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Gonzales-Gustavson E, Timoneda N, Fernandez-Cassi X, Caballero A, Abril JF, Buti M, Rodriguez-Frias F, Girones R. Identification of sapovirus GV.2, astrovirus VA3 and novel anelloviruses in serum from patients with acute hepatitis of unknown aetiology. PLoS One 2017; 12:e0185911. [PMID: 28982120 PMCID: PMC5628893 DOI: 10.1371/journal.pone.0185911] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Accepted: 09/21/2017] [Indexed: 12/14/2022] Open
Abstract
Hepatitis is a general term meaning inflammation of the liver, which can be caused by a variety of viruses. However, a substantial number of cases remain with unknown aetiology. We analysed the serum of patients with clinical signs of hepatitis using a metagenomics approach to characterize their viral species composition. Four pools of patients with hepatitis without identified aetiological agents were evaluated. Additionally, one pool of patients with hepatitis E (HEV) and pools of healthy volunteers were included as controls. A high diversity of anelloviruses, including novel sequences, was found in pools from patients with hepatitis of unknown aetiology. Moreover, viruses recently associated with gastroenteritis as sapovirus GV.2 and astrovirus VA3 were also detected only in those pools. Besides, most of the HEV genome was recovered from the HEV pool. Finally, GB virus C and human endogenous retrovirus were found in the HEV and healthy pools. Our study provides an overview of the virome in serum from hepatitis patients suggesting a potential role of these viruses not previously described in cases of hepatitis. However, further epidemiologic studies are necessary to confirm their contribution to the development of hepatitis.
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Affiliation(s)
- Eloy Gonzales-Gustavson
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
| | - N. Timoneda
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
- Computational Genomics Lab, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain
| | - X. Fernandez-Cassi
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
| | - A. Caballero
- Hospital Universitari Vall d’Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Catalonia, Spain
| | - J. F. Abril
- Computational Genomics Lab, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain
| | - M. Buti
- Hospital Universitari Vall d’Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Catalonia, Spain
| | - F. Rodriguez-Frias
- Hospital Universitari Vall d’Hebron and CIBEREHD del Instituto Carlos III, Barcelona, Catalonia, Spain
| | - R. Girones
- Laboratory of Virus Contaminants of Water and Food, Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain
- * E-mail:
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Abstract
Hepatitis B virus (HBV) infection has long been a critical public health challenge in China. National surveys revealed a prevalence of approximate 10% for chronic HBV infection in general population. HBV has been the leading cause of chronic hepatitis, cirrhosis, and liver cancers in Chinese population and a common pathogen of acute viral hepatitis. Meanwhile, the epidemic provided important opportunities to research the natural history, public health impact, and therapeutic and preventive interventions for HBV in China. In this review, we summarized the selected key epidemiological studies since 1970s regarding HBV infection and its associated liver diseases in China, and provided considerations for future research, prevention and treatment of HBV.
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Yeh CT, Tsao ML. Detection of serum anti-NV-F antibodies in the convalescent phase of severe hepatitis in patients positive for tissue NV-F antigen and novel virus-like particles. J Med Virol 2015; 87:1727-36. [PMID: 25873412 DOI: 10.1002/jmv.24224] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/30/2015] [Indexed: 11/07/2022]
Abstract
Previously, a non-human DNA fragment named NV-F was isolated from a patient with non-A-E fulminant hepatitis. This sequence encoded an incomplete open reading frame (the NV-F antigen). In this study, we developed a western blot assay to detect serum anti-NV-F antibodies. Serum samples from 347 patients with severe hepatitis (ALT > fivefold ULN) were analyzed to understand the prevalence and distribution of the NV-F associated virus (HnFV) infection. Of these patients, acute HnFV infection was diagnosed (by positive serum NV-F DNA) in 34 patients (9.8%). However, none of these 34 serum samples were positive for serum anti-NV-F antibodies. In the remaining patients negative for serum NV-F DNA, 62 (17.9%) were positive for serum anti-NV-F antibodies. Liver biopsy samples from 35 severe hepatitis patients were submitted for immunohistochemistry and electron microscopy examination. Of them, seven were positive for hepatic NV-F antigen expression. Electron microscopy identified a novel virus-like particle in all of the seven NV-F antigen-positive liver tissues but not in the remaining 28 NV-F antigen-negative liver tissues. Longitudinal serum sample analysis revealed transient positivity of serum NV-F DNA in three of the seven patients during the clinical courses. Seroconversion of anti-NV-F antibody from negative to positive was found in four of the seven patients and all positive anti-NV-F antibodies were detected in the convalescent phases. In conclusion, in patients with severe hepatitis, a novel hepatotropic virus, temporarily named HnFV, was found in liver tissues expressing the NV-F antigen. Serum anti-NV-F antibodies were detected in the convalescent serum samples.
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Affiliation(s)
- Chau-Ting Yeh
- Liver Research Center, Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan.,Molecular Medicine Research Center, Chang Gung University, Taoyuan, Taiwan
| | - Mei-Lin Tsao
- Liver Research Center, Department of Hepato-Gastroenterology, Chang Gung Memorial Hospital, Taipei, Taiwan
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Al-Naaimi AS, Turky AM, Khaleel HA, Jalil RW, Mekhlef OA, Kareem SA, Hasan NY, Dhadain AA. Predicting acute viral hepatitis serum markers (A and E) in patients with suspected acute viral hepatitis attending primary health care centers in Baghdad: a one year cross-sectional study. Glob J Health Sci 2012; 4:172-83. [PMID: 22980390 PMCID: PMC4776970 DOI: 10.5539/gjhs.v4n5p172] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2012] [Accepted: 07/24/2012] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Viral hepatitis is an important preventable infectious disease with various rates of occurrence in different areas of the world. The main objective of the present study was to evaluate the role of some risk factors in predicting a positive acute viral hepatitis marker among patients with suspected acute viral hepatitis in a primary health care setting in Baghdad. Besides, finding out the occurrence of jaundice, contribution of viruses A and E to the cases that have occurred in Baghdad province was also searched for. METHODS Over a period of 1 year a descriptive cross sectional study was carried out at the primary health care centers in Baghdad. A questionnaire form was used to collect data about demographic factors and the results of the investigations. Total serum bilirubin and bilirubin in urine were done at the primary health care center laboratory. The rest of the sera samples were sent to Hepatitis referral Lab at Central Public Health Laboratory (CPHL) to be tested for anti HAV IgM and anti HEV IgM using ELISA technique. RESULTS A total of 7,576,372 consultations to primary health care centers were recorded in Baghdad. Among those a total of 2,692 cases (35.5 per 100,000 consultations) were labeled as acute viral hepatitis cases. A positive hepatitis viral marker (A, B, C and E) was found in 1,332 cases (17.6 per 100,000 consultations). More than two fifths (44.8%) of cases were positive for anti-HAV antibodies and another 1.6% had positive anti-HEV antibodies. CONCLUSION During 1 year period, the rate of occurrence of suspected acute viral hepatitis cases was 35.5 per 100000 of consultations to the primary health care centers in Baghdad. Of the total suspected cases, only 17.6 per 100000 of the consultations were positive for one of the viral hepatitis markers. Those who tested positive for one of the viral hepatitis markers represent 49.5% of the suspected cases. Proportion of anti HAV IgM positive tests among suspected cases was 44.8%. Factors that were able to predict positive Anti HAV IgM were (younger age group, negative history of cupping or tattooing, negative past history of jaundice). Male gender was the least important predictor of a positive case for anti HAV IgM. Proportion of Anti HEV IgM positive tests among suspected cases was 1.6%. Of the factors studied, only age was able to predict a positive Anti HEV IgM in those more than 15 years. Further studies are recommended.
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Affiliation(s)
| | - Atallah Mekhlef Turky
- Viral Hepatitis Section, Communicable Disease Control Center, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Hanan Abdulghafoor Khaleel
- Viral Hepatitis Section, Communicable Disease Control Center, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Rasha Waleed Jalil
- Central Public Health Laboratories, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Olah A. Mekhlef
- Central Public Health Laboratories, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Susan Abdul Kareem
- Central Public Health Laboratories, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Nadia Yousif Hasan
- Central Public Health Laboratories, Public Health Directorate, Ministry of Health, Baghdad, Iraq
| | - Azhar Abdulla Dhadain
- Central Public Health Laboratories, Public Health Directorate, Ministry of Health, Baghdad, Iraq
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Lou Y, Wang M, Mao W. Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B. PLoS One 2012; 7:e37644. [PMID: 22649548 PMCID: PMC3359289 DOI: 10.1371/journal.pone.0037644] [Citation(s) in RCA: 79] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2012] [Accepted: 04/26/2012] [Indexed: 12/20/2022] Open
Abstract
Background Red blood cell distribution width (RDW), an automated measure of red blood cell size heterogeneity (e.g., anisocytosis) that is largely overlooked, is a newly recognized risk marker in patients with cardiovascular diseases, but its role in persistent viral infection has not been well-defined. The present study was designed to investigate the association between RDW values and different disease states in hepatitis B virus (HBV)-infected patients. In addition, we analyzed whether RDW is associated with mortality in the HBV-infected patients. Methodology/Principal Findings One hundred and twenty-three patients, including 16 with acute hepatitis B (AHB), 61 with chronic hepatitis B (CHB), and 46 with chronic severe hepatitis B (CSHB), and 48 healthy controls were enrolled. In all subjects, a blood sample was collected at admission to examine liver function, renal function, international normalized ratio and routine hematological testing. All patients were followed up for at least 4 months. A total of 10 clinical chemistry, hematology, and biochemical variables were analyzed for possible association with outcomes by using Cox proportional hazards and multiple regression models. RDW values at admission in patients with CSHB (18.30±3.11%, P<0.001), CHB (16.37±2.43%, P<0.001) and AHB (14.38±1.72%, P<0.05) were significantly higher than those in healthy controls (13.03±1.33%). Increased RDW values were clinically associated with severe liver disease and increased 3-month mortality rate. Multivariate analysis demonstrated that RDW values and the model for end-stage liver disease score were independent predictors for mortality (both P<0.001). Conclusion RDW values are significantly increased in patients with hepatitis B and associated with its severity. Moreover, RDW values are an independent predicting factor for the 3-month mortality rate in patients with hepatitis B.
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Affiliation(s)
- YuFeng Lou
- Department of Clinical Laboratory, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - ManYi Wang
- Department of Clinical Laboratory, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
| | - WeiLin Mao
- Department of Clinical Laboratory, First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang Province, People’s Republic of China
- * E-mail:
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Satoh K, Iwata-Takakura A, Osada N, Yoshikawa A, Hoshi Y, Miyakawa K, Gotanda Y, Satake M, Tadokoro K, Mizoguchi H. Novel DNA sequence isolated from blood donors with high transaminase levels. Hepatol Res 2011; 41:971-81. [PMID: 21718400 DOI: 10.1111/j.1872-034x.2011.00848.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
AIM In Japan, the etiology of 10-20% of cases of acute hepatitis remains unclarified. This study was conducted to verify the agent causing non-A-E hepatitis. METHODS Serum samples from 500 blood donors with elevated alanine aminotransferase (ALT) levels were screened by polymerase chain reaction using primers constructed from conserved areas of RNA virus helicase. The sequence obtained was investigated for viral properties. RESULTS Four blood samples were found to contain a novel DNA sequence of 9496 bp, which was designated KIs-V. KIs-V was sensitive to the restriction enzyme SalI and BstXI. Rolling-circle amplification produced an excessive amount of KIs-V DNA. In sucrose density gradient ultracentrifugation, KIs-V banded at a 1.158-g/cm(3) density. Detergent treatment increased the density of KIs-V. There was no KIs-V DNA amplification from human leukocyte DNA. Serial filtration suggested that KIs-V was included in a 30-50-nm size particle. In silico analysis revealed that KIs-V contained 13 potential genes, none of which showed homology to any viral proteins reported. One gene showed similarity to a DNA polymerase domain. Strong signals for transcription initiation and a CpG island were identified. The nucleotide composition of KIs-V showed a characteristic feature of circular DNA genomes that contain a replication origin and a terminus. In a preliminary study, KIs-V was frequently identified among hepatitis E virus antibody positive individuals with elevated ALT levels. CONCLUSION A new sequence KIs-V was isolated from blood donors with elevated ALT levels. It was suggested that KIs-V is a double-stranded circular DNA genome derived from a novel category of enveloped viruses.
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Affiliation(s)
- Koei Satoh
- Central Blood Institute, Japanese Red Cross, Tokyo Department of Population Genetics, National Institute of Genetics, Mishima Saitama Blood Center, Japanese Red Cross, Saitama, Japan
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7
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Wu KT, Chung KM, Feng IC, Sheu MJ, Kuo HT, Koay LB, Lin CY, Tang LY, Tsai SL. Acute hepatitis E virus infection in Taiwan 2002-2006 revisited: PCR shows frequent co-infection with multiple hepatitis viruses. J Med Virol 2009; 81:1734-42. [PMID: 19697413 DOI: 10.1002/jmv.21442] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
Sporadic cases of acute hepatitis E virus (HEV) infection with production of anti-HEV IgM have been reported occasionally in Taiwan despite no reported outbreaks in the past. This study was undertaken to determine whether serological markers correlated with virus detection. From 2002 to 2006, 72 reported cases of acute hepatitis E seropositive for anti-HEV IgM in Taiwan were enrolled for investigation. Acute phase serum samples were collected for detection of HEV RNA, HBV DNA, HCV RNA, and GBV-C RNA by PCR. The results showed that viral sequences of HEV, HBV, HCV and GBV-C were detected in 54 (75%), 21 (29.2%), 9 (12.5%), and 22 (30.6%) of cases, respectively. Acute hepatitis A co-infection was excluded in all patients because none were seropositive for anti-HAV IgM and, nine patients (12.5%) did not seroconvert to anti-HEV IgG. These results suggest that serum markers did not correlate completely with viremia in the diagnosis of acute HEV infection. Multiple viruses may co-infect with acute hepatitis E virus in Taiwan. Detection of hepatitis E viremia together with seropositivity for anti-HEV IgM and followed by seroconversion to anti-HEV IgG should be included in the diagnostic criteria for HEV infection.
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Affiliation(s)
- Kuan-Ta Wu
- Department of General Medicine, Chi Mei Medical Center, Tainan, Taiwan
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8
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Yeh CT. Is the NV-F agent a novel hepatitis virus? Future Microbiol 2009; 4:123-5. [DOI: 10.2217/17460913.4.2.123] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Affiliation(s)
- Chau-Ting Yeh
- Liver Research Unit, Chang Gung Medical Center, Taipei 105, Taiwan
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Yeh CT, Hsu CW, Chang ML, Tsao ML. Impact of the novel hepatotropic viruslike agent NV-F during chronic hepatitis C virus infection. J Infect Dis 2008; 198:1742-8. [PMID: 18954259 DOI: 10.1086/593178] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
NV-F is a novel hepatotropic viruslike agent. To investigate the impact of the NV-F agent during chronic hepatitis C virus (HCV) infection, 101 consecutive patients with chronic HCV infection were evaluated. NV-F DNA in serum samples and NV-F antigen expression in liver tissues were assessed. All patients subsequently received a 6-month course of interferon-based antiviral therapy. Of the 101 patients, 30 (29.7%) were positive for serum NV-F DNA. Immunohistochemical analysis revealed positive NV-F antigen expression in the liver in 14 of these 30 patients. Patients positive for serum NV-F DNA had significantly higher serum aminotransferase levels (P < .001) and higher Knodell histology activity index values (P < .001). The sustained virological response rate for HCV clearance was not significantly different between patients with and those without detectable serum NV-F DNA. In conclusion, coinfection of the NV-F agent in chronic HCV infection is associated with more severe hepatitis activity.
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Affiliation(s)
- Chau-Ting Yeh
- Liver Research Unit, Chang Gung Memorial Hospital, Taipei, Taiwan.
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Abstract
A number of new hepatitis viruses (G, TT, SEN) were discovered late in the past century. We review the data available in the literature and our own findings suggesting that the new hepatitis G virus (HGV), disclosed in the late 1990s, has been rather well studied. Analysis of many studies dealing with HGV mainly suggests the lymphotropicity of this virus. HGV or GBV-C has been ascertained to influence course and prognosis in the HIV-infected patient. Until now, the frequent presence of GBV-C in coinfections, hematological diseases, and biliary pathology gives no grounds to determine it as an “accidental tourist” that is of no significance. The similarity in properties of GBV-C and hepatitis C virus (HCV) offers the possibility of using HGV, and its induced experimental infection, as a model to study hepatitis C and to develop a hepatitis C vaccine.
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Abe K, Kiuchi T, Tanaka K, Edamoto Y, Aiba N, Sata T. Characterization of erythrovirus B19 genomes isolated in liver tissues from patients with fulminant hepatitis and biliary atresia who underwent liver transplantation. Int J Med Sci 2007; 4:105-9. [PMID: 17479159 PMCID: PMC1852398 DOI: 10.7150/ijms.4.105] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2007] [Accepted: 04/05/2007] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Fulminant hepatitis and biliary atresia are serious problems and their causes have not been explained well. We investigated whether or not erythrovirus B19 is a candidate etiologic agent in such liver disease patients who had undergone liver transplantation. METHODS Liver tissues from 47 patients consisted of 28 fulminant hepatitis and 19 biliary atresia were examined to detect B19 genes by PCR and further analyzed their genomic characterization. RESULTS B19 DNA was detected by nested PCR in 10 of 28 cases (35.7%) livers in the fulminant hepatitis group and 7 of 19 (36.8%) livers in the biliary atresia group, respectively (statistically not significant). Importantly, among the 8 hepatic B19 DNA-positive patients who had paired samples of liver and serum, the serum B19 genome was detectable in only one case. B19 mRNA was identified in all of 10 fulminant hepatitis cases with hepatic B19 DNA, but only 1 out of 7 (14.3%) cases in biliary atresia tested. Furthermore, we obtained ten isolates having the B19 genome with nearly full-length sequences. Interestingly, phylogenetic analysis based on the NS1 gene revealed three different clusters: two for isolates from fulminant hepatitis and the other for isolates from biliary atresia. CONCLUSIONS Our results presented here suggested that B19 may be an etiologic agent of fulminant hepatitis.
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Affiliation(s)
- Kenji Abe
- Department of Pathology, National Institute of Infectious Diseases, Shinjuku-ku, Tokyo, Japan.
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Yeh CT, Chen TC, Chang ML, Hsu CW, Yeh TS, Lee WC, Huang SF, Tsai CC. Identification of NV-F virus DNA in hepatocellular carcinoma. J Med Virol 2007; 79:92-6. [PMID: 17133558 DOI: 10.1002/jmv.20763] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
A fragment of DNA sequence derived from a hepatotropic virus, named NV-F was isolated recently. The aim of this study was to examine whether this virus was associated with hepatocellular carcinoma (HCC). Total cellular DNA was extracted from hepatocellular carcinoma tissues. NV-F virus DNA was detected by PCR. The PCR products were subjected to sequence analysis. Of the 78 HCC samples included, 12 (15.4%) were positive for NV-F virus DNA. Sequence analysis of the 12 amplified DNA fragments revealed a point mutation in one of them. The clinicopathological parameters between patients with and without NV-F virus infection were compared. It was found that patients with NV-F virus infection were older than those without NV-F virus infection (mean ages, 61.5 versus 52.5 years; P = 0.032). Otherwise, no difference was observed between the two groups. Of the 12 HCC patients positive for NV-F virus DNA, 11 patients were co-infected by either hepatitis B or C virus. The remaining patient was a Taiwanese aboriginal inhabitant with cryptogenic cirrhosis. In conclusion, NV-F virus DNA was identified in 15.4% of HCC tissues. HCC patients with NV-F virus infection were significantly older than those without NV-F virus infection.
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Affiliation(s)
- Chau-Ting Yeh
- Liver Research Unit, Chang Gung Medical Center, Taipei, Taiwan.
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Cheng PN, Wang RH, Wu IC, Wu JC, Tseng KC, Young KC, Chang TT. Seroprevalence of hepatitis E virus infection among institutionalized psychiatric patients in Taiwan. J Clin Virol 2007; 38:44-8. [PMID: 17067852 DOI: 10.1016/j.jcv.2006.09.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/22/2006] [Revised: 06/13/2006] [Accepted: 09/08/2006] [Indexed: 01/17/2023]
Abstract
BACKGROUND Hepatitis E virus infection (HEV) remains unclear in institutionalized psychiatric patients. OBJECTIVES To investigate the prevalence and risk factors of HEV infection in a psychiatric institution in Taiwan. STUDY DESIGN A total of 754 patients with psychiatric disorders were enrolled in the study. Clinical features, review of patient charts, and interviews with families were recorded for analysis. Antibody to HEV was tested using a commercial enzyme-linked immunosorbent assays. RESULTS The prevalence of HEV infection in institutionalized patients was as high as 14.5%. Males had higher prevalence than females. It was also found prevalence increased significantly by age group. When compared with patients 30 years old or less, those in the 31-40 year old age group had an odds ratio of 4.89 [95% confidence interval (CI), 1.15-20.82], 41-50 years old of 6.30 (95% CI, 1.48-26.83), and 50 years or older of 6.20 (95% CI, 1.44-26.74). In multivariate logistic regression analysis, age and male gender were the independent risk factors. CONCLUSIONS Institutionalized psychiatric patients had higher prevalence of HEV infection. In addition, there was an age-related increase in exposure to HEV with males that had a higher HEV seropositivity.
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Affiliation(s)
- Pin-Nan Cheng
- Department of Internal Medicine, National Cheng Kung University Hospital, Taipei, Taiwan, ROC
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Hsu CW, Cheng JC, Yeh CT. Quantitative assessment of serum NV-F virus DNA concentrations in samples from patients coinfected with hepatitis B or C virus. J Clin Microbiol 2006; 44:3130-3. [PMID: 16954237 PMCID: PMC1594680 DOI: 10.1128/jcm.00984-06] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
A novel hepatotropic virus, named NV-F virus, was recently identified. The clinical information for this virus is still scarce. Using PCR assay, NV-F viral DNA (NV-F-DNA) was detected in 12 of 50 (24%) hepatitis C virus (HCV)-infected patients (HCV-coinfected [HCVCI] group), 34 of 250 (13.6%) hepatitis B virus (HBV)-infected patients (HBV-coinfected [HBVCI] group), and 28 of 100 (28%) non-A-to-E (NAE) hepatitis patients. Basic clinical parameters were not significantly different among the three groups. By use of a PCR-based quantitative assay, the NV-F-DNA concentration was found to be above the detection limit (1.2 x 10(5) copies/ml) in 12/12 (100%) HCVCI patients, 14/34 (41.2%) HBVCI patients, and 4/28 (14.3%) NAE patients. The median serum NV-F-DNA concentration was 9.3 x 10(5) copies/ml in HCVCI patients, but it was below the detection limit in HBVCI and NAE patients (P values were 0.0045 and 0.0001, respectively). Stepwise multiple regression analysis identified the presence of anti-HCV as an independent factor for NV-F-DNA concentrations (beta = 6.2 x 10(9); P = 0.0245). In HBVCI patients, the NV-F-DNA concentration was inversely correlated with the HBV DNA concentration. The median NV-F-DNA concentration was below the detection limit in patients with HBV DNA concentrations above 1.4 x 10(5) copies/ml, but it was 1.58 x 10(6) copies/ml in patients with HBV DNA concentrations below 1.4 x 10(5) copies/ml (P = 0.030). In conclusion, NV-F-DNA concentrations were higher in HCVCI patients. A reciprocal relationship was found between NV-F-DNA and HBV DNA concentrations in HBVCI patients, indicating the presence of viral interference between these two DNA viruses.
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Affiliation(s)
- Chao-Wei Hsu
- Liver Research Unit, Chang Gung Medical Center, 199, Tung Hwa North Road, Taipei, Taiwan
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Wong RKM, Wai CT. A Bolt Out of the Blue: A Case of Unexpected Acute Liver Failure. ANNALS OF THE ACADEMY OF MEDICINE, SINGAPORE 2006. [DOI: 10.47102/annals-acadmedsg.v35n7p504] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2023]
Abstract
Introduction: We describe an unusual case of acute hepatitis leading rapidly to acute liver failure.
Clinical Picture: Our patient had known chronic hepatitis B with a regenerating nodule confirmed on imaging and histology. He was admitted initially for abdominal discomfort after a trip to China, and investigations showed acute hepatitis with alanine transaminase (ALT) and aspartate transaminase (AST) at 678 and 557 U/L, respectively. Initial differential diagnoses were acute exacerbations of chronic hepatitis B, and viral hepatitis A or E. However, acute Budd-Chiari syndrome was diagnosed on computed tomography (CT) scan of the abdomen, which showed extensive thrombosis of the hepatic vein, all the intrahepatic branches, inferior vena cava, up to the right atrium.
Treatment: Due to the extensive nature of the thrombus, radiological or surgical intervention could not be performed.
Outcome: The patient was managed conservatively but progressed rapidly and died of acute liver failure 16 days after presentation.
Conclusion: Our case highlights the rapidity of progression of acute Budd-Chiari syndrome. Diagnosis and management of Budd-Chiari syndrome are discussed.
Key words: Budd Chiari syndrome, Hepatic vein, Hepatitis B, Liver neoplasm, Thrombosis
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Ke WM, Li XJ, Yu LN, Lai J, Li XH, Gao ZL, Chen PJ. Etiological investigation of fatal liver failure during the course of chronic hepatitis B in southeast China. J Gastroenterol 2006; 41:347-51. [PMID: 16741614 DOI: 10.1007/s00535-005-1781-y] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2005] [Accepted: 11/17/2005] [Indexed: 02/04/2023]
Abstract
BACKGROUND The purpose of this study was to clarify the relationships between patients who had fatal liver failure during the course of chronic hepatitis B and those who were also superinfected with hepatitis A, C, D, or E virus, as well as their hepatitis B virus e system status, so that suitable measures could be adopted to decrease the mortality of patients with chronic hepatitis B. METHODS This study detected superinfections of hepatitis A, C, D, or E virus and the hepatitis B virus e system status in cases of fatal liver failure during the course of chronic hepatitis B by enzyme-lined immunosorbent assay. RESULTS The frequency of superinfections of hepatitis A, C, D, and E virus was 1.4% (4/282), 6.4% (18/282), 1.8% (5/282), and 28.4% (80/282), respectively, overall, 37.9% (107/282). Hepatitis E was prominent and steady in superinfection rates during the past 12 years. In 62.1% (175/282) of patients, the causes of fatal liver failure were not clear. The serological status frequency of HBeAg(+) and anti-HBe(-), HBeAg(-) and anti-HBe(-), and HBeAg(-) and anti-HBe(+) was 20.6% (22/107), 23.4% (25/107), and 56.1% (60/107), respectively, in the group with superinfections of hepatitis A, C, D, or E virus and 31.4% (55/175), 21.1% (37/175), and 47.4% (83/175), respectively, in the group in which causes were not clear. The serological status HBeAg(+) and anti-HBe(-) was more frequent in the group in which causes were not clear than in the group with superinfections of hepatitis A, C, D, or E virus (P < 0.05). Statistically, there were no differences (P > 0.05) between the serological status HBeAg(-), anti-HBe(-) and HBeAg(-), anti-HBe(+) between the two groups. CONCLUSIONS These results suggest that superinfection (107/282) is an important factor in fatal liver failure. The mortality of chronic hepatitis B can be decreased by strict food sanitation and the use of safe blood products. There were no significant relationships between hepatitis B e antigen seroconversion and fatal liver failure during the course of chronic hepatitis B.
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Affiliation(s)
- Wei-Min Ke
- Department of Infectious Diseases, The Third Affiliated Hospital, Sun Yat-Sen University, Shipai, Guangzhou 510630, P. R. China
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Ho TY, Wu SL, Lai IL, Cheng KS, Kao ST, Hsiang CY. An in vitro system combined with an in-house quantitation assay for screening hepatitis C virus inhibitors. Antiviral Res 2003; 58:199-208. [PMID: 12767467 DOI: 10.1016/s0166-3542(03)00004-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Hepatitis C virus (HCV) infection is a serious global health problem. Interferon-alpha (IFN-alpha) and ribavirin have demonstrated efficacy in the treatment of HCV infection; however, these therapies display many side effects. To screen the anti-HCV compounds from plants, we established an in vitro model for inoculation of HCV by centrifugation-facilitated method. The HCV RNA molecules were then quantitated by nested competitive reverse transcription-polymerase chain reaction (cRT-PCR) using fluorescein-labeled primers, and analyzed by ABI Prism 310. The positive and negative strands of HCV RNA were detectable in Vero cells on Day 7 post-infection, suggesting that the HCV RNA was present in the cell model system. The cell culture system was further used to screen the anti-HCV activities of 4 Chinese herbal formulas and 15 formula components. IFN-alpha showed an antiviral effect. The formulas exhibited no anti-HCV activities, while Arnebia euchroma, Thlaspi arvense, and Poncirus trifoliata displayed anti-HCV activities. Therefore, these results pointed out the possibility by using the cell culture system established in this study to screen the herb extracts for their anti-HCV activities.
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Affiliation(s)
- Tin-Yun Ho
- Institute of Chinese Medical Science, China Medical College, ROC, Taichung, Taiwan
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Chu CM, Lin DY, Yeh CT, Sheen IS, Liaw YF. Epidemiological characteristics, risk factors, and clinical manifestations of acute non-A-E hepatitis. J Med Virol 2001; 65:296-300. [PMID: 11536236 DOI: 10.1002/jmv.2033] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
A substantial proportion of acute non-A, non-B hepatitis was of unknown etiology and was termed non-A-E hepatitis. Analysis of the clinical features is needed while attempting to identify the causative agent(s). In this study, the clinical and biochemical features of 53 patients who were admitted to hospital with acute non-A-E hepatitis were compared with a cohort of patients with acute hepatitis C (n = 70) and E (n = 5). In acute non-A-E hepatitis, the sex ratio was 34:19, and ages ranged from 21 to 76 years (median 49). Biochemical tests [median (range)] revealed albumin 3.6 (2.2-4.4) g/dl, AST 714 (193-2311) U/l, ALT 896 (310-3,000) U/l, bilirubin 11.2 (0.9-36.3) mg/dl, and prothrombin time > 1.1 (0-11.5) seconds. No patients reported parenteral exposures or household contact. Forty-five percent had severe hepatitis (i.e., albumin < 3 g/dl, bilirubin > 15 mg/dl or prothrombin time > 3 sec), including 3% with fulminant hepatitis. Chronic evolution was noted in 7%. These features were similar to those of hepatitis C or E, except for a significantly high frequency of parenteral exposures (20%), household contact (16%), and chronicity (70%) in hepatitis C. In conclusion, there is no obvious parenteral risk factor identified in acute non-A-E hepatitis. Clinical severity is similar to that of hepatitis C at least in hospitalized patients, but the rate of chronic evolution is much lower.
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Affiliation(s)
- C M Chu
- Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University, Taipei, Taiwan.
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