Blastocystis incidence, spontaneous clearance, persistence and risk factors in a rural community in Thailand: A prospective cohort study

Objective: To investigate the incidence, spontaneous clearance, persistence and risk factors of Blastocystis infection in a rural community in Thailand. Methods: In February 2016, a cohort study was conducted in a rural community of Thailand. Baseline information of intestinal parasitic infections and follow-up visits were conducted. Blastocystis infection was detected in stool samples examined with short-term in vitro cultivation using Jones' medium supplemented with 10% horse serum. Participants were tested for Blastocystis infection at every study visit. Cox proportional hazard regression analysis was used to evaluate co-variates to determine the incidence of Blastocystis infection. Results: Of 733 enrolled participants, 57 (7.78%) were positive and 676 (92.22%) were negative for Blastocystis infection. All 676 participants were followed-up for Blastocystis infection between December 2016 and January 2018. In all, 52 of 482 cases (10.79%) comprised individual Blastocystis infection. The incidence density rates of Blastocystis infection, of spontaneous clearance of the disease and of persistent infection were 8.13, 63.14 and 38.70 per 1 000 person-months of follow-up, respectively. Our multivariate analysis revealed that opened defecation in fields or bushes (HR=4.8; 95% CI =2.1-10.4, P <0.001), raising cows (HR=2.8; 95% CI =1.1-7.1, P =0.032), not washing hands after animal contact (HR=2.1; 95% CI =1.0-4.2, P =0.044) and presenting symptoms of nausea or vomiting (HR=2.3; 95% C/=1.0-5.3, P =0.047) were predictive associated risks for the incidence of Blastocystis infection. Conclusions: Our study indicates that the best way to prevent Blastocystis infection can be by maintaining good personal hygiene, hand washing after animal contact and improving sanitary facilities.

Blastocystis incidence, spontaneous clearance, persistence and risk factors in a rural community in Thailand: A prospective cohort study

Objective: To investigate the incidence, spontaneous clearance, persistence and risk factors of Blastocystis infection in a rural community in Thailand. Methods: In February 2016, a cohort study was conducted in a rural community of Thailand. Baseline information of intestinal parasitic infections and follow-up visits were conducted. Blastocystis infection was detected in stool samples examined with short-term in vitro cultivation using Jones' medium supplemented with 10% horse serum. Participants were tested for Blastocystis infection at every study visit. Cox proportional hazard regression analysis was used to evaluate co-variates to determine the incidence of Blastocystis infection. Results: Of 733 enrolled participants, 57 (7.78%) were positive and 676 (92.22%) were negative for Blastocystis infection. All 676 participants were followed-up for Blastocystis infection between December 2016 and January 2018. In all, 52 of 482 cases (10.79%) comprised individual Blastocystis infection. The incidence density rates of Blastocystis infection, of spontaneous clearance of the disease and of persistent infection were 8.13, 63.14 and 38.70 per 1 000 person-months of follow-up, respectively. Our multivariate analysis revealed that opened defecation in fields or bushes (HR=4.8; 95% CI =2.1-10.4, P <0.001), raising cows (HR=2.8; 95% CI =1.1-7.1, P =0.032), not washing hands after animal contact (HR=2.1; 95% CI =1.0-4.2, P =0.044) and presenting symptoms of nausea or vomiting (HR=2.3; 95% C/=1.0-5.3, P =0.047) were predictive associated risks for the incidence of Blastocystis infection. Conclusions: Our study indicates that the best way to prevent Blastocystis infection can be by maintaining good personal hygiene, hand washing after animal contact and improving sanitary facilities.

Relationship between interleukin-28B single nucleotide polymorphism and spontaneous clearance and antiviral efficacy of hepatitis C virus infection in Huzhou area of Zhejiang Province / 中华传染病杂志

Objective To analyze the effect of single nucleotide polymorphism ( SNP) rs8099917 of interleukin-28B ( IL-28B) on spontaneous virus clearance and the efficacy of antiviral therapy in hepatitis C virus (HCV) infected patients in Huzhou area of Zhejiang Province.Methods A total of 268 HCV-infected patients were enrolled.The high sensitive HCV RNA quantification , HCV genotype and the IL-28B rs8099917 SNP were detected at baseline.One hundred and sixty-three patients received pegylated interferon α-2a ( Peg-IFNα-2a) and ribavirin (RBV) combined antiviral therapy (referred as PR treatment) for 48 weeks, who were followed up for 24 weeks.The remaining 44 patients were treated with sofosbuvir and daclatasvir for 12 weeks. The virological response of patients with different IL-28B rs8099917 genotypes was monitored.The count data was compared by χ2 test.Results The distributions of IL-28B rs8099917 SNP were 84.33%for TT genotype and 15.67%for GT genotype, while the GG genotype was not detected.Of the 135 patients with acute HCV infection, 61 cases had spontaneous viral clearance , 74 cases were converted to chronic infection.The spontaneous clearance rates were 47.11% for TT genotype and 28.57% for GT genotype.There was no significant difference of the spontaneous clearance rate between TT and GT genotype (χ2 ＝1.072, P＝0.30). In 163 chronic hepatitis C (CHC) patients with PR treatment, the rate of sustained virological response (SVR) after 24 weeks follow-up was 86.50%(141 cases).SVR rate in patients with TT genotype was significantly higher than those with GT genotype (91.67%vs 47.36%, χ2 ＝28.212, P＜0.05).There was no statistically significant difference of the SVR rates between genotype 1b and 2a (χ2 ＝1.525, P＞0.05).In 44 patients received sofosbuvir and daclatasvir treatment , both SVR rates of TT genotype and GT genotype were 100%. Conclusions In Huzhou area of Zhejiang Province , there is no significant correlation between IL-28B rs8099917 genotype and spontaneous clearance in patients with acute HCV infection , but the genotype of IL-28B rs8099917 is valuable for the prediction of PR treatment efficacy , the SVR rate of the TT genotype is superior to the GT genotype.The SVR rate can reach 100% in patients received combination therapy of sofosbuvir and daclatasvir independent of polymorphism of IL-28B.

Analysis of the related factors of spontaneous clearance of hepatitis B virus DNA in patients with chronic hepatitis B virus infection / 中华传染病杂志

Objective To observe the incidence of spontaneous clearance of hepatitis B virus (HBV) DNA in chronic hepatitis B (CHB) patients ,and to investigate the related factors of the spontaneous clearance of HBV DNA and to determine the time to start antiviral therapy .Methods Patients who met the inclusion criteria were recruited from the follow-up cohort of chronic HBV infection from January 2008 to August 2017 for observation .The liver function including alanine aminotransferase (ALT) levels ,HBV DNA load and serum markers of HBV were measured at baseline ,month 1 ,month 3 and month 6 of follow-up . Evaluation index included cumulative HBV DNA negative conversion rate and cumulative HBeAg negative conversion rate .Multivariable analysis was used to analyze the factors associated with the spontaneous clearance of HBV DNA .Results A total of 116 patients were recruited in this study .All the patients showed ALT level elevation at baseline .Without antiviral treatment ,the cumulative HBV DNA negative conversion rate was 12 .9％ after 6-month observation .HBeAg negative conversion rate was 22 .5％ .Multivariable analysis showed that patients without a family history of HBV infection ,baseline ALT level >3 times the upper limit of normal (ULN) and HBV DNA level <6 lg copies/mL had higher cumulative HBV DNA spontaneous clearance rate .HBV DNA negative conversion rate in patients whomet all the above three conditions was up to 75％ .Conclusions In CHB patients and ALT level elevation for the first time , some patients could achieve spontaneous clearance of HBV DNA without antiviral therapy .Patients without a family history of HBV infection ,baseline ALT level >3 ULN and HBV DNA level <6 lg copies/mL have higher rate of cumulative HBV DNA spontaneous clearance .

Function of the IL28B gene in Hepatitis B virus infection / 生物工程学报

Hepatitis B virus (HBV) that causes Hepatitis B with a high chronic rate, could lead to hepatic cirrhosis and hepatocellular carcinoma. The IL28B gene belongs to a new interferon family λ and its genetic polymorphisms are identified to be associated with treatment effect and viral clearance. The purpose of this review is to discuss the role of the IL28B gene in treatment response and viral clearance of HBV-infected individuals, and further to reveal the mechanisms. This review could provide a theoretical basis for personalized medicines of HBV patients.

Correlation of IL-28B gene polymorphism and natural outcome of hepatitis C / 中国免疫学杂志

Objective:To explore the association between interleukin(IL)-28B single nucleotide polymorphisms and natural outcome of hepatitis C virus.Methods:The IL-28B rs12979860 locus was genotyped in 266 HCV infected volunteer blood donors(107 spontaneous cleared and 159 chronic infection) and 97 healthy controls using Sanger sequencing assay.The difference in rs12979860 genotypes and allele frequencies between the six groups(107 spontaneous cleared and 159 chronic infection,266 HCV infection and 97 healthy controls,159 chronic infection and 97 healthy controls) were analyzed by statistics.Results:159 HCV chronic infection,107 spontaneous cleared and 97 healthy controls,were shown more CC genotype,accounting for 83.6%,95.3%and 86.6%,respectively, while the CT genotype accounted for 16.4%,4.7%and 13.4%respectively.No TT genotype was found.The CC/CT genotype was not significant difference between HCV infection and healthy controls,chronic infection and healthy controls(χ2=0.204,P=0.652;χ2=0.406,P=0.524),but between chronic infections and spontaneous clearance had statistically significant(χ2=8.474,P=0.004),the frequence of C allele in spontaneous cleared was higher than HCV chronic infection(χ2=7.949,P=0.005).Conclusion: The gene polymorphism of IL-28B rs12979860 is not related to HCV susceptibility,but there are differences in chronic infection and spontaneous cleared,showing the C allelic in favor of HCV spontaneous cleaed.

Relationship between interleukin 28B, equilibrative nucleoside transporters 1 gene polymorphisms and spontaneous clearance of HCV in HIV/HCV co-infectors / 中华流行病学杂志

Objective To explore the association between interleukin 28B (IL-28B),equilibrative nucleoside transporters 1 (ENT1) gene polymorphisms and spontaneous clearance of HCV in HIV/HCV co-infectors in Hunan province.Methods Genotypes of IL-28B and ENT1 (rs12980275,rs12979860,rs8099917 and rs760370) were analyzed in 107 HIV/HCV co-infectors in Hunan province and the distributions of gene polymorphisms were compared between chronic hepatitis and spontaneous clearance groups.Results The major genotypes in rs12980275,rs12979860 and rs8099917 of IL-28B were AA,CC and TT in HIV/HCV co-infectors,which accounted for 84.1％ of each.The three single nucleotide polymorphisms were highly linkage disequilibrium (r2＞0.94) and the differences of genotype distribution were statistically significant between chronic hepatitis and the spontaneous clearance groups (P＜0.05).Infectors which carrying the major genotypes were more susceptible to spontaneous clearance of HCV.Differences of the genotype distributions in rs760370 of ENT1 were not statistically significant between the two groups.Conclusion Genotypes AA,CC and TT of IL-28B were related to spontaneous clearance of HCV in HIV/HCV co-infectors.

Acute hepatitis C infection with unclear route of transmission / Infección aguda de hepatitis C sin vía clara de trasmisión

A 43-year old man acquired acute hepatitis C virus (HCV) infection with unclear route of transmission. There were no known sexual or other risk factors for HCV acquisition. Phylogenetic analysis confirmed that the case was infected with identical genotype 1b strain. After symptomatic treatment for three weeks, the HCV was spontaneously cleared and liver function recovered.

Un hombre de 43 anos adquirió la infección del virus de la hepatitis aguda tipo C (VHC) por una via de trasmisión incierta. No habia ningún factor de riesgo sexual u otro conocido para la adquisición del VHC. El análisis filogenético confirmó que el caso se infectó con una cepa 1b de genotipo idéntico. Tras del tratamiento sintomático por tres semanas, el VHC se eliminó espontáneamente y lafunción del higado fue recuperada.

Studies on the relationship between polymorphism of IL-28B rs8099917 and the outcome of HBV infection / 中华流行病学杂志

Objective To investigate the correlation between IL-28B rs8099917 polymorphism and the outcome of HBV infection.Methods Genotype ofrs8099917(T＞G) in IL-28B locus was determined by TaqMan SNP genotyping from 486 individuals which including 199 chronic HBV carriers (including 100 HBV-induced liver cirrhosis and 99 HBV-related HCC).143 people with selflimited infection and 144 healthy people served as controls.Multivariate analysis was used to assess the effect of IL-28B rs80999 1 7 SNP among all the studied groups.Results Distribution of genotype and allele of the rs8099917 locus were in accordance with Hardy-Weinberg equilibrium in different groups or with the total population.The frequencies of the rs8099917 TT,GT,GG genotypes were 89.3％,10.5％ and 0.2％,and the frequency of allele T and G accounted for 94.5％ and 5.5％,respectively.In respect of genotype or allele frequency,there was no significant differences found among the groups(P＞0.05 ).When comparing with the TT genotype,data from the multinomial logistic analysis showed that the ORs and (95％CI) of TG/GG genotypes were 1.589 (0.735-3.437),1.351 (0.550-3.316) and 1.704 (0.717-4.052),respectively.The genotype frequencies in different groups with different clinical features showed that TG/GG genotypes significantly increased the risk of r-GT Ⅱ( + ) for individuals with HBV-related HCC (X2=17.534,P=0.001 ),with OR as 14.821 (3.227-68.064).It was particularly so for males(X2=14.924,P=0.014),with OR(95％CI) as 45.000(2.772-730.571 ).Conclusion IL-28B rs8099917 SNP had no correlation with the outcome of HBV infection.