ABSTRACT
We determine whether the serum KL-6/MUC1 (KL-6) levels in patients with type C liver disease can be used to assay inflammatory activity and the stage of fibrosis of patients, as well as to screen high-risk groups for the development of hepatocellular carcinoma (HCC). Study subjects included 130 patients with type C chronic hepatitis (CH), 15 patients diagnosed with type C acute hepatitis (AH) and 17 healthy control subjects. Frozen serum samples were obtained from each subject to determine the KL-6 levels using an enzyme-linked immunosorbent assay (EIA) method. The mean KL-6 levels in patients were as follows: 150.1 U/ml for healthy controls, 203.7 U/ml for AH patients, 225.7 U/ml for F0 stage, 207.4 U/ml for F1 stage, 235.8 U/ml for F2 stage, 193.3 U/ml for F3 stage, and 276.2 U/ml for F4 stage in CH patients. The mean serum KL-6 level in patients with F4 stage was significantly higher than that in healthy controls. No relationship was observed between the serum KL-6 levels and liver histology. However, the degree of irregular regeneration (IR) of hepatocytes and the levels of KL-6 were significantly correlated according to the progression of F stages. The cumulative incidence of HCC in the high KL-6 level group (>/=300 U/ml) was significantly greater than that in the low level group. Our results suggest that the determination of serum KL-6 levels may be useful in screening high-risk groups for the development of HCC.
ABSTRACT
Polyarteritis nodosa (PAN), an extra-hepatic complication of hepatitis type B, is usually treated with a combination of immunosuppressive and antiviral drugs. Less commonly, interferon (IFN) has been used alone. A 57-year-old man was admitted to our hospital with epididymitis and acute hepatitis with genotype A, hepatitis B virus (HBV). He became a carrier with complicating PAN. The administration of interferon alpha2b (IFNalpha2b) at a dose of 6 MU/day for 4 weeks alleviated abdominal and neuronal symptoms related to PAN, although HBV replication was not eliminated. This is the first case of PAN with HBV of genotype A and which was treated with IFN alone. This case indicates the possibility that IFN is efficacious for extra-hepatic complications of hepatitis type B and suggests that differences in genotype may be associated with variation in the likelihood of progression to persistent infection and the incidence of extra-hepatic complications in Japan.
ABSTRACT
In the present study, we compared the molecular epidemiology of GBV-C/HGV co-infection and the clinical profiles in patients diagnosed with either type B or type C hepatitis virus infection from Nanjing in Southeast China and Yanbian in Northeast China, with those at the Nihon University Hospital in Tokyo. The patients included 97 men in Nanjing, 66 men and women in Yanbian, and 249 men and women at the Nihon University Hospital. GBV-C/HGV RNA was detected using reverse transcriptase polymerase chain reaction as described by Abe et al. The prevalence of GBV-C/HGV co-infection in Nanjing, Yanbian, and Tokyo was 18.8, 23.3, and 3.5% in type B liver diseases, respectively, and 3.6, 11.1, 7.3% in type C liver diseases, respectively. A comparison of background factors between GBV-C/HGV RNA-positive and -negative patients revealed no significant differences in any parameter between Nanjing, Yanbian, and Tokyo. A phylogenic tree analysis of nucleotide sequences showed that the Nanjing strain was closely related to the Shanghai, Hong Kong, and Tokyo isolates, while the Yanbian isolate was closely related to the Korean, Mongolia, and Tokyo strains. These isolates were classified to the East Asian type of genotype 3. The results of the phylogenic tree analysis suggests that the GBV-C/HGV isolates from China and Japan have a common origin. Therefore, the prevalence of GBV-C/HGV infection may be geographically determined, irrespective of racial differences.
