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1.
Arch. argent. pediatr ; 122(3): e202310130, jun. 2024. tab, graf
Article in English, Spanish | LILACS, BINACIS | ID: biblio-1554608

ABSTRACT

Introducción. Durante 2020 y 2021, la circulación de los virus influenza se mantuvo por debajo de lo esperado en todo el mundo. En Argentina, en el año 2022 observamos una circulación ininterrumpida de influenza todo el año. Nuestros objetivos fueron describir los patrones de circulación y las características clínicas de niños internados con influenza. Población y métodos. Estudio retrospectivo, analítico, observacional. Se incluyeron todos los niños internados en un centro pediátrico con detección del virus influenza durante los años 2019-2022. Resultados. Se internaron 138 pacientes en 4 años; en 2019 se observó una tasa del 4,5/1000 egresos hospitalarios mientras que en 2022, fue del 15,1/1000. En 2020 y 2021 no hubo casos. En el 2019 la mayoría de los casos ocurrieron en invierno, la causa de la internación fue la infección respiratoria aguda baja (IRAB) en el 79 % y se detectó influenza A en el 92 % de los casos. En el 2022, la mayoría de los casos ocurrieron en primavera, el 62 % presentó IRAB y en el 56 % se detectó influenza A. Ambos períodos tuvieron similares frecuencias de vacunación y de comorbilidades. Conclusiones. En el 2022 se registraron más internaciones por influenza, lo que podría corresponder a que se realizaron métodos diagnósticos moleculares, que son más sensibles, y se observó un cambio en la estacionalidad con más casos en primavera. En 2019 predominó influenza A en infecciones del tracto respiratorio inferior, mientras que en el 2022 influenza A y B fueron similares, y hubo más formas extrapulmonares.


Introduction. During 2020 and 2021, the circulation of influenza virus remained below expectations worldwide. In Argentina, in 2022, we observed an uninterrupted circulation of influenza all year round. Our objectives were to describe the circulation patterns and clinical characteristics of hospitalized children with influenza. Population and methods. Retrospective, analytical, observational study. All children with influenza virus admitted to a children's hospital during the 2019­2022 period were included. Results. A total of 138 patients were admitted over 4 years; in 2019, the rate of hospital discharges was 4.5/1000, compared to 15.1/1000 in 2022. No cases were recorded in 2020 and 2021. In 2019, most cases were observed in the winter; in 79%, the cause was acute lower respiratory tract infection (ALRTI); influenza A was detected in 92%. In 2022, most cases occurred in the spring; 62% developed ALRTI; and influenza A was detected in 56%. Similar rates of vaccination and comorbidities were observed in both periods. Conclusions. In 2022, more hospitalizations due to influenza were recorded, which may have correlated with the use of more sensitive molecular diagnostic testing and a change in seasonality, with more cases observed in the spring. In 2019, influenza A predominated in lower respiratory tract infections, while in 2022, cases of influenza A and B were similar, with more extra-pulmonary forms.


Subject(s)
Humans , Child, Preschool , Child , Respiratory Tract Infections/epidemiology , Influenza, Human/diagnosis , Influenza, Human/epidemiology , COVID-19/diagnosis , COVID-19/epidemiology , Argentina/epidemiology , Retrospective Studies , Pandemics , Hospitalization , Hospitals
2.
Bol. latinoam. Caribe plantas med. aromát ; 23(1): 152-159, ene. 2024. graf
Article in English | LILACS | ID: biblio-1554187

ABSTRACT

Medicinal plants are used to cure diseases, and their replacement is frequent and affects public health. The genus Baccharis has representatives within the medicinal flora of Argentina, although the replacement of the species of this genus known under the vulgar name of "carqueja" by Baccharis spicata has been detected i n herbalists or markets of herbal products. The genotoxic safety of this species has been established in previous work of our group. The aim of this study was to evaluate the antiviral activity of an infusion made from B. spicata leaves against hepatitis B virus with the HepG2.2.15 cellular system and to determine cytotoxicity in HepG2.2,15, A549 and Vero cell lines. Infusion of B. spicata was active to inhibit HBV replication with an EC 50 of 22.54 µg/mL and a CC 50 of 190 µg/mL.


Las plantas medicinales son empleadas para la cura de enfermedades, y su sustituc ión es frecuente y afecta a la salud pública. El género Baccharis posee representantes dentro de la flora medicinal de Argentina, aunque se ha detectado la sustitución de las especies de dicho género conocidas bajo el nombre vulgar de "carqueja" por Baccha ris spicata en herboristerías o mercados de productos herb arios . Se ha establecido la seguridad genotóxica de esta especie en trabajos previos de nuestro grupo. Este estudio buscó evaluar la actividad antiviral de una infusión elaborada a partir de hojas de B. spicata frente al virus de la hepatitis B con el sistema celular HepG2.2.15 y determinar la citotoxicidad en las líneas celulares HepG2.2.15, A549 y Vero. La infusión de B. spicata fue activa para inhibir la replicación del virus con un EC 50 de 22.54 µg/mL y un CC 50 de 190 µg/mL.


Subject(s)
Antiviral Agents/administration & dosage , Plant Extracts/administration & dosage , Baccharis/chemistry , Hepatitis B/drug therapy , Antiviral Agents/pharmacology , Virus Replication/drug effects , Plant Extracts/pharmacology , Cell Line/drug effects , Hepatitis B virus/drug effects , Plant Leaves , Asteraceae , Medicine, Traditional
3.
Organ Transplantation ; (6): 435-442, 2024.
Article in Chinese | WPRIM | ID: wpr-1016909

ABSTRACT

<b>Objective</b> To investigate the long-term safety and effectiveness of withdrawal of hepatitis B immuneglobulin (HBIG) and/or nucleos(t)ide analogues (NAs) to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with hepatitis B-related diseases after successful vaccination. <b>Methods</b> Baseline data of 76 liver transplant recipients undergoing hepatitis B immune reconstitution after receiving hepatitis B vaccines were retrospectively analyzed. The vaccination and response, the follow-up results of respondents with HBIG and/or NAs withdrawal, and the reinfection of HBV after withdrawal of HBIG and/or NAs were analyzed. <b>Results</b> The time interval from liver transplantation to hepatitis B vaccination was 26 (20, 40) months. The time interval from vaccination to response was 15 (8,27) months. Initially, 76 recipients withdrew HBIG, and 36 recipients withdrew HBIG and NAs. During the follow-up, 12 of 76 recipients who withdrew HBIG resumed use of HBIG, and 16 of 36 recipients who withdrew HBIG and NAs resumed use of NAs. The withdrawal time of HBIG and NAs was 135 (98,150) and 133 (34,149) months, respectively. Sixteen respondents did not receive booster, and 36 respondents received boosters on a regular basis. The time interval between the first booster and HBIG withdrawal was 44 (11,87) months. No significant differences were observed in baseline data between the respondents with and without boosters (all <i>P</i>>0.05). During the follow-up, 9 recipients were lost to follow-up, 5 were re-infected with HBV, 3 died, and 1 recipient developed graft loss and underwent secondary liver transplantation. Among 5 recipients re-infected with HBV, 4 cases had virus mutation. Significant differences were found between re-infected and uninfected patients regarding withdrawal of NAs and hepatitis B e antigen (HBeAg) positive before transplantation (both <i>P</i><0.05). <b>Conclusions</b> Long-term withdrawal of HBIG is feasible and safe for recipients with successful hepatitis B immune reconstitution after liver transplantation for hepatitis B-related diseases. Nevertheless, whether antiviral drugs can be simultaneously withdrawn remains to be validated.

4.
Article in Chinese | WPRIM | ID: wpr-1017008

ABSTRACT

Objective To analyze the application value of alpha-fetoprotein (AFP) and interleukin-6 (IL-6) in prognosis prediction of hepatitis B virus (HBV) associated liver failure. Methods A total of 135 patients with HBV-related liver failure who underwent treatment at the Infection Department of the Second People's Hospital of Yibin City from July 2020 to June 2022 were selected as the study subjects (observation group). Additionally, 100 patients who underwent physical examination in the hospital during the same period with normal indicators were selected as the control group. Serum levels of AFP and IL-6 were compared between the two groups. Factors influencing the prognosis of HBV-related liver failure were analyzed. Multiple logistic regression was used to analyze the risk factors affecting the prognosis of HBV-related liver failure patients. Results The levels of serum AFP and IL-6 in the control group were lower than those in the control group, and the difference was statistically significant (P10.0 pg/mL were risk factors affecting the prognosis of HBV-related liver failure. Conclusion Serum AFP and IL-6 can predict the prognosis of patients with HBV-related liver failure, which is worthy of clinical study.

5.
Chongqing Medicine ; (36): 644-650, 2024.
Article in Chinese | WPRIM | ID: wpr-1017512

ABSTRACT

Viral hepatitis is a common infectious disease caused by a variety of hepatitis viruses,mainly including types A,B,C,D and E,among which hepatitis B virus(HBV)and hepatitis C virus(HCV)infection are more common.It is one of the important causes of liver cirrhosis and hepatocellular carcinoma.In the case of pregnancy,the interaction between pregnancy and viral infection must be considered,including the impact of the virus on fetal development,the impact on maternal health,and the progression of the disease itself caused by pregnancy,among which the prevention of mother-to-child transmission is the key to reducing the global burden of chronic viral hepatitis.In September 2023,the American College of Obstetricians and Gynecologists(ACOG)published the clinical practice guidelines for viral hepatitis in pregnancy,which replaced the 2007 version.According to the Grading of Recommendations Assessment,Development and Evaluation(GRADE),the guidelines put forward six suggestions.This paper interpreted the important recommended updates of the guidelines one by one,in order to provide help for the clinical practice of viral hepatitis during pregnancy.

6.
Article in Chinese | WPRIM | ID: wpr-1017788

ABSTRACT

Objective To study the effect of NAD(P)H:quinone oxidoreductase 1(NQO1)expression lev-el on prognosis in patients with hepatitis B virus-related hepatocellular carcinoma(HBV-HCC).Methods A total of 103 patients with HBV-HCC underwent surgical treatment in Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from March 2019 to January 2020 were enrolled.The cancer tissue and adjacent normal tissues were extracted during surgery.Immunohistochemical staining was used to detect the expression of NQO1 in tissues.The clinical and pathological data of patients were collected,and the rela-tionships between high and low expression of NQO1 and pathological characteristics were discussed.A 3-year follow-up was conducted,and the Kaplan-Meier survival curve was drawn and Log-rank test was conducted on median survival time.Then COX model analysis was used to analyze the factors affecting the prognosis of HBV-HCC patients.Results The positive rate of NQO1 in HBV-HCC tissues was 84.47%(87/103)and the high expression rate was 59.22%(61/103).The positive rate and the high expression rate of NQO1 in HBV-HCC tissues were higher than those in adjacent normal tissues(P<0.05).There were statistically significant differences in tumor maximum diameter,number of lesions,American Joint Committee on Cancer(AJCC)staging,and vascular invasion between patients with high and low expression of NQO1(P<0.05).The 3-year follow-up results denoted that the median survival time of patients was 37 months,and no cases were lost in follow-up.Among 103 patients,there were 34 dead cases with an overall survival rate of 66.99%(69/103)and 42 recurrence cases with a recurrence-free survival rate of 59.23%(61/103).Kaplan-Meier survival curve re-sults showed that the overall survival rate and recurrence-free survival rate were 52.46%(32/61)and 50.82%(31/61)in NQO1 high expression group,which were lower than 88.10%(37/42)and 71.43%(30/42)in NQO1 low expression group(P<0.05).COX model analysis results showed that high expression of NQO1,tumor maximum diameter ≥5 cm,multiple lesions,AJCC stage Ⅲ to Ⅳ and vascular invasion were independ-ent risk factors for prognosis(P<0.05).Conclusion NQO1 is highly expressed in HBV-HCC tissue,and is related to the clinicopathological characteristics of patients,so it could be used as an independent biomarker for evaluating prognosis.

7.
Article in Chinese | WPRIM | ID: wpr-1030574

ABSTRACT

ObjectiveTo analyze the etiological results of influenza-like case surveillance in Taizhou, Zhejiang Province from 2013 to 2022, to timely understand the epidemic trend of influenza viruses and the change rule of dominant virus strains, and to provide reference for the prevention and control of influenza in this region. MethodsInfluenza virus nucleic acid was detected by real-time PCR in 24 183 influenza-like cases. ResultsThe positive rate of influenza virus in 24 183 samples was 18.43%, the highest positive type was seasonal H3 (37.34%). There was no a significant difference in positive rate between different genders (χ2=0.148, P=0.701). There was significant difference in the positive rate among different age groups (χ2=496.626, P<0.001), and the highest positive rate was found in the 25‒59 age group (22.56%). The positive rate in different years was statistically significant (χ2=1 670.922, P<0.001). The positive rate from 2013 to 2019 showed an upward trend (χ2=30.559, P<0.001). The lowest positive rate was in 2020 (0.04%), and the positive rate from 2021 to 2022 showed an upward trend (χ2=304.465, P<0.001). The dominant strains were different in different monitoring years. There was a significant difference in the positive rate of influenza in different months (χ2=1 652.455, P<0.001), and the peak of influenza was mainly concentrated in December‒March and July‒August. ConclusionFrom 2013 to 2022, the positive rate of influenza virus in Taizhou showed a wavy dynamic change, and the dominant strains were different in different years, presenting alternate epidemic characteristics. It is necessary to strengthen the etiological surveillance of influenza virus and improve the prevention and control measures with influenza vaccine.

8.
Journal of Clinical Hepatology ; (12): 866-869, 2024.
Article in Chinese | WPRIM | ID: wpr-1030776

ABSTRACT

Guidelines for the prevention and treatment of chronic hepatitis B (2022 edition) expanded the indications for antiviral therapy in patients with chronic hepatitis B. The guidelines recommend to initiate antiviral therapy for patients with chronic HBV infection who have a normal alanine aminotransferase (ALT) level, positive HBV DNA, and an age of >30 years. However, for pregnant women aged >30 years, no consensus has been reached on whether to start antiviral therapy immediately. Some experts believe that pregnant women with a normal ALT level are mostly in the immune-tolerant phase, and antiviral therapy tends to have an unsatisfactory therapeutic effect; in addition, medication during pregnancy may affect the safety of mothers and fetuses. Therefore, it is not recommended to start antiviral therapy immediately in early pregnancy even if the pregnant women are aged >30 years. Other experts believe that immune changes of the body during pregnancy may be a special period for HBV immune clearance, and if the patients are aged >30 years, antiviral therapy should be initiated immediately even if the patient has a normal ALT level; pregnant women may get better virologic and even serological response. With a focus on the above issues, this article elaborates on the purpose, treatment timing, and drug withdrawal timing of antiviral therapy during pregnancy.

9.
Journal of Clinical Hepatology ; (12): 870-874, 2024.
Article in Chinese | WPRIM | ID: wpr-1030777

ABSTRACT

Chronic hepatitis B (CHB) is a major public health issue around the world, and there are currently about 2 million children with hepatitis B virus (HBV) infection in China. HBV infection in children tends to become chronic, leading to high risks of liver cirrhosis and liver cancer in adulthood. Traditionally, it is believed that children with HBV infection are mainly in the immune-tolerant phase and do not require antiviral therapy, and antiviral therapy is only initiated for CHB children who are in the immune-active phase or suffer from compensated or decompensated liver cirrhosis. More and more clinical studies on CHB in children have shown that CHB children tend to have a high response rate to antiviral therapy, especially interferon-based regimens, and young children are at the advantage of clinical cure; however, there are still controversies over whether antiviral therapy should be initiated for children with HBV infection who have a normal alanine aminotransferase (ALT) level and are in the immune-tolerant phase. This article reviews the features of children with HBV infection and the necessity of antiviral therapy for children with a normal ALT level, with a special focus on treatment timing.

10.
Journal of Clinical Hepatology ; (12): 875-879, 2024.
Article in Chinese | WPRIM | ID: wpr-1030778

ABSTRACT

To achieve the goal of “eliminating viral hepatitis as a public health hazard by 2030”, extensive screening, active prevention, and antiviral therapy are currently recommended for chronic hepatitis B virus (HBV) infection; however, no consensus has been reached on whether to initiate antiviral therapy for patients in the immune-tolerant phase of chronic HBV infection. Some experts believe that patients in the immune-tolerant phase tend to have a stable liver immune microenvironment, with a low risk of disease progression and poor response to treatment, and thus it is not recommended to initiate antiviral therapy. However, various other studies have shown that patients in the immune-tolerant phase still have inflammatory damage in the liver, with a risk of disease progression and a high level of cost effectiveness, and therefore, some experts suggest that antiviral therapy should be actively initiated for patients in the immune-tolerant phase. This article performs a literature review of the definition of patients in the immune-tolerant phase of chronic HBV infection and the advantages and disadvantages of antiviral therapy and conducts a preliminary analysis based on previous studies, in order to accumulate the evidence for whether to initiate antiviral therapy in the immune-tolerant phase of chronic HBV infection and lay a foundation for standardized clinical diagnosis and treatment of patients in the immune-tolerant phase.

11.
Journal of Clinical Hepatology ; (12): 934-939, 2024.
Article in Chinese | WPRIM | ID: wpr-1030784

ABSTRACT

ObjectiveTo investigate the value of magnetic resonance imaging-proton density fat fraction (MRI-PDFF) in evaluating hepatic steatosis in patients with chronic hepatitis B virus (HBV) infection. MethodsThe patients, aged >16 years, who visited the outpatient service or were hospitalized in Beijing Tsinghua Changgung Hospital from January 2018 to December 2022 and were diagnosed with chronic HBV infection were enrolled, and all patients underwent MRI examination of the liver in our hospital. The patients were divided into groups based on the presence or absence of liver cirrhosis, and the consistency in PDFF between different hepatic segments was compared between groups. The Kappa consistency test and intraclass correlation coefficient (ICC) were used for consistency analysis. ResultsA total of 76 patients treated with nucleoside analogues were enrolled, among whom 23 (30.26%) had liver cirrhosis. For all patients, the simple arithmetic average of PDFF fluctuated between 1.49% and 30.93%. According to MRI-PDFF ≥5% as the diagnostic criterion for fatty liver disease, there were 29 patients (38.16%) with fatty liver disease among all patients. For all 76 patients, the simple arithmetic average of PDFF was lower than the weighted average of PDFF for the whole liver, and there was no significant difference between the simple arithmetic average of PDFF, the weighted average of PDFF, and the PDFF values of the left and right lobes of the liver (F=0.39, P=0.76). The consistency test showed that the PDFF values of each hepatic segment and the left and right lobes of the liver had strong consistency with the weighted average and simple arithmetic average of PDFF, with an ICC of >0.75, but the consistency between the PDFF value of the right lobe and the weighted average of PDFF was higher than that between the PDFF value of the left lobe and the weighted average of PDFF. In the consistency test of differentiating fatty liver disease in patients with liver cirrhosis, there was poor consistency between the PDFF value of segment Ⅶ and the weighted average of PDFF (Kappa=0.39), with moderate consistency for the left lobe and the Ⅰ, Ⅱ, Ⅲ, Ⅴ, Ⅵ, and Ⅷ segments. For the patients with liver cirrhosis, the lowest consistency was observed between the PDFF value of Ⅶ segment and the weighted average of PDFF for the whole liver, and the highest consistency was observed between the PDFF value of Ⅵ segment and the weighted average of PDFF for the whole liver. For the patients without liver cirrhosis, the lowest consistency was observed between the PDFF value of Ⅱ segment and the weighted average of PDFF for the whole liver, and the highest consistency was observed between the PDFF value of Ⅴ segment and the weighted average of PDFF for the whole liver. ConclusionMRI-PDFF is more comprehensive in evaluating hepatic steatosis in patients with chronic HBV infection, and for the patients with liver cirrhosis, there is poor consistency between the PDFF value of each segment and the weighted average of PDFF.

12.
Journal of Clinical Hepatology ; (12): 940-945, 2024.
Article in Chinese | WPRIM | ID: wpr-1030785

ABSTRACT

ObjectiveTo investigate the liver histopathological features of chronic hepatitis B (CHB) patients with normal alanine aminotransferase (ALT) and their correlation with serological markers. MethodsClinical data were collected from 137 patients with normal ALT who were treated in Wuxi Fifth People’s Hospital from April 2018 to June 2021, and the differences in liver histopathology and serological markers were analyzed, as well as the correlation between liver histopathology and serological markers. The chi-square test was used for comparison of categorical data between groups, and the Kruskal-Wallis H test was used for comparison of data between multiple groups. A Spearman rank correlation test was performed, and logistic regression was used to perform the multivariate analysis. ResultsIn the ALT ≤20 U/L, 20‍ ‍—‍ ‍29 U/L, and 30‍ ‍—‍ ‍40 U/L groups, the patients with significant inflammatory necrosis (≥G2) accounted for 57.4%, 53.4%, and 75%, respectively, and the patients with significant fibrosis (≥S2) accounted for 63.8%, 62.1%, and 75%, respectively. There was a significant difference in the degree of inflammatory necrosis between the patients with positive or negative HBeAg, the patients with different levels of serum HBV DNA, and the patients with different levels of serum HBV RNA (χ2=10.008, 6.911, and 7.946, all P<0.05), and there was a significant difference in fibrosis stage between the patients with positive or negative HBeAg and the patients with different levels of serum HBV RNA (χ2=7.996 and 10.874, both P<0.05). The degree of liver inflammation and fibrosis stage were not significantly correlated with serum HBV DNA (rs=0.024, P=0.785; rs=0.039, P=0.652), while they were significantly correlated with serum HBV RNA (rs=0.222, P=0.009; rs=0.187, P=0.029). The multivariate analysis showed that in CHB patients, positive HBeAg was an independent risk factor for inflammatory necrosis (odds ratio [OR]=-0.302, 95% confidence interval [CI]: -1.160 to 0.386, P=0.002) and fibrosis (OR=-0.387, 95%CI: -1.160 to 0.386, P=0.011). ConclusionThere are varying degrees of inflammatory necrosis and fibrosis in the liver of CHB patients with normal ALT, and positive HBeAg is independent risk factor for significant inflammatory necrosis and fibrosis in liver tissue of these patients.

13.
Journal of Clinical Hepatology ; (12): 1126-1129, 2024.
Article in Chinese | WPRIM | ID: wpr-1032259

ABSTRACT

ObjectiveTo investigate the correlation of serum angiopoietin-1 (Ang-1), angiopoietin-2 (Ang-2), and Ang-1/Ang-2 ratio with HBA DNA and alanine aminotransferase (ALT) in patients with chronic hepatitis B (CHB) or liver cirrhosis. MethodsClinical data and serum specimens were collected from 99 patients with CHB and 59 patients with liver cirrhosis who were admitted to Beijing YouAn Hospital, Capital Medical University, from March 2018 to October 2019, and 46 individuals who underwent physical examination were enrolled as control group. PCR was used to measure serum HBV DNA level, and ELISA was used to measure the serum levels of Ang-1 and Ang-2. The serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio were compared between groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups, and the Bonferroni method was used for further comparison between two groups; the Spearman correlation analysis was used to investigate the correlation of Ang-1, Ang-2, and Ang-1/Ang-2 ratio with HBV DNA and ALT. ResultsCompared with the control group, the CHB group and the liver cirrhosis group had a significant reduction in the level of Ang-1 (479.0 pg/mL and 208.4 pg/mL vs 671.0 pg/mL, both P<0.05), and compared with the CHB group, the liver cirrhosis group had a significant reduction in the level of Ang-1 (P<0.001). Compared with the control group, the CHB group and the liver cirrhosis group had a significant increase in the level of Ang-2 (286.1 pg/mL and 438.4 pg/mL vs 198.0 pg/mL, both P<0.001), and compared with the CHB group, the liver cirrhosis group had a significant increase in the level of Ang-2 (P<0.001). Compared with the control group, the CHB group and the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio (1.6 and 0.5 vs 3.4, both P<0.001), and compared with the CHB group, the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio (P<0.001). The Spearman correlation analysis showed that in the CHB group, Ang-1 was negatively correlated with HBV DNA and ALT (r=-0.400 and -0.394, both P˂0.001), Ang-2 was positively correlated with HBV DNA and ALT (r=0.365 and 0.351, both P<0.001), and Ang-1/Ang-2 ratio was negatively correlated with HBV DNA and ALT (r=-0.463 and -0.473, both P<0.001); in the liver cirrhosis group, Ang-1, Ang-2, and Ang-1/Ang-2 ratio had no correlation with HBV DNA or ALT (all P>0.05). ConclusionThere are significant changes in the serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio in patients with CHB or liver cirrhosis, and Ang-1, Ang-2, and Ang-1/Ang-2 ratio reflects the degree of liver injury in patients with CHB to a certain extent.

14.
Article in Chinese | WPRIM | ID: wpr-1032313

ABSTRACT

ObjectiveTo explore the importance of post-vaccination serological testing (PVST) for children exposed to hepatitis B virus (HBV), and analyze the factors affecting the progress of PVST. MethodsThe study focused on hepatitis B surface antigen (HBsAg)-positive pregnant women and their newborns residing in Tongzhou District, Beijing, who delivered at various obstetric institutions from January 1, 2020 to March 31, 2022. The obstetric institutions and community health service centers conducted follow-up visits 1 to 2 months after the children had received three doses of the hepatitis B vaccine (HepB). ResultsThe vaccination rate of hepatitis B immunoglobulin (HBIg) was 100.00% (800/800), with a successful PVST follow-up rate of 85.88% (687/800) in Tongzhou District. The initial non-response rate to immunization was 0.29% (2/687), but successful immunization was achieved after re-immunization. The mother-to-infant transmission rate of hepatitis B was 0. Children who did not undergo PVST accounted for 14.13% (113/800), with the main reasons being delays due to the COVID-19 pandemic, parents’ reluctance to allow venous blood collection due to the young age of the children, and loss to follow-up because children moved back to their parents’ place of origin. Logistic regression analysis showed that the proportion of PVST was higher among high-risk children (OR=30.009,P=0.001), children with family residing in Beijing (OR=2.218,P=0.002), and children whose mothers were <35 years old (OR=1.687,P=0.020). ConclusionPVST is necessary for assessing the status of HBV immune response in newborns after vaccination with HepB. The COVID-19 pandemic impacted the implementation of PVST for children exposed to HBV. Strengthening the management of non-high-risk children, those living outside Beijing, and children with mothers aged ≥ 35 years old may increase the rate of PVST in Tongzhou District.

15.
Journal of Clinical Hepatology ; (12): 441-445, 2024.
Article in Chinese | WPRIM | ID: wpr-1013118

ABSTRACT

Chronic hepatitis B virus (HBV) infection is the main cause of the disease burden of viral hepatitis worldwide, and meanwhile, due to changes in lifestyle and dietary habits, the incidence rate of metabolic associated fatty liver disease (MAFLD) is constantly increasing, making MAFLD the leading chronic liver disease around the world. Chronic HBV infection comorbid with MAFLD is becoming more and more common in clinical practice. Metabolic factors, rather than viral factors, are the main cause of chronic HBV infection comorbid with MAFLD. During disease progression, steatohepatitis and fibrosis, rather than steatosis, are the main influencing factors for the progression to liver cirrhosis and hepatocellular carcinoma. For patients with chronic HBV infection and MAFLD, integrated management of virus and metabolic factors is of great importance. This article reviews the tissues regarding the interaction, prognosis, and clinical management of chronic HBV infection and MAFLD.

16.
Journal of Clinical Hepatology ; (12): 446-452, 2024.
Article in Chinese | WPRIM | ID: wpr-1013119

ABSTRACT

Hepatitis B virus (HBV) is considered a “metabolic virus” that can influence a variety of metabolic processes. There is still a lack of definite conclusion on the association between chronic HBV infection and the various types of metabolic dysfunction, and little is known about the mechanism of the association of chronic HBV infection with the diseases characterized by metabolic disorder, such as metabolic syndrome, diabetes, and metabolic associated fatty liver disease. Currently it is believed that hepatitis B x gene (HBx), derived from HBV genome, might play an important role in mediating systemic metabolic alterations after HBV infection, and HBx influences the metabolism of carbohydrates and lipids and causes metabolic dysfunction by retgulating the expression profiles of the key proteins such as PPARγ, C/EBPα, SREBP, and FATP2. Nonalcoholic fatty liver disease (NAFLD) is the most severe manifestation of metabolic dysfunction in the liver, and since both NAFLD and HBV infection can cause liver injury, the research on the interaction between them has attracted more and more attention, with controversies requiring further exploration. Therefore, this article elaborates on the research advances in chronic HBV infection and metabolic dysfunction, so as to provide ideas for subsequent studies.

17.
Journal of Clinical Hepatology ; (12): 453-456, 2024.
Article in Chinese | WPRIM | ID: wpr-1013120

ABSTRACT

Chronic hepatitis B virus (HBV) infection is a worldwide public health issue and a leading cause of liver fibrosis, liver cirrhosis, liver failure, and primary liver cancer in China. The incidence rate of nonalcoholic fatty liver disease (NAFLD) is gradually increasing with the improvement in the living standards of people and the changes in dietary structure. Population-based studies have found that HBV infection can influence the development of NAFLD, but the mechanism remains unknown. Hepatic steatosis can also influence the expression of HBV serum pathogenic indicators, and its combination with NAFLD and other metabolic dysfunction diseases can increase the risk of liver fibrosis, liver cirrhosis, and liver cancer. Chronic HBV infection is closely associated with metabolic dysfunction, and more studies are needed in the future to better understand related mechanisms, so as to provide a theoretical foundation for clinical diagnosis and treatment.

18.
Journal of Clinical Hepatology ; (12): 457-460, 2024.
Article in Chinese | WPRIM | ID: wpr-1013121

ABSTRACT

With the rapid growth of metabolic dysfunction (MD) worldwide, there is also a gradual increase in the number of patients with chronic hepatitis B virus (HBV) infection and MD. Comorbidity with metabolic disorders such as hyperglycemia, hypertension, and dyslipidemia may increase the risk of adverse liver outcomes and cardiovascular events in patients with chronic HBV infection and affect the response to anti-HBV therapy. The standardized management of patients with chronic HBV infection and MD has become a challenge at present, and further in-depth research on the interaction between MD and HBV and targeted management strategies will help to optimize the clinical management of patients with chronic HBV infection.

19.
China Pharmacy ; (12): 866-871, 2024.
Article in Chinese | WPRIM | ID: wpr-1013551

ABSTRACT

Tenofovir disoproxil fumarate (TDF) is a first-line treatment for chronic hepatitis B. With increasing use worldwide, the adverse events of renal injury caused by this drug have also attracted industry attention. This article reports a 61- year-old patient with liver cancer complicated with hepatitis B virus (HBV) infection. The patient started using TDF in mid-March 2022 and developed kidney injury after 2 months of treatment, during which he received 2 courses of donafenib combined with sintilimab chemotherapy and irregular administration of diclofenac for pain relief. In this paper, Naranjo’s assessment scale was used to evaluate the drugs that may be associated with renal injury, including TDF and sintilimab, and the drugs that are suspected to be associated with renal injury are donafenib and diclofenac. The renal injury caused by TDF can be judged according to the changes in the patient’s condition, the incidence of drug-induced renal injury, clinical manifestations, occurrence time, occurrence mechanism, drug combination, and high-risk factors. The changes of serum creatinine in patients with liver cancer complicated with HBV infection after TDF should be dynamically monitored in the clinic, and the dose of antiviral drugs should be adjusted if necessary and other antiviral drugs with less impact on renal function can be selected, to provide individualized medication recommendations for tumor patients, reduce the incidence of TDF-related renal injury.

20.
Journal of Clinical Hepatology ; (12): 797-803, 2024.
Article in Chinese | WPRIM | ID: wpr-1016527

ABSTRACT

Intrahepatic cholangiocarcinoma (ICC) is a type of primary liver cancer that accounts for about 10%‍ — ‍15% of the total cases, and its incidence and mortality rates tend to increase significantly around the world, especially in Asian countries. At present, radical liver resection is the only possible cure for ICC, but with a fairly high postoperative recurrence rate and a poorer prognosis than hepatocellular carcinoma. Therefore, it is urgently needed to further investigate the mechanisms of the development and progression of ICC and search for more effective treatment methods. Some epidemiological data suggest that chronic hepatitis B virus infection is one of the most important predisposing factors for ICC, yet little is known about its oncogenic effects. This article summarizes the epidemiological evidence that links the two diseases and briefly elaborates on the mechanisms of the development and progression of HBV-associated ICC, so as to help to gain a better understanding of the role of HBV in the development and progression of ICC.

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