ABSTRACT
Chronic hepatitis B (CHB) is one of the most common infections worldwide. Currently approved treatments of CHB include nucleoside/nucleotide analogues (NAs). However, long-term NA therapy is associated with accumulation of resistant mutations within the hepatitis B virus (HBV) polymerase gene. The incidence of naturally occurring HBV mutations leading to primary antiviral resistance has not been fully elucidated yet. The objective of present study was to detect the frequency of mutations within the HBV polymerase gene in 263 patients naïve to nucleoside/nucleotide analogues. Prevalence of HBV Pol gene mutations secondary to NA treatment in patients without pre-existing antiviral resistance mutations was also examined. Retrospective analysis showed that HBV Pol gene mutations were present in 7 out of 263 patients prior to the treatment. Mutations observed in NA-naïve CHB patients were associated only with resistance to lamivudine and adefovir. Compensatory mutations were observed as well. In the course of antiviral treatment, HBV Pol gene mutations were identified in 65 out of the remaining 256 CHB patients (25.39%), while no mutations of any type were detected in 160 patients (62.5%). The profiles of detected mutations were comparable to those observed in other studies that focused on the analysis of clinically relevant NA-resistant mutations. In conclusion, we found out that antiviral resistance mutations may pre-exist in the overall viral population present in untreated patients, although the incidence of HBV Pol gene mutations in NA-naïve CHB patients was low and reached only up to 2.66%. However, possible circulation and transmission of NAs-resistant HBV mutants in human population should be taken into account.
Subject(s)
Antiviral Agents/therapeutic use , Gene Products, pol/genetics , Hepatitis B virus/drug effects , Hepatitis B, Chronic/drug therapy , Mutation , Nucleosides/therapeutic use , Nucleotides/therapeutic use , Adult , Aged , Aged, 80 and over , Female , Hepatitis B virus/genetics , Hepatitis B, Chronic/virology , Humans , Male , Middle Aged , Mutation/drug effects , Nucleosides/chemistry , Nucleotides/chemistry , Retrospective Studies , Young AdultABSTRACT
Selected parameters of the lipid metabolism were evaluated in patients with HBsAg-positive chronic, active hepatitis. A decrease in alpha-lipoproteins and an increase in plasma biliary acids level were found.
Subject(s)
Bile Acids and Salts/blood , Hepatitis B/blood , Hepatitis, Chronic/blood , Lipoproteins, HDL/blood , Adult , Female , Hepatitis B Antigens/analysis , Humans , Lipids/blood , Male , Middle AgedABSTRACT
Serum Zn2+, Cu2+, and Mg2+ were assayed in patients with chronic persisting hepatitis HBsAg-positive. Significantly decreased serum magnesium with increased serum copper levels were noted.
Subject(s)
Hepatitis, Chronic/blood , Trace Elements/blood , Adult , Copper/blood , Female , Humans , Magnesium/blood , Male , Middle Aged , Zinc/bloodABSTRACT
Delayed cutaneous hypersensitivity was assessed in 120 patients (among them 109 HBsAg positive), with chronic persistent hepatitis, chronic active hepatitis, and compensated as well as decompensated liver cirrhosis by simultaneous application of seven standardized antigens and negative control ("Multitest CMI"). In 21 patients, after 12-24 months the tests were repeated. The sum of indurations of all positive responses ("score") were calculated. Responsiveness measured as results below a normal values was related to the advancing of liver disease (from 13% in chronic persistent hepatitis up to 77% in compensated and 61% in decompensated liver cirrhosis). A comparative analysis (t-Student test) of the arithmetical means of the "scores" revealed statistically significant differences between results obtained in diagnostic groups. It was also dependent from the severity of liver disease. Patients with chronic persistent hepatitis (without specific treatment) and patients with chronic active hepatitis (treated using thymus extract, TFX - "Polfa") has showed an increased "score" values. In contrast to this group, all persons with liver cirrhosis without skin-responsiveness in the first and second tests (anergy) died at the period of 18 months. "Multitest CMI" can be of value in assessing of results of immunotherapy, as well as prognosis of the course of advanced liver disease.
