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Objective To investigate the relationship between HBV mutations in the precore (PC)/core promoter region and the liver histological changes in HBeAg negative CHB patients. Method A total of 71 HBeAg negative CHB patients with liver biopsy from April 2012 to Dec 2013 were enrolled. DNA was extracted from blood serum, then the HBV S gene and PC/core promoter region were amplified by semi-nested PCR and sequenced. The relationship between significant liver histological changes and viral factors were analyzed by Logistic regression analysis. Results The incidence of significant necroinflammation (15.8% vs. 27.3%, χ2 =1.398, P = 0.237) and significant fibrosis (71.1% vs. 84.4%, χ2= 1.926, P = 0.165) were found to be similar between patients infected with HBV genotype B and genotype C . By Logistic regression analysis including risk factors of age, sex, HBV genotype and mutations (T1753V,A1762T/G1764A,A1846T and G1896A), the A1762T/G1764A mutation in HBV associated with significant necroinflammation (OR = 4.296, P = 0.037), while factors of age, sex, genotype and other mutation were not associated with significant liver histological changes. (all P > 0.05). Conclusion Mutation in PC/core promoter region of HBV may act as a marker to evaluate the liver histological changes.
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Objective To investigate the epidemiological and clinical features of acute hepatitis E (AHE).Methods All the data of AHE patients from April 2005 to October 2011 were collected and their epidemiological features were retrospectively analyzed.Patients were divided into two groups:patients with single hepatitis E virus (HEV ) infection and patients with HEV/hepatitis B virus (HBV ) coinfection,to compare the biochemical parameters and outcomes and to find out the risk factors for AHE related liver failure.Kruskal-Wallis test,Chi square test,and Logistical regression analysis were used for statistical analysis.Results A total of 621 cases were included in the present study and most patients were elderly male and happened from February to May every year.The incidence of AHE related liver failure and mortality was 18.68% and 1 .93%,respectively.Compared to the single HEV group (n=331 ),the HEV/HBV group (n = 280 )had a longer hospital stay (46 d vs 40 d,Z = - 4.591 ,P < 0.01 ),a significantly lower prothrombin activity (55 .5 % vs 78.7%,Z =-7.998,P <0.01 )and a significantly higher incidence of AHE related liver failure (30.7% vs 9.1 %,χ2 =46.229,P <0.01 ).In single HEV related liver failure group (n=30),the percentages of early-stage,interim-stage and end-stage live failure were 53.33%,23.33% and 23.33%,respectively.While in the HEV/HBV related liver failure group (n=86),the corresponding numbers were 34.88%,31 .40% and 33.72%,respectively.The differences were not statistically significant (χ2 = 3.176,P = 0.204 ).Additionally,the clinical outcome between these two groups was also comparable (83.33% vs 91 .86%,χ2 =0.945 ,P = 0.331 ).The Logistic analysis showed that age over 50 years (OR=2.080,P =0.002)and coinfection with HBV (OR=5 .632, P <0.01)were risk factors for AHE related liver failure.Conclusions AHE is seasonal and mainly occurs in elderly male.Advanced age and HBV coinfection may be risk factors of severe AHE.
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Objective To evaluate the preventive effect of entecavir on liver injury in chronic HBV infected patients complicated with tuberculosis receiving anti-tuberculosis treatment.Methods A total of 102 chronic HBV infected patients complicated with tuberculosis were collected from Guangzhou Eighth People' s Hospital and Guangzhou Chest Hospital during January 2011 and May 2012.Patients were divided into three groups:group A (n =33) received entecavir plus anti-tuberculosis treatment,group B (n =29) received lamivudine plus anti-tuberculosis treatment,and group C (n =40) received anti-tuberculosis treatment only.Liver injury,termination of treatment,liver function and HBV DNA load before and after treatment were observed.SPSS 13.0 was used for statistial analysis.Results Two cases (6.1％) in group A,6 cases (20.6％) in group B and 22 cases (55.0％) in group C had liver injury,and the difference among three groups was of statistical difference (x2 =22.126,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =3.024,P＞0.05).One case (3.0％) in group A,3 cases (10.3％) in group B and 15 cases (37.5％) in group C terminated the treatment,and the difference among three groups was of statistical significance (x2 =16.008,P ＜ 0.01),but the difference between group A and group B was not significant (x2 =1.410,P ＞0.05).ALT and AST in group A and group B were not of significant differences before and after anti-tuberculosis treatment,but those in group C were significantly higher (Z =18.306,16.821,P ＜ 0.01).There was no significant difference in HBV DNA load among three groups before the treatment (Z =0.460,P ＞ 0.05),while HBV DNA loads in group A and group B significantly decreased during the treatment,and the difference among three groups after the treatment was significant (Z =23.213,P ＜0.01).In addition,lower HBV DNA load was observed in group A compared with group B after one month anti-tuberculosis treatment (Z =8.109,P ＜ 0.01).Conclusion Early use of entecavir can effectively prevent liver injury during anti-tuberculosis treatment,ensuring anti-tuberculosis treatment and anti-HBV treatment carried out as planned.