114E was simultaneously detected. Although five mutations from the control group were found at the same location (aa58–aa100), no mutations of occult HBV infection were detected. CONCLUSION: The prevalence of occult HBV infection is not low among ‘anti-HBc alone’ subjects. Variable mutations in the S gene and pre-S gene were associated with the occurrence of occult HBV infection. Further larger scale studies are required to determine the significance of newly detected mutations.

Comparison of CRP,PCT and IL-6 in patients with two types of ends of HBV infection / 国际检验医学杂志

Objective We investigate the possible effect of inflammative indicator C reactive protein(CRP) ,interleukin‐6(IL‐6) and procalcitonin(PCT) on the outcome of HBV infection .Methods The clinical data and peripheral serum of 48 patients with HBV related hepatocellular carcinoma and 48 patients with decompensated cirrhosis were collected ,HBV copy numbers ,PCT ,IL‐6 , CRP ,ALT ,AST ,prothrombin time(PT ) and other indicators were tested for comparison and correlative analysis .Results HBV copy numbers ,PCT ,CRP ,lymphocytes and mononuclear cells showed no significant difference between primary hepatocellular car‐cinoma and decompensated cirrhosis group;however ,IL‐6 level was significantly higher in decompensated liver cirrhosis than in hep‐atocellular carcinoma ,as opposed to the absolute number of neutrophils .Conclusion IL‐6 increase may be related to final outcome of HBV infection ,dynamic monitoring IL‐6 is helpful to evaluate the prognosis of HBV infection .

Influence factors analysis of acute-on-chronic liver failure effects of chronic hepatitis B virus infection / 中国综合临床

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.