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Objective This study focused on the recurrence risks of viral hepatitis B (VHB) after liver transplantation for hepatitis B virus (HBV)-related liver diseases.Methods A total of 599 patients undergoing liver transplantation due to HBV-related liver disease [hepatic cellular cancer (HCC),decompensated liver cirrhosis (DLC),acute liver failure (ALF)] were included in this study.All patients included in this study have been followed up for at least 12 months for liver biochemistry and HBV testing,altogether with the clinical presentation and outcomes.Treatment protocols about prevention of VHB recurrence in perioperative period and after liver transplantation,the time interval and influencing factors of VHB recurrence,and the disease prognosis were analyzed.Results Of the 599 patients,VHB recurrence were observed in 36 cases.The rate of VHB recurrence was 7.2％ (23/319),5.6％ (13/232) and 0 (0/48) for HCC,DLC and ALF,respectively.The rate of VHB recurrence was 2.3％,5.5％ and 6％ for 1 year,5 years and 8 years,respectively.The rate of VHB recurrence in the lamivudine group was significantly higher than in enticavir group and combination therapy group [16.5％ (22/133),2.9％ (8/280),3.2％ (6/186),respectively,P ＜ 0.05].Conclusion HCC and DLC as liver transplantation indication are independent risk factors for VHB recurrance after liver transplantatuib.For liver transplantation patients with HBV-related liver disease,entecavir monotherapy and combination therapy (lamivudine and adefovir,or tenofovir are both more effective on the prophylaxis of VHB recurrance than lamivudine monotherapy.
RESUMO
Objective To study the recurrence risks of viral hepatitis B (VHB) after liver transplantation for hepatitis B virus (HBV)-related liver diseases.Methods A total of 599 patients undergoing liver transplantation due to HBV-related liver disease [hepatic cellular cancer (HCC),decompensated liver cirrhosis (DLC),acute liver failure (ALF)] were included in this study.All patients included in this study have been followed up for at least 12 month for liver biochemistry and HBV testing,altogether with the clinic presentation and outcomes.Treatment protocols about prevention of VHB recurrence in perioperative period and after liver transplantation,the time interval and influence factors of VHB recurrence,and the disease prognosis were analyzed.Results Of the 599 patients,36 cases of VHB recurrence were observed.The rate of VHB recurrence was 7.2％ (23/319),5.6％ (13/232) and 0 (0/48) for HCC,DLC and ALF,respectively.The rates of VHB recurrence were 2.3％,5.5％,6％ for 1 year,5 years and 8 years,respectively.The rate of VHB recurrence in the lamivudine group was significantly higher than in enticavir group and combination therapy group [16.5％ (22/133),2.9％ (8/280),and 3.2％ (6/186),respectively,P＜0.05 for all].Conclusion HCC and DLC as liver transplant indications are independent risk factors for VHB recurrence after liver transplant.For liver transplant patients with HBV-related liver disease,entecavir monotherapy and combination therapy (lamivudine and adefovir,or tenofovir) are both more effective on the prophylaxis of VHB recurrence than lamivudine monotherapy.
RESUMO
Objective To investigate the correlation between seminal plasma hepatitis B virus (HBV) DNA copy and semen parameters and sperm DNA fragmentation (SDF).Methods The seminal plasma HBV-DNA was detected by the real-time PCR in 148 infertility males,and those with serum HBV-DNA above (positive) or below (negative) 5.0 × 102U/ml were analyzed respectively by semen parameters,sperm morphology and sperm DNA fragmentation (SDF).Results Of 148 male,60 (40.5％) were seminal plasma HBV-DNA positive,and of 60 positive patients,56 (93.3％) were serum hepatitis B e antigen(HBeAg) positive,which was higher than those of seminal plasma HBV-DNA negative males (31cases,35.2％).Serum HBeAg and HBV-DNA in seminal plasma HBV-DNA positive patients were 845.7(0.2 ～ 1455.0) S/CO and (1.7 ± 1.1) × 108U/ml,which were higher than those of HBV-DNA negative patients [HBeAg:0.1 (0.1 ～ 1374.0) S/CO;HBV-DNA:(2.3 ± 1.1) × 107 U/ml,P ＜ 0.01].Seminal plasma HBV-DNA positive patients exhibited lower semen volume,sperm concentration,the percentage of forward moving sperm and less normal morphology compared to HBV-DNA negative patients [(2.44±1.2)mlvs.(3.07±1.3)ml,(66.8±49.1) ×106/mlvs.(87.1 ±65.4) ×106/ml,(54.3± 16.1)％ vs.(59.1 ±15.3)％,(3.77 ±2.8)％ vs.(6.15 ±4.2)％,P＜0.05].The number of patients with teratozoospermia was significantly higher in seminal plasma HBV-DNA positive patients (56.7％ versus 34.1％,(P ＜ 0.01).The SDF in seminal plasma HBV-DNA positive patients was(18.1 ± 12.3)％,while it was(14.4 ± 8.4)％ in negative patients,and the difference of SDF in these two groups was significantly (t =2.197,P ＜ 0.05).Conclusion Seminal plasma HBV-DNA positive could affect the semen parameters,sperm morphology and SDF.