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Mo Y, Jin F, Li D, Zou W, Zhong J, Tong Z, Wang W, Qian F. Prevalence and molecular characteristics of occult hepatitis B virus infection among blood donors in Huzhou City, eastern China. Gene 2024; 927:148718. [PMID: 38914243 DOI: 10.1016/j.gene.2024.148718] [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: 02/22/2024] [Revised: 05/23/2024] [Accepted: 06/20/2024] [Indexed: 06/26/2024]
Abstract
Occult hepatitis B virus (HBV) infection (OBI) is a significant challenge for HBV prevention and control. We investigated the prevalence and surface (S) gene mutations of OBI among blood donors in Huzhou City, eastern China. The hepatitis B surface antigen (HBsAg) was routinely screened among 44,256 blood donors. HBV-DNA was detected using the Roche cobas®system. Serum samples that were HBsAg negative and HBV-DNA positive were selected, and the HBV S gene was amplified and sequenced. HBV genotype and S gene mutations were analyzed. The OBI rate in these blood donors was 0.070 % (31/44,256). Among the blood donors with OBI, only two cases (2/31, 6.5 %) were anti-HBc negative. The S gene sequences of 28 samples were successfully obtained, and we found that HBV genotype C (21/28, 70 %) was predominant among blood donors with OBI. Most S gene mutations were associated with OBI, and the high frequency mutations included N40S, G44E, Q51R/P, T113A/S,T118K/M, P120Q/S/T, and Y161F/S. Notably, amino acid substitutions at some sites differed from those reported previously, such as Y72F, G102V, P127L, Q129P, and S143T. Additionally, six novel mutations (S31I/N/R, P46L, S58C, C76Y, Y200F/C, and I208T) that may be associated with OBI were found. OBI was detected in a certain proportion of blood donors in Huzhou City. S gene mutations play an important role in OBI development. Further research is required to explore the functions of novel S gene mutants in OBI pathogenesis. The findings of this study may provide important insights to prevent HBV transmission through blood transfusions.
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Affiliation(s)
- Yanping Mo
- Huzhou Center Blood Station, 577 Fenghuang Road, Huzhou, Zhejiang 313000, China
| | - Fang Jin
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China
| | - Dongli Li
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China
| | - Weihua Zou
- Department of Laboratory Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Jianfeng Zhong
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Zhaowei Tong
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Weihong Wang
- Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China; Department of Infectious Diseases, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China
| | - Fuchu Qian
- Departmentof Precision Medicine, Huzhou Central Hospital, Affiliated Central Hospital, Huzhou University, Huzhou, Zhejiang 313000, China; Huzhou Key Laboratory of Precision Medicine Research and Translation for Infectious Diseases, Huzhou Central Hospital, Affiliated Huzhou Hospital, Zhejiang University School of Medicine, Huzhou, Zhejiang 313000, China.
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2
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Liu H, Chen S, Liu X, Lou J. Effect of S-region mutations on HBsAg in HBsAg-negative HBV-infected patients. Virol J 2024; 21:92. [PMID: 38654327 PMCID: PMC11040738 DOI: 10.1186/s12985-024-02366-2] [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: 02/25/2024] [Accepted: 04/15/2024] [Indexed: 04/25/2024] Open
Abstract
BACKGROUND Occult HBV infection (OBI) is a special form of hepatitis B virus (HBV) infection that may cause Liver cirrhosis and hepatocellular carcinoma, causing significant harm to patients. Given the insidious nature of OBI, it is usually not easy to be detected. Most of the samples currently studied are concentrated on blood donors, however, patients in this special state have not been fully studied. This project aimed to study the effect of HBV S region mutations on HBsAg in patients with clinical OBI. METHODS Collect 107 HBsAg-/HBV DNA + blood samples from Beijing Youan Hospital, Capital Medical University from August 2022 to April 2023. Next, the successfully extracted and amplified HBV DNA S regions were sequenced. Construct mutant plasmids to verify the cell function of the high-frequency mutation sites and explore the possible molecular mechanism. RESULTS Sixty-eight HBsAg-negative samples were sequenced, revealing high-frequency amino acid substitution sites in the HBV S protein, including immune escape mutations (i.e., sY100C、sK122R、sI126T、sT131P、and sS114T) and TMD (Transmembrane domain) region substitutions (i.e., sT5A、sG10D、sF20S、and sS3N). We constructed a portion of the mutant plasmids and found that sT5A, sF20S, sG10D, sS3N, sI68T, and sI126T single point mutations or combined mutations may decrease HBsAg expression or change the antigenicity of HBsAg leading to detection failure. CONCLUSIONS HBsAg-negative patients may show various mutations and amino acid replacement sites at high frequency in the HBV S-region, and these mutations may lead to undetectable Hepatitis B surface antigen (HBsAg), HBsAg antigenic changes or secretion inhibition.
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Affiliation(s)
- Hui Liu
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Shuxiang Chen
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Xin Liu
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China
| | - Jinli Lou
- Clinical Laboratory Center, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China.
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3
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Takuissu GR, Kenmoe S, Amougou Atsama M, Atenguena Okobalemba E, Mbaga DS, Ebogo-Belobo JT, Bowo-Ngandji A, Oyono MG, Magoudjou-Pekam JN, Kame-Ngasse GI, Menkem EZ, Selly Ngaloumo AA, Banlock ATR, Feudjio AF, Zemnou-Tepap C, Meta-Djomsi D, Nyimbe Mviena GL, Nyebe Eloundou I, Yéngué JF, Kenfack-Zanguim J, Ndzie Ondigui JL, Zekeng Mekontchou RM, Touangnou-Chamda SA, Kamtchueng Takeu Y, Taya-Fokou JB, Mbongue Mikangue CA, Kenfack-Momo R, Kengne-Nde C, Nkie Esemu S, Njouom R, Ndip L. Global epidemiology of occult hepatitis B virus infections in blood donors, a systematic review and meta-analysis. PLoS One 2022; 17:e0272920. [PMID: 35994469 PMCID: PMC9394819 DOI: 10.1371/journal.pone.0272920] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2022] [Accepted: 07/28/2022] [Indexed: 11/19/2022] Open
Abstract
This study aimed to assess the global prevalence of occult hepatitis B in blood donors. We searched PubMed, Web of Science, Global Index Medicus, and Excerpta Medica Database. Study selection and data extraction were performed by at least two independent investigators. Heterogeneity (I2) was assessed using the χ2 test on the Cochran Q statistic and H parameters. Sources of heterogeneity were explored by subgroup analyses. This study is registered with PROSPERO, number CRD42021252787. We included 82 studies in this meta-analysis. The overall prevalence of OBI was 6.2% (95% CI: 5.4–7.1) in HBsAg negative and anti-HBc positive blood donors. Only sporadic cases of OBI were reported in HBsAg negative and anti-HBc negative blood donors. The overall prevalence of OBI was 0.2% (95% CI: 0.1–0.4) in HBsAg negative blood donors. The prevalence of OBI was generally higher in countries with low-income economic status. The results of this study show that despite routine screening of blood donors for hepatitis B, the transmission of HBV by blood remains possible via OBI and/or a seronegative window period; hence there is a need for active surveillance and foremost easier access to molecular tests for the screening of blood donors before transfusion.
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Affiliation(s)
- Guy Roussel Takuissu
- Centre for Food, Food Security and Nutrition Research, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Sebastien Kenmoe
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
- * E-mail:
| | - Marie Amougou Atsama
- Centre de Recherche sur les Maladies Émergentes et Re-Emergentes, Institut de Recherches Médicales et d’Etudes des Plantes Médicinales, Yaounde, Cameroon
| | | | | | - Jean Thierry Ebogo-Belobo
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | - Arnol Bowo-Ngandji
- Department of Microbiology, The University of Yaounde I, Yaounde, Cameroon
| | - Martin Gael Oyono
- Centre for Research on Health and Priority Pathologies, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | - Ginette Irma Kame-Ngasse
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | | | | | | | - Dowbiss Meta-Djomsi
- Centre de Recherche sur les Maladies Émergentes et Re-Emergentes, Institut de Recherches Médicales et d’Etudes des Plantes Médicinales, Yaounde, Cameroon
| | | | | | | | | | | | | | | | - Yrene Kamtchueng Takeu
- Medical Research Centre, Institute of Medical Research and Medicinal Plants Studies, Yaounde, Cameroon
| | | | | | - Raoul Kenfack-Momo
- Department of Biochemistry, The University of Yaounde I, Yaounde, Cameroon
| | - Cyprien Kengne-Nde
- Epidemiological Surveillance, Evaluation and Research Unit, National AIDS Control Committee, Douala, Cameroon
| | | | - Richard Njouom
- Virology Department, Centre Pasteur of Cameroon, Yaounde, Cameroon
| | - Lucy Ndip
- Department of Microbiology and Parasitology, University of Buea, Buea, Cameroon
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Jiang X, Chang L, Yan Y, Ji H, Sun H, Xiao Y, Song S, Feng K, Nuermaimaiti A, Wang L. Role of S Protein Transmembrane Domain Mutations in the Development of Occult Hepatitis B Virus Infection. Emerg Microbes Infect 2022; 11:2184-2196. [PMID: 35976035 PMCID: PMC9518280 DOI: 10.1080/22221751.2022.2114849] [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] [Indexed: 11/29/2022]
Abstract
Occult HBV infection (OBI) is a special infection status during Hepatitis B virus (HBV) infection. The underlying mechanism of its occurrence remains unclear. This study conducted sequencing analysis on 104 OBI plasma samples and 524 HBsAg positive samples from 29 blood centres, and searched for high-frequency mutations in transmembrane domain (TMD) of S protein in the OBI population. Plasmids with TMD high-frequency mutations were constructed, in vivo and in vitro functional experiments were performed to investigate possible molecular mechanisms of OBI occurrence. We found 22 high-frequency TMD mutations in genotype B OBI strains. Among them, five mutations can lead to impairment of HBsAg secretion; seven mutations had accumulated intracellular HBsAg while extracellular HBsAg didn’t decrease compared to wildtype. This study chose C85R from TMD2, F220C, and F220Y from TMD4 for further exploration. Protein structure predication showed these three mutant HBsAg displayed changed hydrophilic properties and tended to accumulate in the phospholipid bilayer of cell membrane. Mutant HBsAg’s secretion disorder may induce OBI. On the other hand, V168A + V177A from TMD3 expressed increased HBsAg both in intracellular and extracellular levels. This mutation had most unstable natural conformation and may be inclined to transition into V177A or V168A + S174N + V177A. These three mutations were more prone to mixed infection, presenting a state of coexistence, thus approaching the impaired secretion pattern of OBI. This study demonstrated TMD mutations could contribute to the occurrence of OBI and provided a theoretical basis for OBI study and the functional cure of chronic hepatitis B virus infection.
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Affiliation(s)
- Xinyi Jiang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Le Chang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Ying Yan
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Huimin Ji
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Huizhen Sun
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Yingzi Xiao
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Shi Song
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Kaihao Feng
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Abudulimutailipu Nuermaimaiti
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
| | - Lunan Wang
- National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology; Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, P.R. China.,Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, P.R. China.,Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, P.R. China."
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5
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Huo T, Cao J, Tian Y, Shi X, Wu L, Zhang M, Wong LL, Zhao L. Effect of Concomitant Positive Hepatitis B Surface Antigen on the Risk of Liver Metastasis: A Retrospective Clinical Study of 4033 Consecutive Cases of Newly Diagnosed Colorectal Cancer. Clin Infect Dis 2019; 66:1948-1952. [PMID: 29293940 DOI: 10.1093/cid/cix1118] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 12/22/2017] [Indexed: 12/16/2022] Open
Abstract
Background The aim of this study was to evaluate the effect of chronic hepatitis B infection on the risk of synchronous colorectal liver metastasis (synCRLM). Methods A total of 4033 consecutive patients with newly diagnosed colorectal cancer (CRC) with hepatitis B testing were enrolled. The prevalence of synCRLM was compared between hepatitis B surface antigen (HBsAg)-positive and -negative patients; significant predictors for synCRLM were analyzed by logistic regression analysis; Fibrosis-4 Index for Liver Fibrosis (FIB-4), aspartate aminotransferase-to-platelet ratio index (APRI), and hepatitis B e antigen (HBeAg) status were compared between patients with or without synCRLM. Results The prevalence of synCRLM was significantly higher in the HBsAg+ patients than that in the HBsAg- patients (15.57% vs 8.60%; P < .001, χ2 test). A logistic regression analysis indicated that HBsAg+ showed the highest hazard ratio (2.317 [95% confidence interval, 1.406-3.820]) for synCRLM. Both FIB-4 and APRI were significantly higher in those with HBsAg positivity but no synCRLM compared to those with HBsAg positivity and synCRLM (FIB-4: 1.23 [0.92-1.88] vs 1.09 [0.74-1.51], P = .045; APRI: 0.23 [0.227-0.387] vs 0.18 [0.171-0.309], P = .023, Mann-Whitney test; all shown as median [25th-75th percentile]); HBeAg positivity was detected in 26.32% of those with positive HBsAg and synCRLM compared to 18.45% of those with positive HBsAg but no synCRLM; the difference was not statistically significant. Conclusions Concomitant chronic HBV infection significantly increases the risk of CRLM, and for HBsAg+ CRC patients, elevated FIB-4/APRI may be antimetastatic. Further study is needed to determine whether active HBV replication is prometastatic.
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Affiliation(s)
- Tingting Huo
- Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Jinan
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, China
| | - Jingyu Cao
- Department of Hepatobiliary Surgery, Affiliated Hospital of Qingdao University, China
| | - Yaowen Tian
- Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Jinan
- School of Medicine and Life Sciences, University of Jinan-Shandong Academy of Medical Sciences, China
| | - Xuetao Shi
- Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Jinan
| | - Liqun Wu
- Department of Hepatobiliary Surgery, Affiliated Hospital of Qingdao University, China
| | - Mingzhi Zhang
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, China
| | - Linda L Wong
- Department of Surgery, University of Hawaii School of Medicine, Honolulu
| | - Lei Zhao
- Department of Hepatobiliary Surgery, Shandong Cancer Hospital and Institute, Jinan
- Department of Oncology, the First Affiliated Hospital of Zhengzhou University, China
- Shandong Cancer Hospital Affiliated to Shandong University, China
- Shandong Academy of Medical Science, Jinan, China
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6
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Wang T, Chen J, Zhang Q, Huang X, Xie N, Zhang J, Cai T, Zhang Y, Xiong H. Prevalence of hepatitis G virus infection among 67,348 blood donors in mainland China. BMC Public Health 2019; 19:685. [PMID: 31159757 PMCID: PMC6547458 DOI: 10.1186/s12889-019-6948-1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2019] [Accepted: 05/07/2019] [Indexed: 01/11/2023] Open
Abstract
Background Hepatitis G virus (HGV) infection transmitted from blood donors is a concern in China, as many articles about HGV infection in Chinese blood donors from different provinces have been published. This study aimed to evaluate the overall prevalence of HGV infection in Chinese blood donors and analyse the potential risk of HGV infection through blood transfusion in China. Methods We performed a literature search in PubMed, EMBASE, Web of Science, the Chinese BioMedical Literature Database (CBM) and the China National Knowledge Infrastructure (CNKI) up to October 2018 regarding the prevalence of HGV in Chinese blood donors. Eligibility assessment and data extraction were conducted independently by 2 researchers, and meta-analysis was performed to synthesize the data. Heterogeneity was evaluated using Cochran’s Q test and quantified using the I2 statistic. Subgroup analyses were performed to identify the possible sources of heterogeneity. Publication bias was assessed using both funnel plot and Egger’s tests. Results A total of 102 studies with 67,348 blood donors published from 1996 to 2016 and covering 26 provinces or municipalities were included for further analyses. The pooled prevalence of HGV was 3.91% (95%CI: 3.18–4.71%) by enzyme immune assay/enzyme linked immunosorbent assay (EIA/ELISA) and 3.25% (95%CI: 2.35–4.26%) by polymerase chain reaction (PCR). The prevalence of HGV may be significantly affected by region, province or municipality and potentially by the paid/voluntary status of the blood donors. No significant difference was found between plasma and full blood donation. Conclusions The prevalence of HGV in blood donors from China was similar to that in blood donors from many other countries and higher than that of some other hepatitis viruses, such as hepatitis B virus. The risk of transfusion-transmitted HGV still exists after routine blood donor screening, especially in those patients coinfected with other hepatitis viruses and/or HIV. On the basis of our study, we may suggest adding HGV screening for blood transfusions in mainland China in the future. Electronic supplementary material The online version of this article (10.1186/s12889-019-6948-1) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Taiwu Wang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China.,Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, 210002, People's Republic of China
| | - Juecai Chen
- The First Affiliated Hospital of Chengdu Medical College, Chengdu, 610500, People's Republic of China
| | - Qi Zhang
- Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, 210002, People's Republic of China
| | - Xia Huang
- Chongqing Blood Center, Chongqing, 400015, People's Republic of China
| | - Nanzhen Xie
- Chongqing General Hospital, Chongqing, 400013, People's Republic of China
| | - Jinhai Zhang
- Center for Disease Control and Prevention of Eastern Theater Command, Nanjing, 210002, People's Republic of China
| | - Tongjian Cai
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China
| | - Yao Zhang
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China.
| | - Hongyan Xiong
- Department of Epidemiology, College of Preventive Medicine, Army Medical University (Third Military Medical University), Chongqing, 400038, People's Republic of China.
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7
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Liu C, Chang L, Wang L. HBV DNA Test Among Blood Donations May Require Two Amplification Targets. Indian J Hematol Blood Transfus 2019; 35:544-550. [PMID: 31388271 DOI: 10.1007/s12288-018-01064-8] [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: 05/10/2018] [Accepted: 12/13/2018] [Indexed: 12/25/2022] Open
Abstract
To analyze the risk and reason of false-negative HBV DNA results of NAT reagents among blood donations of China and discuss the necessity of two amplification targets for HBV DNA tests among donations. In this study, samples that showed discordant results on two commercially available assay platforms were further detected by established in-house methods based on conserved regions of the HBV genome. The HBV concentration of these samples was determined using two commercially available reagents. The samples with high titers of HBV were detected by an in-house method. The samples showing high Ct differences between two regions in the in-house method were further sequenced and aligned with primers and probes. The results showed that the established method has a good detection performance. The mismatch between reverse primers and sample sequences led to decreased detection capacity of S and C regions by the in-house method, but it could be compensated by another region. Among the false-negative samples detected by commercial reagents, most were because of low titers; however, there were 7 samples with HBV DNA concentrations much higher than the LOD of the commercial reagents, which may be due to mismatch of the primer or probe. This study highlights the potential risk of HBV false-negative detection by commercial NAT reagents. The dual-target assay may be helpful for HBV screening and reduce the risk of false-negative detection.
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Affiliation(s)
- Chao Liu
- 1National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730 People's Republic of China
- 2Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People's Republic of China
- 3Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
| | - Le Chang
- 1National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730 People's Republic of China
- 2Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People's Republic of China
| | - Lunan Wang
- 1National Center for Clinical Laboratories, Beijing Hospital, National Center of Gerontology, No. 1 Dahua Road, Dongdan, Beijing, 100730 People's Republic of China
- 2Beijing Engineering Research Center of Laboratory Medicine, Beijing Hospital, Beijing, People's Republic of China
- 3Graduate School, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People's Republic of China
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8
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Huang X, Ma C, Zhang Q, Shi Q, Huang T, Liu C, Li J, Hollinger FB. Impact of "a" determinant mutations on detection of hepatitis B surface antigen (HBsAg) in HBV strains from Chinese patients with occult hepatitis B. J Med Virol 2017; 89:1796-1803. [PMID: 28513915 DOI: 10.1002/jmv.24859] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2016] [Accepted: 04/03/2017] [Indexed: 12/12/2022]
Abstract
This study was designed to detect mutations that occur within the "a" determinant in the S gene of the hepatitis B virus (HBV) in patients with occult hepatitis B (OHB), and to analyze the influence of these mutations on expression and reactivity of the hepatitis B surface antigen (HBsAg). Twenty-three certified OHB samples were compared to 32 HBsAg positive samples from patients with chronic hepatitis B. The median HBV DNA levels in the OHB group were significantly lower than those in the control group (P < 0.0001). Mutations within the "a" determinant were analyzed by gene amplification and sequencing. This revealed mixed infections in which clones within a sample displayed either different mutations or mutations in association with clones that exhibited wild type amino acid patterns. Sequencing analysis also showed a significant difference between the proportions of amino acid mutations observed in the OHB and control groups. Seven recombinant S (rS) proteins with corresponding OHB mutations and three wild type alleles were expressed and purified in the Pichia pastoris expression system to preserve conformational attributes, and their reactivity analyzed using six commercial HBsAg assays. The OHB sera were HBsAg nonreactive while the rS proteins with corresponding OHB mutations were universally reactive. Thus, we postulate that the reduced binding affinity between mutated HBsAg and its antibody may not be as important in defining OHB as is the effect of specific mutations in the preS/S region of the genome that affect the synthesis and secretion of the S protein and/or the virion.
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Affiliation(s)
- Xiangyan Huang
- Department of Blood Transfusion, The General Hospital of Jinan Military Command, Jinan, P. R. China
| | - Chenyun Ma
- Department of Medical Laboratory, Shanghai Seventh People's Hospital, Shanghai, P. R. China
| | - Qiang Zhang
- Department of Orthopedics, The General Hospital of Jinan Military Command, Jinan, P. R. China
| | - Qingfen Shi
- Department of Laboratory Diagnostics, Jinan Infectious Disease Hospital, Jinan, P. R. China
| | - Tao Huang
- Department of Viral Diseases, Shandong Center for Disease Control and Prevention, Jinan, P. R. China
| | - Chao Liu
- Department of Blood Transfusion, The General Hospital of Jinan Military Command, Jinan, P. R. China
| | - Jie Li
- Department of Blood Transfusion, The General Hospital of Jinan Military Command, Jinan, P. R. China
| | - F Blaine Hollinger
- Departments of Molecular Virology and Microbiology and Medicine, Baylor College of Medicine, Houston, Texas
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9
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Effects of Hazelnut Consumption on Blood Lipids and Body Weight: A Systematic Review and Bayesian Meta-Analysis. Nutrients 2016; 8:nu8120747. [PMID: 27897978 PMCID: PMC5188407 DOI: 10.3390/nu8120747] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2016] [Revised: 11/07/2016] [Accepted: 11/14/2016] [Indexed: 01/26/2023] Open
Abstract
Hazelnuts are rich in monounsaturated fatty acids and antioxidant bioactive substances: their consumption has been associated with a decreased risk of cardiovascular disease events. A systematic review and a meta-analysis was performed to combine the results from several trials and to estimate the pooled (overall) effect of hazelnuts on blood lipids and body weight outcomes. Specifically, a Bayesian random effect meta-analysis of mean differences of Δ-changes from baseline across treatment (MDΔ) (i.e., hazelnut-enriched diet vs. control diet) has been conducted. Nine studies representing 425 participants were included in the analysis. The intervention diet lasted 28–84 days with a dosage of hazelnuts ranging from 29 to 69 g/day. Out of nine studies, three randomized studies have been meta-analyzed showing a significant reduction in low-density lipoprotein (LDL) cholesterol (pooled MDΔ = −0.150 mmol/L; 95% highest posterior density interval (95%HPD) = −0.308; −0.003) in favor of a hazelnut-enriched diet. Total cholesterol showed a marked trend toward a decrease (pooled MDΔ = −0.127 mmol/L; 95%HPD = −0.284; 0.014) and high-density lipoprotein (HDL) cholesterol remained substantially stable (pooled MDΔ = 0.002 mmol/L; 95%HPD = −0.140; 0.147). No effects on triglycerides (pooled MDΔ = 0.045 mmol/L; 95%HPD = −0.195; 0.269) and body mass index (BMI) (pooled MDΔ = 0.062 kg/m2; 95%HPD = −0.293; 0.469) were found. Hazelnut-enriched diet is associated with a decrease of LDL and total cholesterol, while HDL cholesterol, triglycerides and BMI remain substantially unchanged.
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10
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Prevalence of HBV DNA among 20 million seronegative blood donations in China from 2010 to 2015. Sci Rep 2016; 6:36464. [PMID: 27833112 PMCID: PMC5105122 DOI: 10.1038/srep36464] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 10/17/2016] [Indexed: 12/21/2022] Open
Abstract
The prevalence of HBV DNA among seronegative blood donations in China has not been studied extensively on a nationwide scale. The aim of this study was to analyse the prevalence, trend, distributions, and serological characteristics of HBV DNA positive/seronegative blood donations. We collected HBV test data from all blood banks of China from 2010 to 2015 and performed supplemental serological tests and quantitative detection of HBV DNA of the seronegative/HBV DNA positive blood donations. We analysed the prevalence of HBV DNA among seronegative blood donations screened by varying nucleotide acid test (NAT) reagents. The analysis results showed that a total of 20,084,187 seronegative blood donations were screened by NAT from 2010 to 2015 in China. The average frequency of HBV DNA among seronegative blood donations was 1/1482, but there has been a steady increase from 1/1861 in 2011 to 1/1269 in 2015. The geographical distribution of seronegative and HBV DNA positive blood donations was roughly consistent with that of HBsAg. The most common serological pattern was HBeAb and HBcAb positive. In conclusion, our study offeres fundamental data of seronegative and HBV DNA positive blood donations throughout China.
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11
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Zhong L, Xi G, Zhang L, Liu S, Wan L, Yu L, Zhou M, Zhang J, He Y. The estimation of prevalence and risk factors of hepatitis B virus infection among blood donors in Chengdu, China. J Med Virol 2015; 88:260-7. [PMID: 26241150 DOI: 10.1002/jmv.24339] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/24/2015] [Indexed: 12/29/2022]
Abstract
The reported positive rates of hepatitis B virus surface antigen (HBsAg) among Chinese blood donors generally do not include data from pre-donation rapid tests. The aim of this study was to estimate the prevalence of serologic markers for HBsAg and risk factors among blood donors from Chengdu, China. From April 2010 to March 2011, a total of 16,875 blood donors were enrolled. Data from HBsAg tests before and after donations were collected to estimate the prevalence of HBsAg. A case-control study was conducted in 265 unique HBsAg-positive blood donors and 530 seronegative donors between January 2011 and October 2012. The odds ratio (OR) and 95% confidence interval (CI) were calculated using conditional logistic regression. The population attributable risk (PAR) was estimated. The prevalence of HBsAg was 3.17% (95%CI, 2.91-3.43%). The following risk factors were associated with HBV infection: non-vaccination for HBV (OR = 4.236; 95%CI, 2.72-6.60%), razor sharing (OR = 2.370; 95%CI, 1.46-3.84%), dental treatment (OR = 1.714; 95%CI, 1.21-2.43%), acupuncture (OR = 1.983; 95%CI, 1.20-3.28%), a family history of HBV infection (OR = 2.257; 95%CI, 1.32-3.86%), and endoscopy (OR = 2.17; 95%CI, 1.04-4.51%). The PAR values of the risk factors were 42.77%, 31.78%, 13.68%, 6.18%, 6.09%, and 2.85%, respectively, and the total PAR was 68.78%. The prevalence of HBsAg among Chinese blood donors is still high. HBV vaccinations can provide protection. Blood contact from sharing instruments is still a high risk route of transmission for HBV. Immunization programs and behavioral interventions should be used to prevent blood donation infections and improve blood safety.
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Affiliation(s)
- Li Zhong
- Department of Quality Control, Chengdu Blood Center, Chengdu, China
| | - Guangxiang Xi
- Department of Blood Supply, Chengdu Blood Center, Chengdu, China
| | - Lanjiang Zhang
- Department of Blood Screening, Chengdu Blood Center, Chengdu, China
| | - Shuangli Liu
- Department of Blood Collection, Chengdu Blood Center, Chengdu, China
| | - Like Wan
- Department of Blood Preparation, Chengdu Blood Center, Chengdu, China
| | - Lian Yu
- Department of Donor Service, Chengdu Blood Center, Chengdu, China
| | - Min Zhou
- Department of Donor Service, Chengdu Blood Center, Chengdu, China
| | - Jie Zhang
- Department of Administration Office, Chengdu Blood Center, Chengdu, China
| | - Yi He
- Department of Quality Control, Chengdu Blood Center, Chengdu, China
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12
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Claims and compensation for complications resulting from blood transfusions in China from 1998 to 2013. Transfus Apher Sci 2015; 53:329-36. [PMID: 26099664 DOI: 10.1016/j.transci.2015.06.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Revised: 06/06/2015] [Accepted: 06/08/2015] [Indexed: 12/25/2022]
Abstract
The purpose of this study was to find causes, outcomes, and trends in malpractice litigation involving blood transfusions in China. This study examines 108 claims resulting from transfusion-related complications over a period of 15 years. The primary outcomes associated with these claims included transfusion-transmitted infection (98 cases, 90.8%), transfusion reactions (nine cases, 8.3%), and failures to obtain informed consent (one case, 0.9%). The specialty of obstetrics and gynecology was more likely to be accepted in judgment. As the supreme status of law, Blood Donation Law plays an important role in the blood safety, which results in less HCV infection cases occurred after 1998. Though the 2002 and 2010's rules give opposite liability principle, the fault liability and no-fault liability, the statistics shows that rules do not have an effect on different liabilities in judicial practice. The current study concludes that the risk of serious adverse transfusion reactions may be significantly increased by unnecessary transfusions.
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13
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Li X, Kang H, Wang S, Deng Z, Yang T, Jia Y, Yang Y. Knowledge, attitude, and behavior of hepatitis B virus infection among chinese dental interns. HEPATITIS MONTHLY 2015; 15:e25079. [PMID: 26045703 PMCID: PMC4451273 DOI: 10.5812/hepatmon.15(5)2015.25079] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/02/2014] [Revised: 03/16/2015] [Accepted: 04/19/2015] [Indexed: 12/11/2022]
Abstract
BACKGROUND Blood is frequently involved in dental treatment procedures, which increases the exposure of dentists to a variety of blood-borne pathogens and microorganisms such as Hepatitis B Virus. OBJECTIVES The current study aimed to assess Chinese dental and medical interns' knowledge, attitude and behavior (KAB) towards Hepatitis B Virus (HBV) infection and to evaluate which exact KAB phase respondents were involved in. PATIENTS AND METHODS A self-administered questionnaire survey was conducted on 313 fifth to eighth year students. Descriptive statistics and bivariate analyses were used to identify correlations between KAB and the results obtained from different grades. RESULTS Despite the fact that Chinese dental interns had good general knowledge level, they lacked the experience with active and artificial immunities against HBV. Graduates forgot basic knowledge and applied the methods without understanding the terms. Compared with the medical interns, dental interns were less willing to treat patients with HBV infection. All three required vaccination doses were received by a significant number of dental interns. However the frequency of antibody titer status check and the use of eye wear or face mask were not satisfying. CONCLUSIONS It is therefore recommended that Chinese dental interns continue improving knowledge level, assume more positive attitude by accumulating clinical experience, and pay more attention to the overlooked procedures. The results of the current study can help the Chinese dental interns on theoretical studies and clinical practices regarding HBV.
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Affiliation(s)
- Xinyi Li
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Hengjiu Kang
- College of Engineering, University of California, Davis, United States of America
| | - Shuai Wang
- West China School of Stomatology, Sichuan University, Chengdu, China
| | - Zhaomin Deng
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Ting Yang
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
| | - Yiping Jia
- Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China
- Corresponding Authors: Yiping Jia, Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China. Yuan Yang, Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China. Tel: +86-18980040777, E-mail:
| | - Yuan Yang
- Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China
- Corresponding Authors: Yiping Jia, Department of Ultrasound, No.4 West china Teaching Hospital, Sichuan University, Chengdu, China. Yuan Yang, Department of Microbiology, West China School of Preclinical and Forensic Medicine, Sichuan University, Chengdu, China. Tel: +86-18980040777, E-mail:
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14
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Kwak MS, Kim YJ. Occult hepatitis B virus infection. World J Hepatol 2014; 6:860-869. [PMID: 25544873 PMCID: PMC4269905 DOI: 10.4254/wjh.v6.i12.860] [Citation(s) in RCA: 64] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2014] [Revised: 09/23/2014] [Accepted: 10/29/2014] [Indexed: 02/06/2023] Open
Abstract
Occult hepatitis B virus (HBV) infection (OBI) refers to the presence of HBV DNA in the absence of detectable hepatitis B surface antigen. Since OBI was first described in the late 1970s, there has been increasing interest in this topic. The prevalence of OBI varies according to the different endemicity of HBV infection, cohort characteristics, and sensitivity and specificity of the methods used for detection. Although the exact mechanism of OBI has not been proved, intra-hepatic persistence of viral covalently closed circular DNA under the host’s strong immune suppression of HBV replication and gene expression seems to be a cause. OBI has important clinical significance in several conditions. First, OBI can be transmitted through transfusion, organ transplantation including orthotopic liver transplantation, or hemodialysis. Donor screening before blood transfusion, prophylaxis for high-risk organ transplantation recipients, and dialysis-specific infection-control programs should be considered to reduce the risk of transmission. Second, OBI may reactivate and cause acute hepatitis in immunocompromised patients or those receiving chemotherapy. Close HBV DNA monitoring and timely antiviral treatment can prevent HBV reactivation and consequent clinical deterioration. Third, OBI may contribute to the progression of hepatic fibrosis in patients with chronic liver disease including hepatitis C. Finally, OBI seems to be a risk factor for hepatocellular carcinoma by its direct proto-oncogenic effect and by indirectly causing persistent hepatic inflammation and fibrosis. However, this needs further investigation. We review published reports in the literature to gain an overview of the status of OBI and emphasize the clinical importance of OBI.
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15
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Utsumi T, Yano Y, Hotta H. Molecular epidemiology of hepatitis B virus in Asia. World J Med Genet 2014; 4:19-26. [DOI: 10.5496/wjmg.v4.i2.19] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/26/2013] [Revised: 02/25/2014] [Accepted: 03/17/2014] [Indexed: 02/05/2023] Open
Abstract
Although safe and effective vaccines against hepatitis B virus (HBV) have been available for three decades, HBV infection remains the leading cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) worldwide, especially in Asian countries. HBV has been classified into at least 9 genotypes according to the molecular evolutionary analysis of the genomic DNA sequence and shown to have a distinct geographical distribution. Novel HBV genotypes/subgenotypes have been reported, especially from Southeast Asian countries. The clinical characteristics and therapeutic effectiveness of interferon (IFN) and nucleos(t)ide analogues vary among different HBV genotypes. Mutations at T1653C in subgenotype C2 from Japan and South Korea, C/A1753T and C1858T in subgenotype C1 from Vietnam, and C1638T and T1753V in subgenotype B3 from Indonesia were reported to be associated with advanced liver diseases including HCC. Genotype distribution in Japan has been changed by an increasing ratio of subgenotype A2 in chronic hepatitis B. While a large number of epidemiological and clinical studies have been reported from Asian countries, most of the studies were conducted in developed countries such as Taiwan, China, South Korea and Japan. In this review, the most recent publications on the geographical distribution of genetic variants of HBV and related issues such as disease progression and therapy in Asia are updated and summarized.
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