1
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Wang Y, Shen G, Lu R, Liu J, Zhang F, Wang H, Cai W, Zhang F. The prevalence of HDV among HBsAg-positive populations with and without HIV-1 in China. Int J Infect Dis 2024; 140:70-77. [PMID: 38218378 DOI: 10.1016/j.ijid.2023.12.014] [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: 10/23/2023] [Revised: 12/24/2023] [Accepted: 12/29/2023] [Indexed: 01/15/2024] Open
Abstract
BACKGROUND Existing research has provided evidence of changes in hepatitis delta virus (HDV) prevalence worldwide. This study aimed to investigate the prevalence and molecular characteristics of HDV to elucidate its spread in China. METHODS A total of 3,000 samples were collected from 2,241 HBV monoinfections and 759 HBV/HIV-1 coinfections across 13 sites in northern, southern, western, and southwestern China. Serological and virological prevalence were determined by detecting anti-HDV antibodies and HDV RNA. RESULTS The study revealed a 2.63% (95% CI: 2.06-3.21) seroprevalence of HDV among HBV infections in China, exhibiting regional variation. HDV seroprevalence was notably higher at 7.91% (95% CI: 5.98-9.83) in HBV and HIV-1 coinfections. Region and HIV-1 infection were identified as risk factors for HDV infection. Virological prevalence was 0.67% (95% CI: 0.38-0.96) in HBV infections and 2.24% (95% CI: 1.18-3.29) in HBV/HIV-1 coinfections. The predominant HDV genotype in China was HDV-2a, followed by HDV-1. Participants with anti-HDV positivity demonstrated significantly higher proportions of abnormal liver dysfunction and elevated HBV DNA load (P < 0.001) compared to anti-HDV-negative participants. CONCLUSIONS This study highlights the HDV epidemic in China, sheds light on its geographical distribution and high-risk populations, and provides insights for developing strategies to manage the spread of HDV in the country.
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Affiliation(s)
- Yan Wang
- Innovation Center for Neurological Disorders and Department of Neurology, Xuanwu Hospital, Capital Medical University, National Clinical Research Center for Geriatric Diseases, Beijing, China; Clinical and Research Center for Infectious Diseases, Beijing Ditan Hospital, Beijing, China
| | - Guizhou Shen
- The first People's Hospital of Liangshan Yi Autonomous Prefecture, Sichuan, China
| | - Ruichao Lu
- Chest Hospital of Guangxi Zhuang Autonomous Region, Guangxi, China
| | - Jun Liu
- Department of HIV/AIDS, Third People's Hospital of Kunming, Yunnan, China
| | - Feng Zhang
- Health Commission, Xinjiang Uyghur Autonomous Region, Xinjiang, China
| | - Hui Wang
- Third People's Hospital of Shenzhen, Second Affiliated Hospital of Southern University of Science and Technology, Guangdong, China
| | - Weiping Cai
- Guangzhou Eighth People's Hospital, Guangzhou Medical University, Guangdong, China
| | - Fujie Zhang
- Clinical and Research Center for Infectious Diseases, Beijing Ditan Hospital, Beijing, China.
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2
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Zi J, Li YH, Wang XM, Xu HQ, Liu WH, Cui JY, Niu JQ, Chi XM. Hepatitis D virus dual-infection among Chinese hepatitis B patient related to hepatitis B surface antigen, hepatitis B virus DNA and age. World J Gastroenterol 2023; 29:5395-5405. [PMID: 37900584 PMCID: PMC10600800 DOI: 10.3748/wjg.v29.i38.5395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2023] [Revised: 08/21/2023] [Accepted: 09/26/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND The screening practices for hepatitis D virus (HDV) are diverse and non-standardized worldwide, and the exact prevalence of HDV is uncertain. AIM To estimate HDV prevalence and investigate viral marker quantity trends in patients with hepatitis D. METHODS We collected 5594 serum samples from patients with hepatitis B in Jilin Province, China (3293 males and 2301 females, age range of 2 to 89 years). We then conducted tests for hepatitis B surface antigen (HBsAg), hepatitis B Virus (HBV) DNA, anti-hepatitis D antigen (HDAg), and HDV RNA. RESULTS We found that the prevalence of anti-HDAg and HDV RNA among hepatitis B patient were 3.6% (3.2-4.2%) and 1.2% (0.9-1.5%), respectively, 87.69% of hepatitis D patients were 51-70 years old. HDV infection screening positive rate of patients with HBV DNA levels below 2000 IU/mL (2.0%) was higher than those above 2000 IU/mL (0.2%). Among anti-HDAg positive patients, the HDV RNA positive rate was positively correlated with the HBsAg level and anti-HDAg level. There was a weak correlation between HBsAg and anti-HDAg levels among hepatitis D patients. CONCLUSION Our study highlights the importance of considering multiple factors when assessing the severity of HDV infection, comprehensive evaluation of patients' clinical and laboratory parameters is necessary for proper diagnosis and treatment.
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Affiliation(s)
- Jun Zi
- Gene Therapy Laboratory, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
| | - Yu-Huan Li
- Gene Therapy Laboratory, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
| | - Xiao-Mei Wang
- Department of Hepatology, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
| | - Hong-Qin Xu
- Department of Hepatology, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
| | - Wen-Hui Liu
- Department of Histology and Embryology, College of Basic Medical Sciences, Jilin University, Changchun 130061, Jilin Province, China
| | - Jia-Yue Cui
- Department of Histology and Embryology, College of Basic Medical Sciences, Jilin University, Changchun 130061, Jilin Province, China
| | - Jun-Qi Niu
- Department of Hepatology, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
| | - Xiu-Mei Chi
- Gene Therapy Laboratory, Center for Pathogen Biology and Infectious Diseases, First Hospital of Jilin University, Changchun 130061, Jilin Province, China
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3
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Systematic Review of Hepatitis C Virus Prevalence in the WHO Western Pacific Region. Viruses 2022; 14:v14071548. [PMID: 35891529 PMCID: PMC9320901 DOI: 10.3390/v14071548] [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: 06/11/2022] [Revised: 07/11/2022] [Accepted: 07/13/2022] [Indexed: 11/16/2022] Open
Abstract
BACKGROUND This review aimed to identify hepatitis C virus (HCV) prevalence estimates among the general population and six key populations (people who inject drugs, men who have sex with men, sex workers, prisoners/detainees, Indigenous people, and migrants) in the World Health Organization Western Pacific Region (WHO WPR). METHODS Original research articles published between 2016 and 2020 were identified from bibliographic databases. Publications were retrieved, replicas removed, and abstracts screened. Retained full texts were assessed and excluded if inclusion criteria were not met. Methodological quality was assessed using the Johanna Briggs Institute critical appraisal checklist for prevalence data. Data on HCV exposure and active infection were extracted and aggregated and forest plots generated for each population by country. RESULTS There were no HCV prevalence estimates in any population for more than half of WPR countries and territories. Among the 76 estimates, 97% presented prevalence of exposure and 33% prevalence of active infection. General population viraemic prevalence was 1% or less, except in Mongolia. Results confirm the endemic nature of HCV among people who inject drugs, with estimates of exposure ranging from 30% in Cambodia to 76% in Hong Kong. CONCLUSIONS Countries require detailed knowledge of HCV prevalence in diverse populations to evaluate the impact of efforts to support WHO HCV elimination goals. Results provide baseline estimates from which to monitor and evaluate progress and by which to benchmark future elimination efforts.
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Yang J, Liu HX, Su YY, Liang ZS, Rao HY. Distribution and changes in hepatitis C virus genotype in China from 2010 to 2020. World J Clin Cases 2022; 10:4480-4493. [PMID: 35663077 PMCID: PMC9125278 DOI: 10.12998/wjcc.v10.i14.4480] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/28/2022] [Accepted: 03/26/2022] [Indexed: 02/06/2023] Open
Abstract
BACKGROUND Hepatitis C virus (HCV) causes a large number of infections worldwide. New infections seem to be increasing according to a report of the World Health Organization in 2015. Although direct-acting antivirals are quite effective for most genotypes of the HCV, some genotypes fail to respond. Therefore, the trend of genotype distribution is vital to better control the development of this infection.
AIM To analyze the distribution and trends of the HCV genotype before and after the emergence of direct-acting antivirals in China.
METHODS We searched all literature published in five electronic databases-China National Knowledge Infrastructure, Wan Fang Data, VIP Chinese Journal Database, Chinese Biomedical Literature Service System, and PubMed-from January 1, 2010 to December 31, 2020. The search strategy combined medical subject headings and free-text terms, including “hepatitis C virus” or “HCV” and “genotype” or “subtype” and ”China” or “Chinese”. Additional relevant articles were searched by manual selection. Data were extracted to build a database. All of the data were totaled according to regions, periods, routes of transmission, and sexes. The percentages in various stratifications were calculated.
RESULTS There were 76110 samples from 30 provinces included in the study. Genotype 1 (G1) accounted for 58.2% of cases nationwide, followed by G2, G6, G3b, G3a, unclassified and mixed infections (17.5%, 7.8%, 6.4%, 4.9%, 1.8%, and 1.2%, respectively). The constitution of genotype varied among different regions, with G6 and G3b being more common in the south and southwest, respectively (28.1%, 15.4%). The past ten years have witnessed a decrease in G1 and G2 and an increase in G3 and G6 in almost all regions. The drug-use population had the most abundant genotypes, with G6 ranking first (33.3%), followed by G1 and G3b (23.4%, 18.5%).
CONCLUSION G3 and G6 pose a new challenge for HCV infection. This study revealed the distribution of HCV genotypes in China over the past 10 years, providing information for HCV management strategies.
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Affiliation(s)
- Jia Yang
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People’s Hospital, Beijing 100044, China
| | - Hui-Xin Liu
- Department of Clinical Epidemiology and Biostatistics, Peking University People’s Hospital, Beijing 100044, China
| | - Ying-Ying Su
- National Institute of Diagnostics and Vaccine Development in Infectious Diseases, School of Public Health, Xiamen University, Xiamen 361000, Fujian Province, China
| | - Zhi-Sheng Liang
- Department of Global Health, School of Public Health, Peking University, Beijing 100044, China
| | - Hui-Ying Rao
- Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People’s Hospital, Beijing 100044, China
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5
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Niro GA, Ferro A, Cicerchia F, Brascugli I, Durazzo M. Hepatitis delta virus: From infection to new therapeutic strategies. World J Gastroenterol 2021; 27:3530-3542. [PMID: 34239267 PMCID: PMC8240063 DOI: 10.3748/wjg.v27.i24.3530] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2021] [Revised: 04/07/2021] [Accepted: 05/27/2021] [Indexed: 02/06/2023] Open
Abstract
The hepatitis delta virus (HDV) is a small RNA virus that encodes a single protein and which requires the hepatitis B virus (HBV)-encoded hepatitis B surface antigen (HBsAg) for its assembly and transmission. HBV/HDV co-infections exist worldwide and show a higher prevalence among selected groups of HBV-infected populations, specifically intravenous drug users, practitioners of high-risk sexual behaviours, and patients with cirrhosis and hepatocellular carcinoma. The chronic form of HDV-related hepatitis is usually severe and rapidly progressive. Patterns of the viral infection itself, including the status of co-infection or super-infection, virus genotypes (both for HBV and HDV), and persistence of the virus’ replication, influence the outcome of the accompanying and manifested liver disease. Unfortunately, disease severity is burdened by the lack of an effective cure for either virus type. For decades, the main treatment option has been interferon, administered as mono-therapy or in combination with nucleos(t)ide analogues. While its efficacy has been reported for different doses, durations and courses, only a minority of patients achieve a sustained response, which is the foundation of eventual improvement in related liver fibrosis. The need for an efficient therapeutic alternative remains. Research efforts towards this end have led to new treatment options that target specific steps in the HDV life cycle; the most promising among these are myrcludex B, which inhibits virus entry into hepatocytes, lonafarnib, which inhibits farnesylation of the viral-encoded L-HDAg large hepatitis D antigen, and REP-2139, which interferes with HBsAg release and assembly.
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Affiliation(s)
- Grazia A Niro
- Department of Gastroenterology, IRCCS Casa Sollievo della Sofferenza Hospital Foundation, San Giovanni Rotondo 71013, Italy
| | - Arianna Ferro
- Department of Medical Sciences, University of Turin, Turin 10126, Italy
| | | | | | - Marilena Durazzo
- Department of Medical Sciences, University of Turin, Turin 10126, Italy
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6
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Hercun J, Koh C, Heller T. Hepatitis Delta: Prevalence, Natural History, and Treatment Options. Gastroenterol Clin North Am 2020; 49:239-252. [PMID: 32389361 DOI: 10.1016/j.gtc.2020.01.004] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
Abstract
Half a century after its discovery, hepatitis delta remains a pertinent global health issue with a major clinical impact in endemic regions and an underestimated prevalence worldwide. Hepatitis delta virus infection follows a challenging clinical course and is responsible for significant liver-related morbidity. Although the only currently available treatment (pegylated interferon) does not provide consistent results, emerging therapeutic options are promising. This article explores the epidemiology, natural history, as well as current and potential therapeutic options for hepatitis delta virus infection.
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Affiliation(s)
- Julian Hercun
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Room 4-5722, Bethesda, MD 20892, USA.
| | - Christopher Koh
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Room 4-5722, Bethesda, MD 20892, USA
| | - Theo Heller
- Liver Diseases Branch, National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, 10 Center Drive, Room 4-5722, Bethesda, MD 20892, USA
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7
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Sharafi H, Rezaee-Zavareh MS, Miri SM, Alavian SM. Global Distribution of Hepatitis D Virus Genotypes: A Systematic Review. HEPATITIS MONTHLY 2020; 20. [DOI: 10.5812/hepatmon.102268] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
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8
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Piauiense JNF, Costa CCS, Silva RJS, Cardoso YMN, Di Miceli JFF, Resque RL, Lemos JAR, Fischer B, Pinho JRR, Kupek E, Martins LC, Oliveira-Filho AB. Hepatitis B Virus Infection among People Who Use Illicit Drugs: Prevalence, Genotypes and Risk Factors in the State of Amapá, Northern Brazil. Subst Use Misuse 2020; 55:1633-1639. [PMID: 32338560 DOI: 10.1080/10826084.2020.1756334] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Background: Several records of high prevalence of HBV have been made in northern Brazil. Among risk groups for viral infection, people who use illicit drugs (PWUDs) stand out, especially if they inject drugs and engage in risky sexual behavior. Objectives: In this study, the prevalence, genotype distribution and factors associated with hepatitis B virus (HBV) exposure in PWUDs were estimated. Methods: This cross-sectional study used snowball sampling from nine different sites. Socio-demographic, economic, drug use and health-related information were collected of 308 PWUDs from nine municipalities in the state of Amapá, northern Brazil. Blood samples were tested for the presence of HBV using enzyme-linked immunosorbent assay (ELISA) and real-time polymerase chain reaction (PCR). Logistic regressions were run to identify factors independently associated with HBV exposure. Results: In total, seventy (22.7%) PWUDs were exposed to HBV, and 12 (3.9%) had DNA HBV. Genotypes A (58.4%), D (33.3%) and F (8.3%) were identified. Age ≥35 years, use of injectable drug, daily use of drugs, use of drugs over 12 years, unprotected sex, exchange sex for money/drugs, and >12 sexual partners in the last 12 months were associated with exposure to HBV. Conclusions: This study identified important information on the epidemiological scenario of HBV infection in PWUDs, highlighting the high prevalence of HBV exposure and the urgent need for measures for control and prevention, especially vaccination against this hepatotropic virus.
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Affiliation(s)
- Juliana N F Piauiense
- Laboratório de Células e Patógenos, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil.,Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Camila C S Costa
- Laboratório de Células e Patógenos, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil.,Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Ronylson J S Silva
- Laboratório de Células e Patógenos, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
| | - Yasmin M N Cardoso
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá, Brazil
| | - Jeruza F F Di Miceli
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá, Brazil
| | - Rafael L Resque
- Laboratório de Toxicologia e Química Farmacêutica, Centro de Ciências Biológicas e da Saúde, Universidade Federal do Amapá, Macapá, Brazil
| | - José Alexandre R Lemos
- Instituto de Ciências Biológicas, Universidade Federal do Pará, Belém, Brazil.,Laboratório de Biologia Molecular, Centro de Hemoterapia e Hematologia do Pará, Belém, PA, Brazil
| | - Benedikt Fischer
- Faculty of Medical and Health Sciences, University of Auckland, Grafton, New Zealand.,Department of Psychiatry, University of Toronto, Toronto, Canada.,Departamento de Psiquiatria, Universidade Federal de São Paulo, São Paulo, SP, Brazil
| | - João Renato R Pinho
- Instituto de Medicina Tropical, Universidade de São Paulo, São Paulo, Brazil
| | - Emil Kupek
- Departamento de Saúde Pública, Universidade Federal de Santa Catarina, Florianópolis, Brazil
| | - Luisa C Martins
- Laboratório de Patologia Clínica de Doenças Tropicais, Núcleo de Medicina Tropical, Universidade Federal do Pará, Belém, Brazil
| | - Aldemir B Oliveira-Filho
- Laboratório de Células e Patógenos, Instituto de Estudos Costeiros, Universidade Federal do Pará, Bragança, Brazil
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9
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Mahale P, Aka PV, Chen X, Liu P, Fram BJ, Wang AS, Simenel S, Tseng FC, Chen S, Edlin BR, Glenn JS, O'Brien TR. Hepatitis D Viremia Among Injection Drug Users in San Francisco. J Infect Dis 2019; 217:1902-1906. [PMID: 29800369 DOI: 10.1093/infdis/jiy157] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2017] [Accepted: 03/19/2018] [Indexed: 12/11/2022] Open
Abstract
People who inject drugs (PWID) are commonly exposed to hepatitis B virus (HBV) and hepatitis D virus (HDV). We evaluated the prevalence of HDV viremia among hepatitis B surface antigen (HBsAg)-positive PWID (n = 73) using a new quantitative microarray antibody capture (Q-MAC) assay, HDV western blot, and HDV RNA. HDV Q-MAC performed well in this cohort: anti-HDV, 100% sensitivity and specificity; HDV viremia, 61.5% sensitivity and 100% specificity. Hepatitis D viremia was present in 35.6% of HBsAg-positive participants and was more common in those with resolved compared to chronic hepatitis C (5.1% vs 0.6%; adjusted odds ratio, 9.80; P < .0001).
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Affiliation(s)
- Parag Mahale
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Peter V Aka
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland.,Demographic and Health Surveys, ICF International, Rockville, Maryland
| | - Xiaohua Chen
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California.,Department of Infectious Disease, Shanghai Jiao Tong University Affiliated Sixth People's Hospital, China
| | - Ping Liu
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California
| | - Benjamin J Fram
- Department of Microbiology and Immunology, Stanford University School of Medicine, Palo Alto, California
| | - Alan S Wang
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Scott Simenel
- Department of Microbiology and Immunology, Stanford University School of Medicine, Palo Alto, California
| | - Fan-Chen Tseng
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
| | - Sabrina Chen
- Information Management Services, Calverton, Maryland
| | - Brian R Edlin
- Urban Health Study, University of California San Francisco.,Department of Medicine, Weill Cornell Medical College, New York
| | - Jeffrey S Glenn
- Department of Medicine, Stanford University School of Medicine, Palo Alto, California.,Department of Microbiology and Immunology, Stanford University School of Medicine, Palo Alto, California
| | - Thomas R O'Brien
- Infections and Immunoepidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute, Rockville, Maryland
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10
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Wen B, Zhang J, Liu W, Tang P, Xie T, Huang L, Hu Y, Jin K, Zhang P, Liu Z, Niu L, Qu X. HBV coinfection with HCV alters circulating Tfh cell distribution and impairs HCV neutralizing antibody responses. J Viral Hepat 2019; 26:1002-1010. [PMID: 30972873 DOI: 10.1111/jvh.13106] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2018] [Revised: 03/11/2019] [Accepted: 03/15/2019] [Indexed: 12/17/2022]
Abstract
Hepatitis C virus (HCV) and hepatitis B virus (HBV) coinfection reciprocally influences viral replication and host defence responses. This study aimed to investigate the impact of HBV coinfection on circulating T follicular helper cell (cTfh) distribution and the HCV neutralizing antibody (nAb) response. HCV neutralizing antibody responses were measured in individuals with HCV monoinfection (n = 83) and HBV/HCV coinfection (n = 78) using the HCV pseudoparticle neutralization assay. The frequencies of cTfh cells and their subsets in HCV monoinfection (n = 34) and HBV/HCV coinfection (n = 30) were analysed by flow cytometry. The correlations of clinical parameters, cTfh cells and neutralizing antibody responses were analysed. Compared with HCV monoinfection, the HBV coinfection group showed significantly lower HCV neutralizing antibody responses (P < 0.001) and a decreased frequency of circulating Th1-like Tfh cells (Tfh1) (P = 0.004). In HCV monoinfection, the frequency of the Tfh1 subset was positively correlated with HCV neutralizing antibody responses (R = 0.378, P = 0.03), but this correlation was lost under HBV/HCV coinfection (R = 0.115, P = 0.551). In contrast, the frequency of circulating Th2-like Tfh cells (Tfh2) was negatively correlated with the HCV neutralizing antibody responses (R = 0.404, P = 0.003). Further analysis showed that HBV coinfection enhanced the Tfh2 subset composition within cTfh cells (P < 0.001), which was associated with serum HBsAg in HBV/HCV coinfection (R = 0.521, P = 0.003). As expected, HBsAg also exhibited an inverse association with HCV neutralizing antibody responses in HBV/HCV coinfection (R = 0.59, P < 0.001). In contrast to HCV monoinfection, HBV/HCV coinfection leads to altered cTfh cell distribution and impaired HCV neutralizing antibody responses, which are associated with HBsAg. These findings will be helpful for better understanding the immunopathogenesis of HBV/HCV coinfection.
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Affiliation(s)
- Bo Wen
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Jian Zhang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Wenpei Liu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China.,Affiliated The First People's Hospital of Chenzhou, Southern Medical University, Chenzhou, Hunan, China
| | - Ping Tang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Ting Xie
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Liyan Huang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Yabin Hu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Kun Jin
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Ping Zhang
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Ziyan Liu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Ling Niu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China
| | - Xiaowang Qu
- Translational Medicine Institute, The First People's Hospital of Chenzhou, University of South China, Chenzhou, Hunan, China.,Affiliated The First People's Hospital of Chenzhou, Southern Medical University, Chenzhou, Hunan, China
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11
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Fu P, Lv Y, Zhang H, Liu C, Wen X, Ma H, He T, Ke L, Wu B, Liu J, He M, Liao D, Wang J, Ness P, Liu Y, Shan H. Hepatitis C virus prevalence and incidence estimates among Chinese blood donors. Transfusion 2019; 59:2913-2921. [PMID: 31271469 DOI: 10.1111/trf.15432] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 06/02/2019] [Accepted: 06/04/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Hepatitis C virus (HCV) is an important transfusion-transmitted virus with global significance. The objective of this study was to evaluate the HCV prevalence and incidence among Chinese blood donors from 2013 to 2016. STUDY DESIGN AND METHODS Whole blood and apheresis platelet donations collected from five Chinese blood centers from June 1, 2013, to December 31, 2016, were screened in parallel by two different enzyme-linked immunosorbent assays for anti-HIV 1/2, hepatitis B surface antigen, anti-HCV, and syphilis. Screening-reactive samples were further confirmed by western blot. Confirmatory positive rates among first-time and repeat donors were used to estimate the prevalence and incidence rates. Multivariable logistic regression modeling was used to examine factors associated with HCV infection. RESULTS A total of 1,276,544 donations were collected from five Chinese blood centers, of which an estimated 1203 were confirmed HCV positive. The overall HCV prevalence among first-time donors was 166.56 per 100,000 donors (95% confidence interval, 156.04-177.08). The HCV incidence rate was estimated to be 15.21 (95% confidence interval, 11.83-19.56) per 100,000 person-years among repeat donors. Multivariable logistic regression results showed that increased age, lower educational levels, ethnicity, and occupation were all important factors associated with HCV confirmatory status among first-time donors (p < 0.01). CONCLUSIONS HCV infection is still an important concern for transfusion safety in China. Our findings indicate that continued strong efforts are needed to monitor and control the risk of transfusion-transmitted HCV infection in China. Moreover, to reduce unnecessary donor loss, HCV donor screening procedures should be improved by incorporating confirmatory testing into routine blood center operations.
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Affiliation(s)
- Ping Fu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Yunlai Lv
- Luoyang Blood Center, Luoyang, P. R. China
| | | | - Cunxv Liu
- Guangxi Blood Center, Liuzhou, P. R. China
| | | | - Hongli Ma
- Luoyang Blood Center, Luoyang, P. R. China
| | - Tao He
- Chongqing Blood Center, Chongqing, P. R. China
| | - Ling Ke
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Bingting Wu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Jing Liu
- Johns Hopkins Medical Center, Baltimore, Maryland
| | - Miao He
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Dan Liao
- Research Triangle Institute, Raleigh, North Carolina
| | - Jingxing Wang
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Paul Ness
- Research Triangle Institute, Raleigh, North Carolina
| | - Yu Liu
- Institute of Blood Transfusion, Chinese Academy of Medical Sciences, Chengdu, P. R. China.,Sichuan Blood Safety and Blood Substitute International Science and Technology Cooperation Base, Chengdu, P. R. China
| | - Hua Shan
- Stanford University Medical Center, Palo Alto, California
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12
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Daw MA, Daw AM, Sifennasr NEM, Draha AM, Daw AM, Daw AM, Ahmed MO, Mokhtar ES, El-Bouzedi A, Daw IM. The Epidemiology of Hepatitis D Virus in North Africa: A Systematic Review and Meta-Analysis. ScientificWorldJournal 2018; 2018:9312650. [PMID: 30356409 PMCID: PMC6178169 DOI: 10.1155/2018/9312650] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2018] [Revised: 07/25/2018] [Accepted: 08/27/2018] [Indexed: 12/13/2022] Open
Abstract
BACKGROUND Hepatitis D virus (HDV) infection has been considered a serious neglected pandemic, particularly in developing countries. The virus causes a more severe disease than mono infection with hepatitis B virus (HBV). The epidemiology of HDV is not well documented in North Africa, which is known to be endemic for HBV. In this study, we explored the prevalence of HDV infection and also attempted to identify factors associated with hepatitis D positive status among chronic hepatitis B patients in North Africa. METHODS The electronic databases PubMed, Embase, Scopus, Science Direct, Web of Science, and Google Scholar were comprehensively searched for all papers published between January 1, 1998, and December 31, 2017, using appropriate strategies containing all related keywords, including North Africa, names of countries in the region, and all permutations of hepatitis D virus. The estimated prevalence of HDV in North Africa was calculated as an average of the pooled infection prevalence in each country weighted by the ratio of the country's hepatitis D virus population to the study's sample size in the survey data analysis. FINDINGS A total of 312 studies were identified and 32 were included in this study, with a total sample of 4907 individuals screened for HDV. There was considerable variability in the prevalence estimates of HDV within the countries of the region. The overall prevalence of HDV in the general population of North Africa was 5·01% (95% CI: 1·25-8·27) and in liver disease patients it was 20.7% (95% CI:9.87-44.53). Genotype-1 was the most prominent genotype reported in five published studies. Ten studies reported on HDV RNA in participants who were seropositive for HDV, and four studies highlighted the impact of demographic factors (sex and age). No study showed the impact of risk factors on the prevalence of HDV in North Africa. INTERPRETATION This review provides a comprehensive assessment of the burden of HDV in Northern Africa. There were significant differences in seroprevalence, study population, and diagnostic testing between the countries in the region. The results presented here will alert health professionals to implement clear policies based on evidence to diminish the burden of HDV infection. Such measures may include but are not restricted to improving the laboratory diagnostic tests and initiating patient data registries and blood screening. Further epidemiological and research studies are needed to explore the risk factors, coinfections, and approaches to increase testing for HDV, particularly in high-risk subpopulations, such as intravenous drug users and immigrants, and to define the consequences of HDV infection in North Africa.
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Affiliation(s)
- Mohamed A. Daw
- Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Amina M. Daw
- Department of General Medicine, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Nadia E. M. Sifennasr
- Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Aisha M. Draha
- Department of Pharmacology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Ahmed M. Daw
- Tripoli Medical Centre, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Ali M. Daw
- Tripoli Medical Centre, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Mohamed O. Ahmed
- Department of Microbiology and Parasitology, Faculty of Veterinary Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Ebtisam S. Mokhtar
- Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Tripoli, CC 82668, Tripoli, Libya
| | - Abdallah El-Bouzedi
- Department of Laboratory Medicine, Faculty of Biotechnology, University of Tripoli, CC 82668, Tripoli, Libya
| | - Ibrahem M. Daw
- Department of Planning, Faculty of Engineering, University of Tripoli, CC 82668, Tripoli, Libya
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13
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Wang Y, Glenn JS, Winters MA, Shen LP, Choong I, Shi YL, Bi SL, Ma LY, Zeng H, Zhang FJ. A new dual-targeting real-time RT-PCR assay for hepatitis D virus RNA detection. Diagn Microbiol Infect Dis 2018; 92:112-117. [PMID: 29941366 DOI: 10.1016/j.diagmicrobio.2018.05.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 05/01/2018] [Accepted: 05/23/2018] [Indexed: 12/22/2022]
Abstract
In this study, a real-time reverse transcription-polymerase chain reaction (real time RT-PCR) assay targeting 2 genetic segments was established to detect HDV RNA. Utilizing the World Health Organization International Standard for Hepatitis D Virus RNA, the lower limit of detection was 575 IU/mL, and the linearity of quantification ranged from 575,000 IU/mL to 575 IU/mL. 384 HBsAg-positive samples collected from China were tested by this method and HDV antibody detection. Eleven samples were positive for anti-HDV IgG which may persist after HDV resolution, 6 samples were HDV RNA positive, and 5 samples were positive for anti-HDV IgM. This assay showed more sensitivity than the detection of anti-HDV IgM. These data demonstrate that the real-time RT-PCR assay for HDV RNA could be implemented in the clinical detection of HDV infection in chronic HBV-infected patients in China.
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Affiliation(s)
- Yan Wang
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China; Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Clinical Center for HIV/AIDS, Capital Medical University, Beijing, P.R. China
| | - Jeffrey S Glenn
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California, USA
| | - Mark A Winters
- Division of Gastroenterology and Hepatology, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA; Department of Microbiology and Immunology, Stanford University School of Medicine, Stanford, California, USA
| | - Li-Ping Shen
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Ingrid Choong
- Eiger BioPharmaceuticals, Inc. Palo Alto, California, USA
| | - Ya-Lun Shi
- Beijing Anapure BioScientific Co. Ltd, Beijing, China
| | - Sheng-Li Bi
- National Institute for Viral Disease Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, China
| | - Li-Ying Ma
- State Key Laboratory of Infectious Disease Prevention and Control, National Center for AIDS/STD Control and Prevention, Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases, Chinese Center for Disease Control and Prevention, Beijing, P.R. China
| | - Hui Zeng
- Institute of Infectious Diseases, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Fu-Jie Zhang
- Clinical and Research Center of Infectious Diseases, Beijing Ditan Hospital, Clinical Center for HIV/AIDS, Capital Medical University, Beijing, P.R. China.
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14
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Taleban R, Moafi M, Ataei B, Yaran M, Nokhodian Z, Kassaian N, Adibi P, Javadi A. Seroprevalence of Hepatitis B Infection and Associated Risk Factors among Drug Users in Drop-in Centers of Isfahan, Iran. Int J Prev Med 2018; 9:46. [PMID: 29899884 PMCID: PMC5981222 DOI: 10.4103/ijpvm.ijpvm_382_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 10/30/2017] [Indexed: 01/28/2023] Open
Abstract
Background: Scientists perceive drug users (DUs) as a high-risk population for hepatitis B virus (HBV) infection. Effective strategies aiming at the reduction of HBV infection can be depicted when its epidemiological status is clearly defined. The present study provides new insight into associated risk factors of HBV infection and its seroepidemiological status among DUs attending drop-in centers (DICs). Methods: This was a cross-sectional study, which was implemented in 7 DICs of Isfahan province. The sample size included 539 participants. Demographic data and risk factors for HBV infection were obtained by a trained social worker using a self-made structured questionnaire. Venous blood sample was obtained and tested for hepatitis B surface antigen (HBsAg), hepatitis B surface antibody, and total hepatitis B core antibody (HBcAb) using enzyme-linked immunosorbent assay. Results: Mean age of the participants was 31.76 ± 8.4 years. They were generally male, Iranian, urban, with an education level of high school or less. The prevalence of HBV infection (HBsAg and/or HBcAb) was 18% (88.490). Regression analysis showed that age, bloodletting, and drug injection, being the sexual partner of injecting DU (IDU), as well as frequency and duration of imprisonment positively correlated with HBV infection. Conclusions: Drug injection bloodletting, and being the sexual partner of IDU, as well as frequency and duration of imprisonment could be considered as contributing factors in HBV infection.
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Affiliation(s)
- Roya Taleban
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mohammad Moafi
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Behrooz Ataei
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Majid Yaran
- Acquired Immunodeficiency Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Zary Nokhodian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Nazila Kassaian
- Infectious Diseases and Tropical Medicine Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Peyman Adibi
- Integrative Functional Gastroenterology Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abbasali Javadi
- Nosocomial Infection Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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15
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Zhang S, Wang F, Zhang Z. Current advances in the elimination of hepatitis B in China by 2030. Front Med 2017; 11:490-501. [PMID: 29170919 DOI: 10.1007/s11684-017-0598-4] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2017] [Accepted: 10/11/2017] [Indexed: 12/11/2022]
Abstract
With its 78 million chronic carriers, hepatitis B virus (HBV) infection is still one of the leading public health challenges in China. Over the last two decades, China has made great progress on the prevention of HBV transmission through national vaccination programs. Zero transmission from mother to infant has been proposed as the current goal. Available anti-HBV therapy is efficacious in suppressing HBV replication; however, it fails to completely cure patients with chronic hepatitis B and even requires lifelong treatment. To reduce the costs and improve the efficacy, several trials have been recently conducted in China to optimize the current anti-HBV managements. Novel biomarkers were identified to predict treatment outcomes, and new promising treatment strategies were developed. Reports also indicate that coinfections of HBV with other hepatotropic viruses and human immunodeficiency virus are common in China and cause severe liver diseases, which should be recognized early and treated properly. Work is still needed to eliminate hepatitis B in China by 2030.
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Affiliation(s)
- Shuye Zhang
- Shanghai Public Health Clinical Center and Institute of Biomedical Sciences, Fudan University, Shanghai, 200032, China
| | - Fusheng Wang
- Department of Infectious Diseases, Beijing 302 Hospital, Beijing, 100039, China
| | - Zheng Zhang
- Research Center for Clinical & Translational Medicine, Beijiing 302 Hospital, Beijing, 100039, China.
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16
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HBV/HCV dual infection impacts viral load, antibody response, and cytokine expression differently from HBV or HCV single infection. Sci Rep 2016; 6:39409. [PMID: 28009018 PMCID: PMC5180099 DOI: 10.1038/srep39409] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2016] [Accepted: 11/23/2016] [Indexed: 02/07/2023] Open
Abstract
Hepatitis B virus/hepatitis C virus (HBV/HCV) dual infection is common among high-risk individuals. To characterize the virological and immunological features of patients with HBV/HCV dual infection, we enrolled 1,049 individuals who have been identified as injection drug users. Patients were divided into single and dual infection groups according to the serological markers. We found the average HCV RNA level was significantly lower; however, HBV viral load was significantly higher in HBV/HCV dual-infected patients (n = 42) comparing HCV single infection (n = 340) or HBV single infection (n = 136). The level of anti-HBs in patients who experienced spontaneous HBV clearance was higher than that in HCV single-infected patients with HBV spontaneous clearance. The level of anti-HCV E2 in HBV/HCV dual infection was lower than that detected in HCV single infection. Serum levels of IL-6, IL-8, and TNF-α were significantly lower in HBV/HCV dual-infected patients than in patients infected with HBV or HCV alone. Taken together, two viral replications are imbalanced in dual infected patients. The anti-HBs and anti-HCV E2 antibody production were impaired and proinflammatory IL-6, IL-8, and TNF-α also downregulated due to dual infection. These findings will help further understanding the pathogenesis of HBV/HCV dual infection.
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