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Li H, Huang H, Huang W, Du M, Long D, Xu G, Mei W, Huang K. Hepatitis C virus subtype diversity and transmission clusters characteristics among drug users in Zhuhai, South China. BMC Infect Dis 2024; 24:451. [PMID: 38685009 PMCID: PMC11057121 DOI: 10.1186/s12879-024-09323-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Accepted: 04/15/2024] [Indexed: 05/02/2024] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) infection poses a major public health challenge globally, especially among injecting drug users. China has the world's largest burden of HCV infections. However, little is known about the characteristics of transmission networks among drug user populations. This study aims to investigate the molecular epidemiology and transmission characteristics of HCV infections among drug users in Zhuhai, a bustling port city connecting Mainland China and its Special Administrative Regions. METHODS Participants enrolled in this study were drug users incarcerated at Zhuhai's drug rehabilitation center in 2015. Their sociodemographic and behavioral information, including gender, promiscuity, drug use method, and so forth, was collected using a standardized questionnaire. Plasmas separated from venous blood were analyzed for HCV infection through ELISA and RT-PCR methods to detect anti-HCV antibodies and HCV RNA. The 5'UTR fragment of the HCV genome was amplified and further sequenced for subtype identifications and phylogenetic analysis. The phylogenetic tree was inferred using the Maximum Likelihood method based on the Tamura-Nei model, and the transmission cluster network was constructed using Cytoscape3.8.0 software with a threshold of 0.015. Binary logistic regression models were employed to assess the factors associated with HCV infection. RESULTS The overall prevalence of HCV infection among drug users was 44.37%, with approximately 19.69% appearing to clear the HCV virus successfully. Binary logistic regression analysis revealed that those aged over 40, engaging in injecting drug use, and being native residents were at heightened risk for HCV infection among drug user cohorts. The predominant HCV subtypes circulating among those drug users were 6a (60.26%), followed by 3b (16.7%), 3a (12.8%), 1b (6.41%) and 1a (3.85%), respectively. Molecular transmission network analysis unveiled the presence of six transmission clusters, with the largest propagation cluster consisting of 41 individuals infected with HCV subtype 6a. Furthermore, distinct transmission clusters involved eight individuals infected with subtype 3b and seven with subtype 3a were also observed. CONCLUSION The genetic transmission networks revealed a complex transmission pattern among drug users in Zhuhai, emphasizing the imperative for a targeted and effective intervention strategy to mitigate HCV dissemination. These insights are pivotal for shaping future national policies on HCV screening, treatment, and prevention in port cities.
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Affiliation(s)
- Hongxia Li
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
- School of Public Health, Jinan University, Guangzhou, Guangdong, China
| | - Huitao Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Wenyan Huang
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Man Du
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Dongling Long
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China
| | - Guangxian Xu
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
| | - Wenhua Mei
- Zhuhai Center for Disease Control and Prevention, Zhuhai, Guangdong, China.
- School of Public Health, Jinan University, Guangzhou, Guangdong, China.
| | - Kaisong Huang
- Guangdong Provincial Key Laboratory of Medical Molecular Diagnostics, The First Dongguan Affiliated Hospital, Guangdong Medical University, Dongguan, Guangdong, China.
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Lin Y, Zheng L, Fang K, Zheng Y, Wu J, Zheng M. Proportion of liver cancer cases and deaths attributable to potentially modifiable risk factors in China. Int J Epidemiol 2023; 52:1805-1814. [PMID: 37431632 DOI: 10.1093/ije/dyad100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/04/2022] [Accepted: 06/23/2023] [Indexed: 07/12/2023] Open
Abstract
BACKGROUND Understanding the differences in the burden of liver cancer due to different risk factors across provinces is critical to informing and improving liver cancer prevention and control. In this study, we estimated the population attributable fractions (PAFs) of liver cancer in all 31 provinces of China in 2016. METHODS Prevalence estimates of risk factors were derived from representative surveys. We used pooled relative risks obtained from several recent large-scale pooled analyses or high-quality meta-analyses. We calculated PAFs using multiple formulas which included exposure prevalence and relative risk data stratified by sex, age and province, and then combined and created overall PAFs by sex, risk factors and risk factor groups. RESULTS Approximately 252 046 liver cancer cases {69.5% [95% confidence interval (CI) 52.6, 76.5]} and 212 704 deaths [67.7% (95% CI 50.9, 74.6)] were attributable to modifiable risk factors in China in 2016. The overall PAF for liver cancer was approximately 1.5 times higher in men than in women, with the top three risk factors in men being hepatitis B virus (HBV), smoking and alcohol drinking, whereas in women, they were HBV, excess body weight and hepatitis C virus (HCV). Among the risk factor groups, infectious agents had the highest PAF, followed by behavioural factors and metabolic factors. CONCLUSIONS The PAF for liver cancer caused by modifiable risk factors varies widely among provinces and socioeconomic and geographical regions in China. The use of tailored primary prevention strategies across provinces and socioeconomic and geographical regions has great potential to reduce the burden and disparities of liver cancer.
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Affiliation(s)
- Yushi Lin
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Luyan Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Kailu Fang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Yang Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
- Department of General Practice, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Jie Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
| | - Min Zheng
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, National Clinical Research Center for Infectious Diseases, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, First Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, China
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Kamga Wouambo R, Panka Tchinda G, Kagoue Simeni LA, Djouela Djoulako PD, Yateu Wouambo CI, Tamko Mella GF, Tchoumi Leuwat EP, Bello D, Fokam J. Anti-hepatitis C antibody carriage and risk of liver impairment in rural-Cameroon: adapting the control of hepatocellular carcinoma for resource-limited settings. BMC Infect Dis 2023; 23:875. [PMID: 38093205 PMCID: PMC10717920 DOI: 10.1186/s12879-023-08880-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 12/07/2023] [Indexed: 12/17/2023] Open
Abstract
BACKGROUND The Viral hepatitis elimination by 2030 is uncertain in resource-limited settings (RLS), due to high burdens and poor diagnostic coverage. This sounds more challenging for hepatitis C virus (HCV) given that antibody (HCVAb) sero-positivity still lacks wide access to HCV RNA molecular testing. This warrants context-specific strategies for appropriate management of liver impairment in RLS. We herein determine the association between anti-HCV positivity and liver impairment in an African RLS. METHODS A facility-based observational study was conducted from July-August 2021 among individuals attending the "St Monique" Health Center at Ottou, a rural community of Yaounde,Cameroon. Following a consecutive sampling, consenting individuals were tested for anti-HCV antibodies, hepatitis B surface antigen (HBsAg) and HIV antibodies (HIVAb) as per the national guidelines. After excluding positive cases for HBsAg and/or HIVAb, liver function tests (ALT/AST) were performed on eligible participants (HBsAg and HIVAb negative) and outcomes were compared according to HCVAb status; with p < 0.05 considered statistically significant. RESULTS Out of 306 eligible participants (negative for HBsAg and HIVAb) enrolled, the mean age was 34.35 ± 3.67 years. 252(82.35%) were female and 129 (42.17%) were single. The overall HCVAb sero-positivity was 15.68%(48/306), with 17.86% (45/252) among women vs. 5.55%(3/54) among men [OR (95%CI) = 3.69(2.11-9.29),p = 0.04]. HCVAb Carriage was greater among participants aged > 50 years compared to younger ones [38.46%(15/39) versus 12.36% (33/267) respectively, OR(95%CI) = 4.43(2.11-9.29), p < 0.000] and in multipartnership [26.67%(12/45)vs.13.79%(36/261) monopartnership, OR (95%CI) = 2.27(1.07-4.80),p = 0.03]. The liver impairment rate (abnormal ALT+AST levels) was 30.39%(93/306), with 40.19%(123/306) of abnormal ALT alone. Moreover, the burden of Liver impairment was significantly with aged> 50 versus younger ones [69.23% (27/39) versus 24.72%(66/267) respectively, p < 0.000). Interestingly, the burden of liver impairment (abnormal AST + ALAT) was significantly higher in HCVAb positive (62.5%, 30/48) versus HCVAb negative (24.42%, 63/258) participants, OR: 3.90 [1.96; 7.79], p = 0.0001. CONCLUSIONS In this rural health facility, HCVAb is highly endemic and the burden of liver impairment is concerning. Interestingly, HCVAb carriage is associated with abnormal liver levels of enzyme (ALT/AST), especially among the elderly populations. Hence, in the absence of nuclei acid testing, ALT/AST are relevant sentinel markers to screen HCVAb carriers who require monitoring/care for HCV-associated hepatocellular carcinoma in RLS.
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Affiliation(s)
- Rodrigue Kamga Wouambo
- Faculty of Science, Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon.
- American Society for Microbiology (ASM), ASM Cameroon, Bangangte, Cameroon.
| | - Gaelle Panka Tchinda
- American Society for Microbiology (ASM), ASM Cameroon, Bangangte, Cameroon
- Ecole de Santé Publique, Université Libre de Bruxelles, Bruxelles, Belgium
| | - Luc Aime Kagoue Simeni
- American Society for Microbiology (ASM), ASM Cameroon, Bangangte, Cameroon
- Department of Microbiology, Faculty of Health Science, University of Buea, Buea, Cameroon
| | - Paule Dana Djouela Djoulako
- American Society for Microbiology (ASM), ASM Cameroon, Bangangte, Cameroon
- Faculty of Medicine, Sorbonne University, Paris, France
| | | | - Ghislaine Flore Tamko Mella
- Laboratory of Fundamental Virology, Centre for Research on Emerging and Reemerging Diseases (CREMER), Yaounde, Cameroon
| | | | - Djoda Bello
- Faculty of Science, Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
| | - Joseph Fokam
- Faculty of Health Sciences, University of Buea, Buea, Cameroon
- Virology Laboratory, Chantal BIYA International Reference Centre for Research on HIV/AIDS Prevention and Management (CIRCB), Yaounde, Cameroon
- Faculty of Medicine and Biomedical Sciences, University of Yaounde I, Yaounde, Cameroon
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Liu Y, Su J, Wang X, Xu H, Wang H, Kang R, Zheng L, Wang Y, Liu C, Jing Y, Zhang S. Hepatitis C Knowledge and Self-Reported Testing Behavior in the General Population in China: Online Cross-Sectional Survey. JMIR Public Health Surveill 2023; 9:e39472. [PMID: 38079213 PMCID: PMC10760629 DOI: 10.2196/39472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2022] [Revised: 08/08/2023] [Accepted: 11/09/2023] [Indexed: 12/18/2023] Open
Abstract
BACKGROUND The World Health Organization has proposed a worldwide target of eliminating hepatitis C virus (HCV) by 2030. A better understanding of HCV, testing behaviors, and associated factors in the general population is essential. OBJECTIVE This study aimed to assess HCV knowledge, self-reported HCV testing behavior, and willingness to undergo HCV screening in the general Chinese population. METHODS A cross-sectional online survey of the general Chinese population aged ≥15 years was conducted from November 2021 to May 2023. Participant characteristics were assessed based on their knowledge level and uptake of HCV testing. Participants ever having heard of HCV were recognized as being aware of HCV and asked additional HCV knowledge questions using a brief, validated 9-item scale. Participants with 0-3 points and who were unaware of HCV were categorized as having poor knowledge, and those with 4-6 points and 7 points were categorized as having fair and good knowledge, respectively. Participant uptake of HCV testing, testing results, reasons for undergoing or not undergoing HCV testing, and willingness to undergo HCV screening were collected through self-reports. Ordinal and binary logistic regression analyses were used to assess factors associated with the HCV knowledge level and the uptake of HCV testing, respectively. RESULTS A total of 1491 valid participants' questionnaires were included. Of these, 714 (47.6%) participants were aware of HCV. The proportion of participants with poor, fair, and good HCV knowledge was 63.4% (945/1491), 9.3% (139/1491), and 27.3% (407/1491), respectively. A total of 465 (31.2%) participants reported ever undergoing HCV testing, and 4 (0.9%) were anti-HCV antibody positive. Most participants were tested for HCV following blood donation (353/465, 75.9%). The most common reasons for not undergoing HCV screening were a lack of HCV awareness (665/1026, 64.8%), followed by a low self-perceived risk of infection (176/1026, 17.2%). Of 1026 participants who had never undergone HCV testing, 937 (91.3%) were willing to undergo HCV screening if universal screening was provided at no cost. The HCV knowledge level was positively associated with the HCV testing rate. Participants who were less educated, lived in rural areas, resided in West China, and were currently alcohol drinkers had lower HCV knowledge and reduced odds of having undergone HCV testing. In contrast, participants with a blood donation history and a family history of hepatitis B virus or HCV infection had higher HCV knowledge and increased odds of prior testing. Participants aged ≥60 years had lower knowledge, and women had reduced odds of having undergone previous HCV testing. CONCLUSIONS The general population of China has low HCV knowledge and testing rate. There is an urgent need for enhanced HCV awareness and scaled-up HCV screening and treatment. Individuals who are less well educated, reside in less-developed areas, currently drink alcohol, and are female should be prioritized for health education and interventions.
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Affiliation(s)
- Yin Liu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Juan Su
- Yinchuan Hospital of Stomatology, Yinchuan, China
| | - Xiaoyang Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Huifang Xu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Hong Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Ruihua Kang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Liyang Zheng
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Yixian Wang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Chunya Liu
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Yiping Jing
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
| | - Shaokai Zhang
- Department of Cancer Epidemiology, The Affiliated Cancer Hospital of Zhengzhou University (Henan Cancer Hospital), Zhengzhou, China
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Zhang Y, Li J, Xie Y, Wu D, Ong J, Marley G, Kamarulzaman A, Lu H, Zou F, Smith JS, Tucker JD, Fu G, Tang W. Pay-it-forward incentives for hepatitis virus testing in men who have sex with men: a cluster randomized trial. Nat Med 2023; 29:2241-2247. [PMID: 37640859 DOI: 10.1038/s41591-023-02519-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Accepted: 07/28/2023] [Indexed: 08/31/2023]
Abstract
Pay-it-forward incentives involve having a person receive a free test with community-generated messages and then asking if those who received a free test would like to donate money to support others to receive free testing. Here we undertook a two-arm cluster-randomized trial to evaluate pay-it-forward incentives with active community participation to promote hepatitis B virus (HBV) and hepatitis C virus (HCV) testing among men who have sex with men in China. Men randomized to the pay-it-forward arm received free HBV and HCV testing and were offered a chance to pay-it-forward by donating money to support the testing of another anonymous person. Each participant paid for their HCV and HBV test at 7.7 USD per test in the standard-of-care arm. The primary outcome was the proportion of men who tested for HBV and HCV. Between 28 March and 6 November 2021, 32 groups (10 men per group) of men were randomized to the pay-it-forward (n = 160, 16 clusters) and standard-of-care (n = 162, 16 clusters) arms, respectively. HBV and HCV rapid testing were higher in the pay-it-forward arm (59.4%) than in the standard-of-care arm (25.3%) (proportion difference 35.2%, 95% confidence interval 24.1-46.3%). No adverse events were reported. The community-led pay-it-forward incentives improved HBV and HCV testing among men who have sex with men. Clinical Trial registration: ChiCTR 2100046140.
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Affiliation(s)
- Ye Zhang
- Kirby Institute, UNSW Sydney, Sydney, New South Wales, Australia
- School of Public Health, Nanjing Medical University, Nanjing, China
| | - Jianjun Li
- Department of HIV/STI Prevention and Control, Jiangsu Provincial Center for Diseases Prevention and Control, Nanjing, China
| | - Yewei Xie
- University of North Carolina Project-China, Guangzhou, China
| | - Dan Wu
- School of Public Health, Nanjing Medical University, Nanjing, China
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Jason Ong
- Central Clinical School, Monash University, Melbourne, Victoria, Australia
- Melbourne Sexual Health Centre, Alfred Health, Carlton, Victoria, Australia
| | - Gifty Marley
- University of North Carolina Project-China, Guangzhou, China
| | - Adeeba Kamarulzaman
- University of Malaysia, Kuala Lumpur, Malaysia
- International AIDS Society, Geneva, Switzerland
| | - Haidong Lu
- Department of Epidemiology of Microbial Diseases, Yale School of Public Health, Yale University, New Haven, CT, USA
| | - Fei Zou
- Department of Biostatistics, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Jennifer S Smith
- Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina, Chapel Hill, NC, USA
| | - Joseph D Tucker
- University of North Carolina Project-China, Guangzhou, China
- Clinical Research Department, Faculty of Infectious and Tropical Diseases, London School of Hygiene and Tropical Medicine, London, UK
| | - Gengfeng Fu
- Department of HIV/STI Prevention and Control, Jiangsu Provincial Center for Diseases Prevention and Control, Nanjing, China.
| | - Weiming Tang
- University of North Carolina Project-China, Guangzhou, China.
- Guangdong Second Provincial General Hospital, Guangzhou, China.
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Niu B, Zang W, Zhou H, Mi Y, Lu C, Li P. Regression in hepatic fibrosis in elderly Chinese patients with hepatitis C receiving direct-acting antiviral treatment. BMC Gastroenterol 2023; 23:102. [PMID: 37013471 PMCID: PMC10069046 DOI: 10.1186/s12876-023-02732-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/20/2023] [Indexed: 04/05/2023] Open
Abstract
BACKGROUND Patients infected with Hepatitis C virus (HCV) are recommended to receive treatment with direct-acting antiviral agents (DAAs), which have been certified to obtain a high sustained virological response (SVR). However, little is known about the benefits of successful anti-viral treatment to elderly patients with hepatic fibrosis. In this study, we aimed to assess degree of fibrosis in elderly patients with chronic hepatitis C (CHC) treated with DAAs, and to evaluate the correlations between identified factors associated with these changes. METHODS This study retrospectively enrolled elderly patients with CHC who received DAAs in Tianjin Second People's Hospital from April 2018 to April 2021. The degree of liver fibrosis was assessed using serum biomarkers and transient elastography (TE) expressed as the liver stiffness (LSM), while the hepatic steatosis was evaluated by controlled attenuated parameter (CAP). Changes in factors related to hepatic fibrosis were examined following treatment with DAAs, and associated prognostic factors were further evaluated. RESULTS We included 347 CHC patients in our analysis, where 127 of these were elderly patients. For the elderly group, the median LSM was 11.6 (7.9-19.9) kPa, and this value was significantly reduced to 9.7 (6.2-16.6) kPa following DAA treatment. Similarly, GPR, FIB-4 and APRI indices were significantly reduced from 0.445 (0.275-1.022), 3.072 (2.047-5.129) and 0.833 (0.430-1.540) to 0.231 (0.155-0.412), 2.100 (1.540-3.034) and 0.336 (0.235-0.528), respectively. While in younger patients, the median LSM reduced from 8.8 (6.1-16.8) kPa to 7.2 (5.3-12.4) kPa, and the trends of GPR, FIB-4 and APRI were also consistent. The CAP in younger patients increased with statistical significance, but we did not observe any significant change in CAP for the elderly group. Based on multivariate analysis, age, LSM, and CAP before baseline were identified as determinants for LSM improvement in the elderly. CONCLUSION In this study, we found that elderly CHC patients treated with DAA had significantly lower LSM, GPR, FIB-4, and APRI values. DAA treatment did not significantly change CAP. Furthermore, we observed correlations between three noninvasive serological evaluation markers and LSM. Finally, age, LSM, and CAP were identified as independent predictors of fibrosis regression in elderly patients with CHC.
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Affiliation(s)
- Bin Niu
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, 300192, China
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Wenqian Zang
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Hui Zhou
- Clinical School of the Second People's Hospital, Tianjin Medical University, Tianjin, 300192, China
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, China
| | - Yuqiang Mi
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, China
- Tianjin Research Institute of Liver Diseases, Tianjin, 300192, China
| | - Chengzhen Lu
- Tianjin Research Institute of Liver Diseases, Tianjin, 300192, China
| | - Ping Li
- Department of Hepatology, Tianjin Second People's Hospital, Tianjin, 300192, China.
- Tianjin Research Institute of Liver Diseases, Tianjin, 300192, China.
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Association of Accelerometer-Measured Sedentary Behavior Patterns With Nonalcoholic Fatty Liver Disease Among Older Adults: The MIND-China Study. Am J Gastroenterol 2023; 118:569-573. [PMID: 36621973 DOI: 10.14309/ajg.0000000000002135] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Accepted: 11/29/2022] [Indexed: 01/10/2023]
Abstract
INTRODUCTION The relationships between sedentary behavior patterns and nonalcoholic fatty liver disease (NAFLD) in older adults are not well investigated. METHODS This population-based study included 1,899 rural-dwelling adults (aged 60 years or older). We assessed sedentary parameters with ActiGraph and defined NAFLD using ultrasonography. RESULTS Long total and prolonged sedentary time were associated with increased likelihoods of NAFLD, whereas engaging more breaks per sedentary hour and reallocating sedentary time to light-intensity physical activity were associated with reduced likelihoods of NAFLD (P linear <0.05). DISCUSSION Shorter sedentary time, engaging more frequent breaks in sedentary behavior, and replacing sedentary time with physical activity are associated with reduced likelihoods of NAFLD in older adults.
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Bao K, Chen J, Liu R, Xiang Y, Gao W. Prevalence of HCV Infection Among Hemodialysis Patients in Lanzhou of Northwestern China. Infect Drug Resist 2022; 15:5609-5617. [PMID: 36172622 PMCID: PMC9512538 DOI: 10.2147/idr.s378600] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 09/15/2022] [Indexed: 11/23/2022] Open
Abstract
Objective To investigate the prevalence of hepatitis C virus (HCV) infection among hemodialysis (HD) patients in Lanzhou of Northwestern China, we interviewed 565 patients from five randomly sampled HD centers in Lanzhou with a structured questionnaire including sociodemographic characteristics, past medical history and HD-related factors. Methods The testing results of anti-HCV and HCV-RNA in a recent HD from clinical information system were collected. A generalized estimated equation (GEE) logistic regression model was used to identify the determinants of HCV infection among HD patients. Results The prevalence of anti-HCV or HCV-RNA infection among HD patients was 1.77% or 1.42% respectively. GEE model showed that history of kidney transplantation (HCV-RNA: OR=19.79, 95%CI: 12.69–30.85) could dramatically increase the risk of current HCV infection in dialysis patients. Compared with never using of blood products, using of blood products (anti-HCV: OR=2.38, 95%CI: 1.22–4.64; HCV-RNA: OR=15.23, 95%CI: 1.79–129.49) could increase the risk of HCV infection in dialysis patients. Moreover, with the increase of HD duration, the risk increased one time or so (anti-HCV: OR=1.83, 95%CI: 1.22–2.72; HCV-RNA: OR=2.00, 95%CI: 1.11–3.61). Furthermore, dialysis in multiple hospitals possessed more than three times risk of HCV infection (anti-HCV: OR=3.56, 95%CI: 3.11–4.08; HCV-RNA: OR=3.35, 95%CI: 1.88–5.96). Besides, HD patients having the history of acupuncture (HCV-RNA: OR=5.56; 95%CI: 1.16–26.67) or surgery (HCV-RNA: OR=6.39; 95%CI: 2.86–14.29) caused an about-six-times risk of current infections. Conclusion It could be concluded that the prevalence of HCV infection was mild and using of blood products or kidney transplantation, long dialysis duration, dialysis in multiple hospitals, surgery or acupuncture treatment were some risk factors of HCV infection among HD patients in Lanzhou of Northwestern China.
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Affiliation(s)
- Kai Bao
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Jijun Chen
- STD and AIDS Prevention and Control Institute, Lanzhou Municipal Center for Disease Control and Prevention, Lanzhou, Gansu, People's Republic of China
| | - Ruifang Liu
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China.,Department of Science and Education, Xi'an No. 5 Hospital, Xi'an, Shanxi, People's Republic of China
| | - Yuanyuan Xiang
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China
| | - Wenlong Gao
- Institution of Epidemiology and Health Statistics, School of Public Health, Lanzhou University, Lanzhou, Gansu, People's Republic of China
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Zhang CH, Cheng Y, Zhang S, Fan J, Gao Q. Changing epidemiology of hepatocellular carcinoma in Asia. Liver Int 2022; 42:2029-2041. [PMID: 35319165 DOI: 10.1111/liv.15251] [Citation(s) in RCA: 93] [Impact Index Per Article: 46.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 12/06/2021] [Accepted: 03/19/2022] [Indexed: 12/24/2022]
Abstract
Liver cancer is the fifth most common cancer and the second leading cause of malignant death in Asia, and Asia reports 72.5% of the world's cases in 2020. As the most common histological type, hepatocellular carcinoma (HCC) accounts for the majority of incidence and mortality of liver cancer cases. This review presents the changing epidemiology of HCC in Asian countries in recent years. Globally, aged, male and Asian populations remain the group with the highest risk of HCC. Hepatitis B virus (HBV) and hepatitis C virus (HCV) are still the leading risk factors of HCC with a slight decline in most Asian countries, which is mainly attributed to HBV vaccination of newborns, prevention of HCV horizontal transmission and treatment of chronic hepatitis. However, the prevalence of HCC caused by metabolic factors, including metabolic syndrome, obesity and non-alcoholic fatty liver diseases, is increasing rapidly in Asian countries, which may eventually become the major cause of HCC. Excessive alcohol consumption continues to be an important risk factor as the average consumption of alcohol is still growing. Hopefully, great effort has been made to better prevention and treatment of HCC in most Asian regions, which significantly prolongs the survival of HCC patients. Asian countries tend to use more aggressive intervention than European and American countries, but it remains unclear whether this preference is related to a better prognosis. In conclusion, HCC remains a major disease burden in Asia, and the management of HCC should be adjusted dynamically based on the changing epidemiology.
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Affiliation(s)
- Chen-Hao Zhang
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Yifei Cheng
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Shu Zhang
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Jia Fan
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China
| | - Qiang Gao
- Liver Cancer Institute, Zhongshan Hospital, and Key Laboratory of Carcinogenesis and Cancer Invasion (Ministry of Education), Fudan University, Shanghai, China.,Key Laboratory of Medical Epigenetics and Metabolism, Institutes of Biomedical Sciences, Fudan University, Shanghai, China.,State Key Laboratory of Genetic Engineering, Fudan University, Shanghai, China
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10
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Liu CJ, Chen PJ. Changing epidemiology of liver disease in Asia: Dual infection of HBV and HCV. Liver Int 2022; 42:1945-1954. [PMID: 34402183 DOI: 10.1111/liv.15040] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 07/23/2021] [Accepted: 08/11/2021] [Indexed: 12/26/2022]
Abstract
Transmission of hepatitis B virus (HBV) and hepatitis C virus (HCV) is similar regarding the mode of transmission and related risk factors. Therefore, it is not rare to encounter dual HBV/HCV infection in populations at risk of parenteral exposure to hepatitis viruses. Besides, in HBV endemic countries before the era of global HBV vaccination, dual HBV/HCV infection was clinically significant likely because of HCV superinfection over pre-existing HBsAg carriage. Universal childhood HBV vaccination was implemented worldwide since 1992. Public education programs for prevention of new hepatitis viral infections have been actively promoted recently by World Health Organization. Apart from preventive measures, potent anti-HBV agents effective in the control of viral replication have been introduced gradually in the past three decades. Direct acting antiviral agents capable of curing HCV infection in more than 97% of patients with chronic hepatitis C have also been widely implemented in the past decade. These interventions will change the epidemiology of new HBV or HCV mono-infection and dual HBV/HCV infection. Understanding the evolution in the epidemiology of dual HBV/HCV infection is important for evaluation of current public health policy towards infectious disease control in different countries. The changing prevalence of dual HBV/HCV infection in certain Asia-Pacific countries will be re-visited based on endemicity of HBV or HCV, as well as in populations at risk of parenteral viral infection.
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Affiliation(s)
- Chun-Jen Liu
- Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
| | - Pei-Jer Chen
- Department of Internal Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan.,Hepatitis Research Center, National Taiwan University College of Medicine and National Taiwan University Hospital, Taipei, Taiwan
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11
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Marley G, Seto WK, Yan W, Chan P, Tucker JD, Tang W, Wong WCW. What facilitates hepatitis B and hepatitis C testing and the role of stigma among primary care patients in China? J Viral Hepat 2022; 29:637-645. [PMID: 35633086 DOI: 10.1111/jvh.13711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2022] [Revised: 04/23/2022] [Accepted: 05/04/2022] [Indexed: 01/13/2023]
Abstract
Approximately 80% of primary healthcare facilities in China were ready to deliver hepatitis care services by 2021. This study aimed to assess hepatitis B and C test uptake, identify the factors associated with testing and determine the predictors of hepatitis stigma among primary care patients. We conducted a cross-sectional survey among patients seeking care in the family medicine and primary care unit of the University of Hong Kong-Shenzhen Hospital, China. Participants were 30 years or older and had not tested for HBV and HCV in the preceding 12 months. Test uptake was defined as self-reported previous HBV and HCV testing. Descriptive statistics, Chi-square test, forward multivariable logistic regression and stepwise multiple linear regression were conducted, and a p-value <.05 was deemed statistically significant. A total of 750 eligible patients completed the survey, and 54.5% (404 ± 0.9) were between 30 and 40 years old. Most participants were heterosexuals 98.0% (n = 735), female 57.5% (n = 431), married 78.3% (587) and earned ≤1500 USD per month 54.4% (n = 408). A 66.1% (n = 496) and 13.7% (n = 103) self-reported previous HBV and HCV testing, respectively, and 62% (n = 468) were vaccinated. HCV testing was associated with HBV testing (aOR = 13.7, 95% CI:2.1-91.5); and HBV testing was associated with family history of HBV (aOR = 2.4, 95%CI:1.1-5.5). Overall hepatitis stigma was about average and decreased with family history of HBV (p = .017). In conclusion, HCV testing uptake among primary care patients was low and needs to be further promoted. Integrating HBV and HCV testing interventions and fostering family-based support for disclosure could effectively improve testing uptake.
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Affiliation(s)
- Gifty Marley
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), Guangzhou, China
| | - Wai-Kay Seto
- Department of Medicine, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China.,Department of Medicine and State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China
| | - Weihui Yan
- Department of Family Medicine & Primary Care, The University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - Polin Chan
- World Health Organization Western Pacific Regional Office, Manila, The Philippines
| | - Joseph D Tucker
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA.,Faculty of Infectious and Tropical Diseases, LSHTM, London, UK
| | - Weiming Tang
- The University of North Carolina Project-China, Global Health Center Office, Guangzhou, China.,Social Entrepreneurship to Spur Health (SESH), Guangzhou, China.,Institute of Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, North Carolina, USA
| | - William C W Wong
- Department of Family Medicine & Primary Care, School of Clinical Medicine, Li Ka Shing Faculty Medicine, The University of Hong Kong, Hong Kong, China
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12
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Su R, Dong L, Wang Y, Sa R, Wang Y. Distribution of hepatitis C virus genotype and subtype between Mongolian and Han in Inner Mongolia. Medicine (Baltimore) 2022; 101:e29545. [PMID: 35839017 PMCID: PMC11132397 DOI: 10.1097/md.0000000000029545] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/20/2022] [Indexed: 11/26/2022] Open
Abstract
Hepatitis C is a serious infectious disease caused by the hepatitis C virus (HCV). HCV genotypes (GT) and subtypes are closely related to geographical distribution. Studies on the distribution of HCV genotypes can help to understand the regional epidemiology and genotype distribution and provide benefits in the treatment for hepatitis C. To provide information about the distribution of HCV genotypes as well as improved prevention and treatment of hepatitis C, we aimed to classify the distribution of HCV genotypes among Mongolian and Han patients with hepatitis C in Inner Mongolia over the past 5 years. Peripheral blood samples of patients with HCV were collected for gene sequencing. To analyze the HCV genotype distribution and possible influencing factors, we determined the viral load and ratios of various genotypes. We found that the most prevalent genotype in Inner Mongolia was 1b, followed by GT2a, GT3a, GT3b, and GT6a. The prevalence of HCV among Mongolian patients was significantly higher than the prevalence in their Han counterparts (χ2 = 16.64, P = .000). There was no significant difference in viral load according to sex among HCV genotypes. However, the viral load of GT 1b was significantly higher than that of GT 2a (F = 3.51, P = .008). The viral load of GT 1b among ethnic Mongolians was significantly higher than that among Han patients (t = 2.28, P = .044). The present study's findings can serve as a basis for developing a personalized treatment for hepatitis C among patients in Inner Mongolia.
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Affiliation(s)
- Ruijun Su
- Clinic Laboratory of the Affiliated Hospital of Inner Mongolia Medical University, Huimin district, Hohhot, P.R. China
| | - Li Dong
- Clinic Laboratory of the Affiliated Hospital of Inner Mongolia Medical University, Huimin district, Hohhot, P.R. China
| | - Yongxiang Wang
- Clinic Laboratory of the Affiliated Hospital of Inner Mongolia Medical University, Huimin district, Hohhot, P.R. China
| | - Renna Sa
- Clinic Laboratory of the Affiliated Hospital of Inner Mongolia Medical University, Huimin district, Hohhot, P.R. China
| | - Yafei Wang
- Clinic Laboratory of the Affiliated Hospital of Inner Mongolia Medical University, Huimin district, Hohhot, P.R. China
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13
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Zhang S, Cheng S, He X, Wang W, Yun K, Man D, Ding H, Li P, Chu Z, Yang X, Shang H, Han X. Remnant Lipoprotein Cholesterol as a Factor Related to Adult Fatty Liver Disease. J Clin Endocrinol Metab 2022; 107:e1598-e1609. [PMID: 34875070 DOI: 10.1210/clinem/dgab825] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/07/2021] [Indexed: 12/25/2022]
Abstract
CONTEXT Dyslipidemia is related to fatty liver disease (FLD), whose relationship with remnant lipoprotein cholesterol (RLP-C), a component of blood lipids, remains unclear. OBJECTIVE To clarify the correlation between RLP-C and the occurrence and severity of FLD and establish an FLD discriminant model based on health check indicators. METHODS Retrospective study of participants who underwent health check-up in the First Affiliated Hospital of China Medical University (Shenyang, China) between January and December 2019. We categorized participants according to liver ultrasound results and analyzed the correlation between RLP-C and occurrence of FLD (n = 38 885) through logistic regression, restricted cubic spline, and receiver operating characteristic curve. We categorized the severity of FLD according to the control attenuation parameter and analyzed the correlation between RLP-C and FLD severity through multiple logistic regression; only males were included (n = 564). RESULTS The adjusted OR (aOR) per SD between RLP-C and FLD was 2.33 (95% CI 2.21-2.46, P < .001), indicating a dose-response relationship (P < .0001). The optimal cut-off value of RLP-C was 0.45 mmol/L and the area under the curve (AUC) was 0.79. The AUC of the 8-variable model was 0.89 in both the training and the validation sets. FLD severity was related to the level of RLP-C (aOR per SD = 1.29, 95% CI 1.07-1.55, P = .008). CONCLUSION RLP-C has a strong positive correlation with FLD occurrence and FLD severity. These results may help clinicians identify and implement interventions in individuals with high FLD risk and reduce FLD prevalence.
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Affiliation(s)
- Shuang Zhang
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
- Units of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
| | - Shitong Cheng
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Xue He
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Wei Wang
- Medical examination center, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Ke Yun
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
| | - Dongliang Man
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Haibo Ding
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- Units of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
| | - Ping Li
- Department of ultrasound, the First Affiliated Hospital of China Medical University, Shenyang, China
| | - Zhenxing Chu
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- Units of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
| | - Xiaotao Yang
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
| | - Hong Shang
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
- Units of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
| | - Xiaoxu Han
- National Clinical Research Center for Laboratory Medicine, The First Affiliated Hospital of China Medical University, Shenyang, China
- Department of Laboratory Medicine, the First Affiliated Hospital of China Medical University, Shenyang, China
- Units of Medical Laboratory, Chinese Academy of Medical Sciences, Shenyang, China
- NHC Key Laboratory of AIDS Immunology (China Medical University), Shenyang, China
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14
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Jia J, Zhu Q, Deng L, Lan G, Johnson A, Chen H, Shen Z, Li J, Xing H, Ruan Y, Li J, Lu H, Vermund SH, Zhu J, Qian HZ. Treatment outcomes of HIV patients with hepatitis B and C virus co-infections in Southwest China: an observational cohort study. Infect Dis Poverty 2022; 11:7. [PMID: 34986877 PMCID: PMC8734096 DOI: 10.1186/s40249-021-00921-5] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Accepted: 12/15/2021] [Indexed: 01/19/2023] Open
Abstract
Background Antiretroviral therapy (ART) has reduced mortality among people living with HIV (PLWH) in China, but co-infections of hepatitis B virus (HBV) and hepatitis C virus (HCV) may individually or jointly reduce the effect of ART. This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART. Methods A retrospective cohort study analysis of 58 239 people living with HIV (PLWH) who initiated antiretroviral therapy (ART) during 2010–2018 was conducted in Guangxi Province, China. Data were from the observational database of the National Free Antiretroviral Treatment Program. Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH. Results Our study showed high prevalence of HBV (11.5%), HCV (6.6%) and HBV-HCV (1.5%) co-infections. The overall mortality rate and treatment attrition rate was 2.95 [95% confidence interval (CI) 2.88–3.02] and 5.92 (95% CI 5.82–6.01) per 100 person-years, respectively. Compared with HIV-only patients, HBV-co-infected patients had 42% higher mortality [adjusted hazard ratio (aHR) = 1.42; 95% CI 1.32–1.54], HCV-co-infected patients had 65% higher mortality (aHR = 1.65; 95% CI 1.47–1.86), and patients with both HCV and HBV co-infections had 123% higher mortality (aHR = 2.23; 95% CI 1.87–2.66). Conclusions HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART. It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH. Graphical Abstract ![]()
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Affiliation(s)
- Jingya Jia
- SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University, Shanghai, China.,Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Qiuying Zhu
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Luojia Deng
- Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Guanghua Lan
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | | | - Huanhuan Chen
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Zhiyong Shen
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Jianjun Li
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China
| | - Hui Xing
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.,State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Yuhua Ruan
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.,State Key Laboratory of Infectious Disease Prevention and Control (SKLID), Chinese Center for Disease Control and Prevention (China CDC), Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Beijing, China
| | - Jing Li
- SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University, Shanghai, China.,Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Hui Lu
- SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University, Shanghai, China.,Department of Bioinformatics and Biostatistics, School of Life Sciences and Biotechnology, Shanghai Jiao Tong University, Shanghai, China
| | - Sten H Vermund
- School of Public Health, Yale University, New Haven, CT, USA
| | - Jinhui Zhu
- Guangxi Key Laboratory of Major Infectious Disease Prevention Control and Biosafety Emergency Response, Guangxi Center for Disease Control and Prevention, Nanning, China.
| | - Han-Zhu Qian
- SJTU-Yale Joint Center for Biostatistics and Data Science, Shanghai Jiao Tong University, Shanghai, China. .,School of Public Health, Yale University, New Haven, CT, USA.
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15
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Mei X, Lu H. Prevalence, diagnosis, and treatment of hepatitis C in Mainland China. Glob Health Med 2021; 3:270-275. [PMID: 34782868 DOI: 10.35772/ghm.2021.01080] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2021] [Revised: 09/30/2021] [Accepted: 10/08/2021] [Indexed: 12/13/2022]
Abstract
Infection with the hepatitis C virus (HCV) is a major cause of liver disease and hepatocellular carcinoma in China. Rapid economic development has had an enormous impact on the epidemiology and treatment of hepatitis C. The prevalence of anti-HCV antibodies in Mainland China is approximately 0.91%, and use of injected drugs has become the main route of HCV transmission in China. Reimbursement for 3 direct-acting antivirals (DAAs) has been approved by the National Medical Insurance scheme in China, which ensures the accessibility of treatment for an HCV infection. To improve the awareness of treatments for hepatitis C among medical personnel and the rate of in-hospital screening for HCV, the Chinese Medical Association has formulated guidelines for the diagnosis and treatment of hepatitis C and a process of in-hospital screening for hepatitis C in China. These efforts have standardized the screening, diagnosis, treatment, and management of hepatitis C. Based on the international strategy for micro-elimination of hepatitis C, China has also screened and treated groups at risk of hepatitis C infection, and this has reduced the number of the infected. The current review describes the status of and issues with the prevalence, diagnosis, and treatment of hepatitis C in Mainland China as part of the global effort to eliminate viral hepatitis by 2030.
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Affiliation(s)
- Xue Mei
- Department of Severe Hepatology, Shanghai Public Health Clinical Center, Fudan University, Shanghai, China
| | - Hongzhou Lu
- Department of Infections Disease, Shenzhen Third People's Hospital, Shenzhen, China
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16
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Im PK, Millwood IY, Kartsonaki C, Guo Y, Chen Y, Turnbull I, Yu C, Du H, Pei P, Lv J, Walters RG, Li L, Yang L, Chen Z. Alcohol drinking and risks of liver cancer and non-neoplastic chronic liver diseases in China: a 10-year prospective study of 0.5 million adults. BMC Med 2021; 19:216. [PMID: 34530818 PMCID: PMC8447782 DOI: 10.1186/s12916-021-02079-1] [Citation(s) in RCA: 19] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2021] [Accepted: 07/28/2021] [Indexed: 12/20/2022] Open
Abstract
BACKGROUND Alcohol consumption is an important risk factor for hepatic neoplastic and non-neoplastic diseases. Questions remain, however, about the relevance to disease risk of drinking patterns and alcohol tolerability, which differ appreciably between Chinese and Western populations. METHODS The prospective China Kadoorie Biobank included 512,715 adults (41% men) aged 30-79 years recruited from ten areas during 2004-2008, recording alcohol intake, drinking patterns, and other characteristics. After median 10 years' follow-up, 2531 incident liver cancer, 2040 liver cirrhosis, 260 alcoholic liver disease (ALD), and 1262 non-alcoholic fatty liver disease (NAFLD) cases were recorded among 492,643 participants without prior cancer or chronic liver disease at baseline. Cox regression was used to estimate adjusted hazard ratios (HR) relating alcohol intake and drinking patterns to each disease. RESULTS Overall, 33% of men and 2% of women drank alcohol regularly (i.e. at least weekly) at baseline. Among male current regular drinkers, alcohol consumption showed positive dose-response associations with risks of several major chronic liver diseases, with HRs per 280 g/week (i.e. around four drinks/day) higher usual alcohol intake of 1.44 (95% CI 1.23-1.69) for liver cancer (n = 547), 1.83 (1.60-2.09) for liver cirrhosis (n = 388), 2.01 (1.77-2.28) for ALD (n = 200), 1.71 (1.35-2.16) for NAFLD (n = 198), and 1.52 (1.40-1.64) for total liver disease (n = 1775). The association with ALD appeared stronger among men reporting flushing (i.e., with low alcohol tolerance). After adjustment for the total amount of weekly alcohol consumption, daily drinkers had significantly increased risk of ALD (2.15, 1.40-3.31) compared with non-daily drinkers, and drinking without meals was associated with significantly greater risks of liver cancer (1.32, 1.01-1.72), liver cirrhosis (1.37, 1.02-1.85), and ALD (1.60, 1.09-2.33) compared with drinking with meals. Female current regular drinkers had significantly higher risk of ALD, but not other liver diseases, than female abstainers. CONCLUSIONS In Chinese men, alcohol intake was associated with significantly increased risks of several major chronic liver diseases, and certain drinking patterns (e.g. drinking daily, drinking without meals) may further exacerbate the disease risks.
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Affiliation(s)
- Pek Kei Im
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Iona Y Millwood
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Christiana Kartsonaki
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Yu Guo
- Chinese Academy of Medical Sciences, Beijing, China
| | - Yiping Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Iain Turnbull
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
| | - Canqing Yu
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Huaidong Du
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Pei Pei
- Chinese Academy of Medical Sciences, Beijing, China
| | - Jun Lv
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Robin G Walters
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
| | - Liming Li
- Department of Epidemiology and Biostatistics, School of Public Health, Peking University, Beijing, China
| | - Ling Yang
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK.
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK.
| | - Zhengming Chen
- Clinical Trial Service Unit and Epidemiological Studies Unit (CTSU), Nuffield Department of Population Health, University of Oxford, Oxford, UK
- Medical Research Council Population Health Research Unit (MRC PHRU), Nuffield Department of Population Health, University of Oxford, Old Road Campus, Oxford, OX3 7LF, UK
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17
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Xia H, Zhang Y, Zaongo SD, Liang J, Gong X, Hu Y, Ma P, Wang F. Direct-acting antiviral treatments display excellent outcomes even in older HCV-infected patients at increased risk of fibrosis. ANNALS OF TRANSLATIONAL MEDICINE 2021; 9:847. [PMID: 34164481 PMCID: PMC8184475 DOI: 10.21037/atm-21-1297] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Background This study compared the efficacy and tolerability of available direct-acting antiviral (DAA) regimens between individuals aged 60 years and older and younger patients in a real-life setting. Specifically, we aimed to provide evidence of the efficacy and safety of DAAs in the treatment of older adults in Tianjin, China. Methods In this retrospective observational cohort study, patients with chronic hepatitis C virus (HCV) were enrolled between April 2018 and December 2019 at 2 tertiary hospitals in Tianjin, China. We assessed the sustained virologic response (SVR) 12 weeks (SVR12) after DAA treatment, and adverse events in two groups using age stratification by comparing older adults (≥60 years) and younger adults (<60 years). Logistic regression analyses were performed to explore the risk factors associated with the SVR12. Results Of 1,106 patients, 440 (39.8%) were ≥60 years of age. The overall SVR12 rate was 97.8% in the entire cohort. In the older adult group, the SVR12 rate was 98.0% (431/440) compared to 97.7% (651/666) in the younger adult group. A multivariate analysis showed that (I) age was not predictive of SVR; and (II) the variables of treatment-experience [adjusted odds ratio (aOR) =27.53; 95% confidence interval (CI) =3.35–226.08; P=0.002] and aspartate aminotransferase (AST) (aOR =1.02; 95% CI =1.01–1.04; P=0.027) were independently associated with the SVR12 in the older adult group. All of the available DAA regimens were well-tolerated in older adult group. Conclusions Chinese older adults with chronic HCV infection showed a significantly higher percentage of fibrosis; however, the available different DAA regimens were safe, well-tolerated, and achieved high rates of SVR in all age subgroups. Our observations suggest that DAA treatment should not be withheld even from older patients suffering from chronic HCV.
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Affiliation(s)
- Huan Xia
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China.,Tianjin Association of STD/AIDS Prevention and Control, Tianjin, China
| | - Yaping Zhang
- The Third Central Clinical College of Tianjin Medical University, Tianjin, China
| | - Silvere D Zaongo
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Jing Liang
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
| | - Xiaowen Gong
- State Key Laboratory of Experimental Hematology, National Clinical Research Centre for Blood Diseases, Institute of Hematology and Blood Diseases Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Tianjin, China
| | - Yue Hu
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China
| | - Ping Ma
- Department of Infectious Diseases, Tianjin Second People's Hospital, Tianjin, China.,Tianjin Association of STD/AIDS Prevention and Control, Tianjin, China
| | - Fengmei Wang
- Department of Gastroenterology and Hepatology, Tianjin Third Central Hospital, Tianjin, China
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Seroprevalence of Hepatitis C Viral Infection in Ethiopia: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2021; 2021:8873389. [PMID: 33897305 PMCID: PMC8052182 DOI: 10.1155/2021/8873389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 02/13/2021] [Accepted: 03/26/2021] [Indexed: 12/12/2022] Open
Abstract
Background Hepatitis C virus is a highly genetically heterogenous bloodborne pathogen that is responsible for acute and chronic hepatitis. Globally, an estimated 71 million population is chronically infected with this virus from which 399,000 people die every year. Its prevalence is high in Ethiopia and varies from region to region, even among different studies within a region. Methods Electronic databases, including Science Direct, Medline, HINARI, African Journals Online, TRIP database, African Index Medicus, and Directory of Open Access Journals, searched from 2010 to 2020 and published articles were included. Due to evidence of considerable heterogeneity, the pooled prevalence of anti-HCV was analyzed using the random-effects model. The possible sources of heterogeneity were analyzed through subgroup analysis, sensitivity analysis, and meta-regression. Funnel plots and Egger's test statistics were used to determine the presence of publication bias. Results The analysis of 56 articles showed that the prevalence of anti-HCV in Ethiopia ranged from 0% to 22%. The pooled prevalence estimated was 2% (95% CI 2.0–3.0), and the meta-regression statistics indicated that the diagnostic method (p=0.037), study group (p=0.005), and level of bias (p=0.035) showed statistically significant association with the outcome variable. The sensitivity analysis claims no influence on the overall effect estimate while removing a single study from the analysis at a time. Egger's test statistics (p ≤ 0.001) declare the presence of publication bias that is handled using time and fill analysis. Conclusions The pooled prevalence of anti-HCV in Ethiopia was high. Predictor variables, including the diagnostic method, study group, and level of bias, showed a statistically significant relationship with the outcome variable. Strengthening the scope of existing prevention and control programs and implementing novel approaches, including screen-and-treat, could significantly help to tackle this critical public health issue. The study provides a current estimate which is valuable for policymakers and other responsible bodies.
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Subclinical Hepatitis C Virus Infection in Patients with Chronic Obstructive Pulmonary Disease: Evidence from a Cross-Sectional Multicenter Observation Study. Jundishapur J Microbiol 2021. [DOI: 10.5812/jjm.109352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background: Patients with hepatitis virus C (HCV) infection have declined levels of forced expiratory volume (FEV), which is a prognostic marker for chronic obstructive pulmonary disease (COPD). Objectives: The current study primarily aimed to investigate the incidence of subclinical HCV infection (clinical signs are absent but positive HCV RNA test performed by polymerase chain reaction) in patients with COPD of Zhejiang province, China, and its secondary aim was to investigate the clinical influence of HCV infection on COPD severity by body mass index, airflow obstruction, dyspnea, and exercise capacity (BODE) scoring index and pulmonary function tests (PFT). Methods: A total of 252 patients with COPD (confirmed by routine lab tests, BODE index, and PFT) were included in a cross-sectional multicenter study. An anti-HCV antibody test was used to diagnose HCV infection. Hepatitis virus C RNA was tested for patients with a HCV antibody-positive test. Results: Twelve patients had a positive anti-HCV antibody test. Of 12 anti-HCV antibody positive test patients, 10 were positive for the HCV RNA. The prevalence of anti-HCV antibody positivity and HCV RNA positivity was 12/ 252 and 10/ 252, respectively. The partial arterial pressure of oxygen was the same for patients with HCV RNA positive test compared to those with a negative anti-HCV antibody test (59.70 ± 5.50 mmHg vs. 63.84 ± 15.63 mmHg, P = 0.791). Patients with a positive HCV RNA test had a higher partial arterial pressure of carbon dioxide compared to those with a negative anti-HCV antibody test (43.70 ± 1.89 mmHg vs. 49.42 ± 7.33 mmHg, P = 0. 007). BODE index was higher for patients with HCV RNA positive test than those with anti-HCV antibody test negative (6 (3 - 7) vs. 4 (2 - 6), P < 0.0001). Among the variables of BODE index scoring, the values of distance walked in 6 min (P < 0.0001) and % predicted forced expiratory volume in 1 s (P < 0.0001) were fewer for patients with HCV RNA positive test than those with a negative anti-HCV antibody test. Conclusion: This study demonstrated that subclinical HCV infection may be observed in COPD patients.
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Li Y, Zhao L, Geng N, Zhu W, Liu H, Bai H. Prevalence and characteristics of hepatitis C virus infection in Shenyang City, Northeast China, and prediction of HCV RNA positivity according to serum anti-HCV level: retrospective review of hospital data. Virol J 2020; 17:36. [PMID: 32178702 PMCID: PMC7077010 DOI: 10.1186/s12985-020-01316-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2019] [Accepted: 03/10/2020] [Indexed: 12/16/2022] Open
Abstract
Objective The prevalence of hepatitis C virus (HCV) infection is typically evaluated based on the current rate of positivity of anti-HCV antibody; however, HCV RNA positivity is considered the main criterion for antiviral treatment of HCV infection in the clinical setting. In this study, we evaluated the prevalence of HCV infection based on anti-HCV and HCV RNA detection in the population of Liaoning Province, and investigated the correlation between serum HCV RNA positivity and anti-HCV levels. Methods A total of 192,202 patients who underwent serum anti-HCV examination at Shengjing Hospital in 2018 were enrolled in the study. Anti-HCV production was tested using a chemiluminescence assay, and serum HCV RNA detection was performed with Roche COBAS TaqMan (CTM) Analyzer. Results The prevalence of anti-HCV was 1.21 and 0.93% among male and female patients in Liaoning Province, respectively. The positive rates of anti-HCV and serum anti-HCV levels were both age-related, in which patients over 40 years of age had a significantly higher anti-HCV positive rate than those younger than 40 years. Among the anti-HCV-positive patients, the average HCV RNA positive rate was 51.66 and 35.93% in males and females, respectively. Spearman rank analysis showed a significantly positive correlation between serum HCV RNA positivity and the level of anti-HCV. The best cut-off value using serum anti-HCV levels to predict the positivity of HCV RNA was determined to be 9.19 signal-to-cut-off ratio (s/co) in males and 10.18 s/co in females. Conclusion The prevalence of anti-HCV in the general population of Liaoning Province was around 1.04%, which was higher than that previously reported from a national survey of HCV infection in China. Approximately 42.9% of the anti-HCV-positive patients also tested positive for HCV RNA. However, the positive correlation between the serum anti-HCV and HCV RNA levels suggests that the positivity of serum HCV RNA can be predicted according to the anti-HCV level in anti-HCV-positive patients, which can improve screening and facilitate timely intervention to prevent the spread of infection.
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Affiliation(s)
- Yurong Li
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004
| | - Lianrong Zhao
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004
| | - Nan Geng
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004
| | - Weijia Zhu
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004
| | - Hongbo Liu
- Department of Health Statistics, School of Public Health, China Medical University, Shenyang, Liaoning, P.R. China, 110122
| | - Han Bai
- Department of Infectious Diseases, Shengjing Hospital of China Medical University, Shenyang, Liaoning, P.R. China, 110004.
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Zhang ZH, Wang H, Zhang DN, Zhu GZ. Notch signaling suppresses CD14 + monocytes cells activity in patients with chronic hepatitis C. APMIS 2019; 127:642-652. [PMID: 31274210 DOI: 10.1111/apm.12980] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2019] [Accepted: 06/28/2019] [Indexed: 12/23/2022]
Abstract
Hepatitis C virus (HCV) infection always leads to chronic hepatitis via dysregulation of host immunity. Notch signaling also modulates the response of monocytes/macrophages. Thus, we aimed to investigate the regulatory role of Notch signaling to CD14+ monocytes. Forty patients with chronic hepatitis C and twenty normal controls (NC) were enrolled. CD14+ monocytes and CD4+ T cells were purified from peripheral bloods. Notch receptors' mRNA expression in CD14+ monocytes was semi-quantified by real-time PCR. Cytokine production by CD14+ monocytes in response to γ-secretase inhibitor (GSI) was investigated by ELISA. GSI-induced CD14+ monocytes activity to HCV clearance in Huh7.5 cells and to CD4+ T cell differentiation was also assessed in direct and indirect contact co-culture system. Notch1 mRNA relative level was approximately 10-fold elevated in CD14+ monocytes from chronic hepatitis C patients when compared with NC. GSI stimulation resulted in enhanced cytokines production by CD14+ monocytes from chronic hepatitis C patients. GSI-stimulated CD14+ monocytes from chronic hepatitis C patients induced suppression of HCV RNA replication in both direct and indirect contact co-culture system of CD14+ monocytes and HCVcc-infected Huh7.5 cells, and this process was accompanied by elevation of interferon-γ production but not increased target cell death. Moreover, GSI stimulation also enhanced CD14+ monocytes-induced Th1 and Th17 cells activation, and this process required direct cell-to-cell contact. Effective antiviral therapy down-regulated Notch1 mRNA expression and promoted cytokine production by CD14+ monocytes from chronic hepatitis C. Current data revealed an important immunoregulatory property of Notch signaling to CD14+ monocytes in chronic HCV infection.
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Affiliation(s)
- Zhi-Hong Zhang
- Department of Clinical Laboratory Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Han Wang
- Department of Clinical Laboratory Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Dong-Na Zhang
- Department of Clinical Laboratory Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
| | - Guang-Ze Zhu
- Department of Clinical Laboratory Medicine, The Affiliated Hospital to Changchun University of Chinese Medicine, Changchun, Jilin Province, China
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