Mother-to-child vertical transmission of hepatitis B virus and its prevention with tenofovir disoproxil fumarate / 临床肝胆病杂志

This article reviews the research advances in mother-to-child vertical transmission of hepatitis B virus (HBV), cause of standard immunoprophylaxis failure against HBV, and use of tenofovir disoproxil fumarate (TDF) during pregnancy to prevent mother-to-child vertical transmission of HBV, in order to provide guidance for future clinical studies. Our purpose is to perform scientific clinical management and completely prevent the mother-to-child transmission of HBV.

Epidemiological and clinical features of human immunodeficiency virus/hepatitis B virus co-infected patients / 中华传染病杂志

Objective To investigate the epidemiologic and clinical features of human immunodeficiency virus (HIV)/hepatitis B virus (HBV)co-infected patients.Methods Patients who confirmed with HIV infection and received highly active anti-retroviral therapy (HAART)at Guangzhou Eighth People′s Hospital were enrolled.HIV/HBV co-infected patients and HIV mono-infected patients were screened and their epidemiological and clinical features were analyzed before HAART.Comparison of the levels of alanine transaminase (ALT),aspartate transaminase (AST),CD4 + T lymphocyte and HIV RNA between the two groups were conducted.The data were statistically analyzed by chi-square test and nonparametric test.Results One hundred and sixty-five out of 1 218 (13.5 %)patients were hepatitis B surface antigen positive.The median ALT and AST levels of HIV mono-infected patients were 29 U/L and 34 U/L respectively,which were both higher than HIV/HBV co-infected patients (22 U/L and 25 U/L, respectively)(Z = - 4.270 and Z = - 5 .780,respectively,both P = 0.000 ).The median CD4 + T lymphocyte count of HIV/HBV co-infected patients was significantly lower than that of HIV mono-infected patients (Z = -2.980,P =0.003 ).The CD4 + T lymphocyte count was lower in hepatitis B e antigen (HBeAg)positive patients than HBeAg negative patients (Z =-2.660,P =0.008).The median CD4 + T lymphocyte count in patients with HBV DNA≥5 lg copy/mL was significantly lower than those with HBV DNA<5 lg copy/mL (Z = -2.311 ,P =0.021 ).The proportions of positive HBV DNA, HBV DNA≥5 lg copy/mL,abnormal ALT and AST in 54 patiens with CD4 + T lymphocyte counts <50/μL were 81 .5 %,66.7%,44.4% and 53.7%,respectively.All were significantly higher than patients with CD4 + T lymphocyte count≥50/μL(χ2 =6.159,P =0.046 ;χ2 =6.618,P =0.037 ;χ2 =7.144,P =0.028 andχ2 =9.586,P =0.008,respectively).Conclusions The prevalence of HBV/HIV co-infection is high in this study.The CD4 + T lymphocyte counts in HIV/HBV co-infected patients are lower,especially in patients with HBeAg positive and high HBV DNA level.The CD4 + T lymphocyte counts are associated with HBV DNA replication levels.

Association between HSD11B2 gene polymorphism and fetal growth / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the relationship between HSD11B2 polymorphisms and fetal growth during normal pregnancy.</p><p><b>METHODS</b>The HSD11B2 promoter/G-209A, G-194C, G-151A and G-126A genotypes were examined in 33 samples from Chinese Han subjects by gene sequencing. HSD11B2 (CA)n microsatellite polymorphism in the first intron was detected in blood samples from 187 maternal and newborn pairs by PCR-capillary electrophoresis.</p><p><b>RESULTS</b>All the HSD11B2 promoter/G-209A, G-194C, G-151A and G-126A genotypes were wild-type GG. The offspring birth weight and any ultrasound parameters describing late gestational fetal body shape were not significantly different between maternal or fetal SS, SL and LL groups or combined SS+SL and LL groups. When considering the relevant confounding factors (gestational age at delivery, newborn's gender, maternal body mass index before pregnancy, maternal weight at delivery and maternal age), the offspring birth weight and late pregnancy ultrasound parameters were still not associated with the maternal or fetal HSD11B2 (CA) n microsatellite polymorphisms.</p><p><b>CONCLUSIONS</b>Fetal and maternal HSD11B2 polymorphism is not related to fetal growth during normal pregnancy.</p>

Hypophosphatemia and chest pain related to adefovir dipivoxil treatment for chronic hepatitis B: report of two cases / 南方医科大学学报

Adefovir dipivoxil (ADV) is an acyclic nucleotide phosphate analogue, currently used for anti-HBV therapy. A few cases of hypophosphatemia related to ADV were reviewed. We report two cases of chronic hepatitis B patients with the chief complaints of chest pain due to hypophosphatemia associated with ADV treatment.

The relationship between chest radiographic changes and clinical manifestations in 148 patients with scrub typhus in Guangdong area / 中华传染病杂志

Objective To investigate the relationship between chest radiographic changes and clinical manifestations in patients with scrub typhus in Guangdong area.MethodsA total of 148 cases of scrub typhus admitted to First Affiliated Hospital of Ji′nan University,Guangzhou Eighth People′s Hospital and the Second People′s Hospital of Yuebei between 1999 and 2010 was retrospectively reviewed.The patients were divided into two groups based on the findings of the chest X-rays (with or without radiographic abnormalities).Furthermore,the clinical characteristics and prognosis in two groups were compared.The statistical analysis was done using t test,chi-square test or Fisher′s exact test.ResultsChest X-rays showed abnormalities in 66 (44.6％) cases,and the chest X-ray features were diverse.The incidences of cough,severe thrombocytopenia,hypoalbuminemia,shock,acute respiratory failure,jaundice and acute renal failure were all significantly increased in group of patients with chest X-rays abnormalities compared with the other group of patients without chest X-rays abnormalities (χ2 =18.193,6.872,17.138,5.608,4.318,7.982 and 7.932,respectively; all P＜0.05).The hospitalization day was longer in patients with chest X-rays abnormalities compared with the patients without chest X-rays abnormalities,but there was no statistical difference [(11.7±7.1)d vs (9.9±5.0)d,t=1.717; P=0.088)],while the mortality was higher(6.1 ％ vs 0; Fisher′s exact test,P =0.038).Conclusions The clinical manifestations of the patients with scrub typhus are diverse,and the presence of abnormal chest X-rays is shown to be associated with the disease severity.Physicians should have the awareness of scrub typhus to make the diagnosis and treatment properly.

Impact of maternal hepatitis B surface antigen carrier status on preterm delivery in southern China / 南方医科大学学报

<p><b>OBJECTIVE</b>To explore the impact of maternal hepatitis B surface antigen (HBsAg) carrier status on the occurrence of preterm birth.</p><p><b>METHODS</b>We analyzed pregnancy-related complications, outcomes and fetal growth index in 188 HBsAg positive singleton pregnant women during the period of May 2009 to July 2011, with 265 HBsAg-negative women with singleton pregnancies in the same period serving as controls.</p><p><b>RESULTS</b>The HBsAg-positive pregnant women showed a significantly higher incidence of placenta praevia than the control group (2.66% vs 0%, P=0.03), and the incidence of preterm delivery (<37 weeks) was also significantly higher in HBsAg-positive group (12.23% vs 6.04%, P=0.02). The incidences of gestational hypertension, preeclampsia, gestational diabetes mellitus, abnormal glucose tolerance, premature rupture of membranes, cesarean delivery, and postpartum hemorrhage showed no significant differences between the two groups (P>0.05), nor did the fetal birth weight, height, head circumference or Apgar scores at 1, 5, and 10 min (P>0.05). Logistic regression identified HBsAg positivity, abnormal ALT, placenta praevia, and severe preeclampsia as the risk factors for preterm delivery.</p><p><b>CONCLUSION</b>HBsAg carrier status can increase the risk of preterm delivery in pregnancy, but it does not seem to affect the fetal growth.</p>