High Frequency of Hepatitis B Core and Surface Antibodies in Hepatitis C Virus-Infected Patients on the Screening Examination.

BACKGROUND: Hepatitis B virus (HBV) and hepatitis C virus (HCV) are important human pathogens that cause chronic liver disease and hepatocellular carcinoma. Co-infection of HBV and HCV is not uncommon, particularly in countries where these two viruses are endemic. Therefore, the characteristics of HBV co-infection in HCV antibody (HCVAb) -positive Japanese patients found on the screening examination were analyzed. PATIENTS AND METHODS: Between January and December 2011, HCVAb status was evaluated as the screening examination in 12,582 patients in Gunma University Hospital, and it was positive in 402 patients (3.2%). In 331 HCVAb-positive/HBs antigen (HBsAg) -negative patients with available residual serum, HBs antibody (HBsAb) and HBc antibody (HBcAb) were examined. In addition, HCV-RNA was examined in 291 patients with available residual serum. HBV-DNA and HBV core-related antigen (HBcrAg) were examined in 106 patients with available residual serum. RESULTS: The HCVAb titer was distributed between 1 and 18 sample/cutoff index (S/CO). 275 patients (83.1%) had a high HCVAb titer (S/CO ≥10). HCV-RNA was positive in 230 (79.0%) patients, and it was more frequently detected in HCVAb high-titer patients (88%) than in low-titer patients (32%; p < 0.0001); 61 (18.4%) and 101(30.5%) patients were positive for HBsAb and HBcAb, respectively. Of 230 HCV-RNA-positive patients, 38 (16.5%) and 59 (25.6%) were positive for HBsAb and HBcAb, respectively. Three (2.8%) and 2 (1.9%) of 106 patients had HBV-DNA and HBVCrAg. The ALT level was higher than 30 IU/L in 146/327 (44.6%) HCVAb-positive patients who had ALT levels measured. Abnormal ALT elevation was more frequent in HCVAb high-titer patients than in low-titer patients (48.3% vs. 26.8%; p = 0.0031), and in HCV-RNA-positive patients than in HCV-RNA-negative patients (54.2% vs. 13.3%; p < 0.001). CONCLUSION: HBV reactivation should be noted in these HCVAb-positive/HBsAg-negative patients on the screening examination if these patients must receive chemotherapy or immunosuppressive therapy. In addition, surveying of HBsAb in addition to HBcAb is also necessary.

[Improvement in peripheral blood T cell subset imbalance in a house with an elimination system for various allergens].

We analyzed the change of peripheral blood T cell subsets after moving into a house with a Healthy Air system (HAS) elimination system for various allergens, e.g. pollens, house dusts, etc. The 20 subjects were divided into an allergic group (13 subjects) and control group (7 subjects). We measured complete blood counts (CBC), white blood cell differentiation (DIFF), CD4/CD8 ratio, Th1/Th2 ratio, and percentage of CD4+CD25+T-cells and regulatory T-cells in peripheral blood, and these data were compared before and 3 and 6 months after moving into the HAS house. There was no significant difference in CBC, DIFF, CD4/CD8 ratio, and Th1/Th2 ratio before and after the move. The mean levels and 95% confidence interval of CD4+CD25+T-cells in the allergic group were as follows: before, 16.66% (12.99-20.34%); at 3 months, 13.86% (10.49-17.22%); and at 6 months, 12.66% (9.28-16.05%), respectively. Those in the control group were as follows: before, 13.60% (5.27-21.93%); at 3 months, 12.51%(5.41-19.61%); and at 6 months, 11.77% (3.93-19.61%), respectively. CD4+CD25+T-cells were significantly decreased at 6 months after the move compared to before the move in the allergic group (p < 0.01). However, there was no significant difference between before and after the move in the control group. The mean levels of regulatory T-cells were not different between before and after the move in both groups. The mean level of CD4+CD25+T-cells in subjects that had improved allergic condition was significantly decreased at 6 months after the move compared to before the move (p < 0.05). These results suggest that decreases in allergens in the home environment may affect lymphocyte subsets.