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Marasciulo F, Passerini I, Fichera A, Ferrari F, Odicino FE, Prefumo F. Hepatocellular carcinoma in pregnancy: A systematic review. Acta Obstet Gynecol Scand 2024; 103:653-659. [PMID: 37533304 PMCID: PMC10993335 DOI: 10.1111/aogs.14640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2023] [Revised: 06/21/2023] [Accepted: 06/23/2023] [Indexed: 08/04/2023]
Abstract
INTRODUCTION Hepatocellular carcinoma (HCC) is the most frequent primary malignant liver tumor and typically develops in the context of chronic liver disease, such as liver cirrhosis or chronic hepatitis B virus infection. Ultrasound evaluation, CT scan, and MRI are used to detect HCC. α-fetoprotein (AFP) is a common marker used to detect HCC in the non-pregnant population, which notoriously increases in pregnant women in relation to gestational age. Treatment is driven by the extent of the disease and the severity of underlying liver disease. Pregnancy may represent an obstacle to diagnosis and appropriate treatment of HCC. The aim of this descriptive systematic review was to describe the clinical features and maternal and neonatal outcomes of HCC in pregnancy. MATERIAL AND METHODS We performed a systematic review of the literature about HCC diagnosed in pregnancy and the postpartum period, with signs or symptoms arising in pregnancy. We included case reports and case series describing the clinical features of women diagnosed with HCC, fibrolamellar variant of HCC, and mixed HCC and cholangiocarcinoma during pregnancy or the postpartum period (with onset of symptoms during pregnancy), from inception to March 2023. The study protocol was registered with the PROSPERO database (Registration number: ID CRD42021275584). RESULTS We identified 180 records. The articles included in this systematic review were 47 case reports and 5 case series, for a total of 63 pregnancies. The two most frequent predisposing conditions were hepatitis B virus infection (30/63; 47%) and liver cirrhosis (14/63; 22%). Ultrasound evaluation was the most used technique to detect HCC. AFP was higher than normal in 28/46 patients tested (61%). Surgical treatment was the most used therapy, both during pregnancy and after delivery. Twenty-six patients (26/63; 42%) died within 6 months of diagnosis. Survival >24 months was 9% (4/46) in symptomatic and 29% (5/17) in asymptomatic women. No patient with cirrhotic liver survived more than 12 months. Thirty-eight newborns were alive at 28 days of age (38/63; 61%). CONCLUSIONS Hepatocellular carcinoma in pregnancy is associated with a high risk of maternal and neonatal mortality. Diagnosis in asymptomatic high-risk women or following abnormal maternal serum AFP screening is associated with better maternal outcomes.
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Affiliation(s)
- Francesco Marasciulo
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Irene Passerini
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Anna Fichera
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Federico Ferrari
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Franco E. Odicino
- Division of Obstetrics and Gynecology, ASST Spedali Civili, Department of Clinical and Experimental SciencesUniversity of BresciaBresciaItaly
| | - Federico Prefumo
- Obstetrics and Gynecology Unit, IRCCS Istituto Giannina GasliniGenoaItaly
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Zhao Y, Li D, Shi H, Liu W, Qiao J, Wang S, Geng Y, Liu R, Han F, Li J, Li W, Wu F. Associations between type 2 diabetes mellitus and chronic liver diseases: evidence from a Mendelian ranldomization study in Europeans and East Asians. Front Endocrinol (Lausanne) 2024; 15:1338465. [PMID: 38495785 PMCID: PMC10941029 DOI: 10.3389/fendo.2024.1338465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Accepted: 02/19/2024] [Indexed: 03/19/2024] Open
Abstract
Objective Multiple observational studies have demonstrated an association between type 2 diabetes mellitus (T2DM) and chronic liver diseases (CLDs). However, the causality of T2DM on CLDs remained unknown in various ethnic groups. Methods We obtained instrumental variables for T2DM and conducted a two-sample mendelian randomization (MR) study to examine the causal effect on nonalcoholic fatty liver disease (NAFLD), hepatocellular carcinoma (HCC), viral hepatitis, hepatitis B virus (HBV) infection, and hepatitis C virus (HCV) infection risk in Europeans and East Asians. The primary analysis utilized the inverse variance weighting (IVW) technique to evaluate the causal relationship between T2DM and CLDs. In addition, we conducted a series of rigorous analyses to bolster the reliability of our MR results. Results In Europeans, we found that genetic liability to T2DM has been linked with increased risk of NAFLD (IVW : OR =1.3654, 95% confidence interval [CI], 1.2250-1.5219, p=1.85e-8), viral hepatitis (IVW : OR =1.1173, 95%CI, 1.0271-1.2154, p=0.0098), and a suggestive positive association between T2DM and HCC (IVW : OR=1.2671, 95%CI, 1.0471-1.5333, p=0.0150), HBV (IVW : OR=1.1908, 95% CI, 1.0368-1.3677, p=0.0134). No causal association between T2DM and HCV was discovered. Among East Asians, however, there was a significant inverse association between T2DM and the proxies of NAFLD (ALT: IVW OR=0.9752, 95%CI 0.9597-0.9909, p=0.0021; AST: IVW OR=0.9673, 95%CI, 0.9528-0.9821, p=1.67e-5), and HCV (IVW: OR=0.9289, 95%CI, 0.8852-0.9747, p=0.0027). Notably, no causal association was found between T2DM and HCC, viral hepatitis, or HBV. Conclusion Our MR analysis revealed varying causal associations between T2DM and CLDs in East Asians and Europeans. Further research is required to investigate the potential mechanisms in various ethnic groups, which could yield new insights into early screening and prevention strategies for CLDs in T2DM patients.
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Affiliation(s)
- Yue Zhao
- Department of Surgery, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Di Li
- Department of Internal Medicine, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Hanyu Shi
- Department of Internal Medicine, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Wei Liu
- Department of General Surgery, Shandong Corps Hospital of Chinese People’s Armed Police Force, Jinan, China
| | - Jiaojiao Qiao
- Department of Nursing, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Shanfu Wang
- Department of Surgery, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Yiwei Geng
- School of Statistic and Data Science, Jiangxi University of Finance and Economics, Nanchang, Jiangxi, China
| | - Ruiying Liu
- Department of Nursing, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Feng Han
- Department of Surgery, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Jia Li
- Department of Health and Epidemic Prevention, Hospital of the First Mobile Corps of the Chinese People’s Armed Police Force, Dingzhou, Hebei, China
| | - Wei Li
- Department of General Surgery, The 980Hospital of the Chinese People's Liberation Army (PLA) Joint Logistics Support Force (Primary Bethune International Peace Hospital of Chinese People's Liberation Army (PLA), Shijiazhuang, Hebei, China
| | - Fengyun Wu
- Department of General Surgery, Characteristic Medical Center of the Chinese People’s Armed Police Force, Tianjin, China
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Liu Y, Nuersulitan R, Zhang C, Huo N, Li J, Song Y, Zhu J, Liu W, Zhao H. Steady Decline of HBV DNA Load under NAs in Lymphoma Patients and a Higher Level of qAnti-HBc Predict HBV Reactivation. J Clin Med 2023; 13:23. [PMID: 38202030 PMCID: PMC10779810 DOI: 10.3390/jcm13010023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Revised: 11/06/2023] [Accepted: 12/08/2023] [Indexed: 01/12/2024] Open
Abstract
Background: Patients with lymphoma and chronic hepatitis B virus infection need to be treated with both chemotherapy and nucleotide analogue (NA) therapy. However, dynamic changes in HBV DNA loads with increasing chemotherapy cycles are lacking. It is unknown whether HBV replication markers, namely, the quantitative hepatitis B core antibody (qAnti-HBc), HBV RNA, and the hepatitis B virus core-related antigen (HBcrAg), are also markers for predicting HBV reactivation (HBVr). Methods: From 29 June 2010 to 6 December 2021, the data of patients with single-site diffuse large B-cell lymphoma and HBV infection (HBsAg+ and HBsAg-/anti-HBc+) were collected from a hospital medical record system, retrospectively. Serum HBV DNA loads (using real-time fluorescent quantitative PCR tests), qAnti-HBc levels (using a newly developed chemiluminescent particle immunoassay), HBV RNA levels (using the simultaneous amplification testing method based on real-time fluorescence detection), and HBcrAg levels (using a Lumipulse G HBcrAg assay) were tested, and factors related to HBVr were analyzed. Results: Under NAs, the HBV DNA loads of 69 HBsAg+ lymphoma patients declined from 3.15 (2.13-4.73) lg IU/mL to 1.00 (1.00-1.75) lg IU/mL, and further declined to 1.00 (1.00-1.04) lg IU/mL at the end of a 24-month follow-up. The qAnti-HBc levels decreased gradually during chemotherapy in HBsAg+ lymphoma patients (F = 7.090, p = 0.009). The HBV RNA and HBcrAg levels remained stable. A multivariate analysis revealed that higher qAnti-HBc levels (1.97 ± 1.20 vs. 1.12 ± 0.84 lg IU/mL, OR = 6.369, [95% CI: 1.523-26.641], p = 0.011) and higher HBV RNA levels (1.00 ± 1.13 vs. 0.37 ± 0.80 lg copies/mL, OR = 3.299, [95% CI: 1.229-8.854], p = 0.018) were related to HBVr in HBsAg-/anti-HBc+ lymphoma patients. Conclusions: HBV DNA loads declined under NAs during chemotherapy in lymphoma patients. In HBsAg-/anti-HBc+ lymphoma patients, a higher level of baseline serum qAnti-HBc and HBV RNA levels can predict the likelihood of HBVr during chemotherapy.
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Affiliation(s)
- Yiqi Liu
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China; (Y.L.); (C.Z.); (N.H.); (J.L.)
| | - Reyizha Nuersulitan
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Thoracic Medical Oncology, Peking University Cancer Hospital & Institute, Beijing 100143, China;
| | - Chi Zhang
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China; (Y.L.); (C.Z.); (N.H.); (J.L.)
| | - Na Huo
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China; (Y.L.); (C.Z.); (N.H.); (J.L.)
| | - Jun Li
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China; (Y.L.); (C.Z.); (N.H.); (J.L.)
| | - Yuqin Song
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100143, China; (Y.S.); (J.Z.)
| | - Jun Zhu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100143, China; (Y.S.); (J.Z.)
| | - Weiping Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education), Department of Lymphoma, Peking University Cancer Hospital & Institute, No. 52 Fucheng Road, Haidian District, Beijing 100143, China; (Y.S.); (J.Z.)
| | - Hong Zhao
- Department of Infectious Disease, Center for Liver Disease, Peking University First Hospital, No. 8 XishiKu Street, Xicheng District, Beijing 100034, China; (Y.L.); (C.Z.); (N.H.); (J.L.)
- Department of Infectious Diseases, Peking University International Hospital, Beijing 102206, China
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Wang L, Peng JL. Association of hypoxia-inducible factor 1α expression with susceptibility to hepatitis B virus-related hepatocellular carcinoma: A meta-analysis. Int J Biol Markers 2023; 38:149-158. [PMID: 37787154 DOI: 10.1177/03936155231204391] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Hypoxia-inducible factor 1α (HIF-1α) triggers tumorigenesis and progression in hepatitis B virus (HBV)-related hepatocellular carcinoma (HCC). Inconsistent findings have been reported on the influence of HIF-1α over-expression on the clinical outcomes of HBV-related HCC. This study aims to clarify the role of HIF-1α overexpression in the tumorigenesis and prognosis of HBV-induced HCC. Systematic and comprehensive search of online papers was carried out to elucidate the contribution of HIF-1α expression to susceptibility of HBV-induced HCC. STATA 12.0 software was utilized to analyze available data extracted from all eligible literature. Publication bias and sensitivity were comprehensively analyzed. A total of 23 published studies involving 2244 subjects were finally screened. The HIF-1α expression was remarkably upregulated in HBV-induced HCC tissues than in normal liver tissues, non-tumorous tissues, paraneoplastic tissues, and non-HBV HCC tissues. The high HIF-1α expression tended to be positively related to capsular infiltration (odds ratio (OR) 1.767; 95% confidence interval (CI) 1.058, 2.950). The HIF-1α expression was relevant to lymph node metastasis (OR 3.778; 95% CI 1.666, 8.568). High levels of HIF-1α expression tended to be closely implicated in portal vein invasion (OR 6.728, 95% CI 2.191, 20.656) but were irrelevant to alpha-fetoprotein, cirrhosis, Edmondson grading, tumor size, age, gender, and histological grade. Analysis of pooled data showed that HIF-1α was not statistically relevant to poor overall survival in HBV-related HCC. Our data provides compelling evidence that HIF-1α overexpression may imply a greater probability of invasion and metastasis in patients with HBV-induced HCC.
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Affiliation(s)
- Lei Wang
- Department of Rehabilitation Medicine, Hunan Provincial People's Hospital, The First Affiliated Hospital of Hunan Normal University, Changsha, Hunan, China
| | - Jin-Lin Peng
- Department of Gastroenterology, The Affiliated Zhuzhou Hospital Xiangya Medical College CSU, Zhuzhou, Hunan, China
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Zhang Y, Zhang X, Xu X, Guo X, Xu S, Ma S, Chen J, Qi X. Association of C-type lectin-like receptor 2 and galectin-1 with portal vein system thrombosis in HBV-related liver cirrhosis. Front Med (Lausanne) 2023; 10:1228636. [PMID: 37720512 PMCID: PMC10501130 DOI: 10.3389/fmed.2023.1228636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 08/15/2023] [Indexed: 09/19/2023] Open
Abstract
Background and aims Hepatitis B virus (HBV) infection is the most common cause of liver cirrhosis. Portal venous system thrombosis (PVST) is a major complication of liver cirrhosis. Recently, it has been shown that C-type lectin-like receptor 2 (CLEC-2) and galectin-1 participate in the activation and aggregation of platelets, thereby promoting the development of thrombosis. This cross-sectional study aims to evaluate the association of serum CLEC-2 and galectin-1 levels with PVST in patients with HBV-related liver cirrhosis. Methods Overall, 65 patients with HBV-related liver cirrhosis were included, of whom 23 had PVST and 42 did not have. Serum CLEC-2 and galectin-1 levels were measured using enzyme-linked immunosorbent assay kits. PVST was assessed by contrast-enhanced computed tomography and/or magnetic resonance imaging scans. Subgroup analyses were conducted according to the degree and location of PVST. Results Patients with PVST had significantly higher serum CLEC-2 (p = 0.006) and galectin-1 (p = 0.009) levels than those without. Patients with partial/complete PVST or fibrotic cord (p = 0.007; p = 0.002), but not those with mural PVST (p = 0.199; p = 0.797), had significantly higher serum CLEC-2 and galectin-1 levels than those without PVST. Patients with superior mesenteric vein thrombosis had significantly higher serum CLEC-2 (p = 0.013) and galectin-1 (p = 0.025) levels than those without PVST. Patients with main portal vein thrombosis had higher serum CLEC-2 (p = 0.020) and galectin-1 (p = 0.066) levels than those without PVST, but the difference in serum galectin-1 level was not significant between them. Conclusion Serum CLEC-2 and galectin-1 levels may be associated with the presence of PVST in HBV-related cirrhotic patients, but this association should be dependent upon the degree of PVST.
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Affiliation(s)
- Yiyan Zhang
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Xintong Zhang
- Chinese People’s Liberation Army General Hospital, Chinese People’s Liberation Army Medical School, Beijing, China
| | - Xiangbo Xu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Shenyang Pharmaceutical University, Shenyang, China
| | - Xiaozhong Guo
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
| | - Shixue Xu
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, China Medical University, Shenyang, China
| | - Shaoze Ma
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Jihong Chen
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
- Postgraduate College, Dalian Medical University, Dalian, China
| | - Xingshun Qi
- Liver Cirrhosis Study Group, Department of Gastroenterology, General Hospital of Northern Theater Command, Shenyang, China
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Kurniawan AA, Maimunah U. A Very Young Adult Female Patient with Hepatitis B Flare: A Case Report. Acta Med Indones 2023; 55:320-326. [PMID: 37915151] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/03/2023]
Abstract
Hepatitis B virus (HBV) infection is a major global health problem. It can cause chronic infection and put people at high risk of death from cirrhosis and liver cancer. This study aims to present a case of chronic hepatitis B flare in a very young adult patient. An 18-year-old previously healthy female presented with jaundice developing in one week, following the previous complaints of nausea, vomiting, abdominal pain, loss of appetite, and tiredness for about three months. The patient had no risk factors for getting HBV infection, but her HBsAg-positive mother was probably an inactive HBV carrier. The hepatitis B serological testing revealed HBsAg positivity, anti-HBs seronegativity, HBeAg positivity, anti-HBe seronegativity, anti-HBc IgM seronegativity, and high levels of HBV DNA detected > 1.70 × 108 IU/mL. There was a sharp increase in serum ALT to ≥ 5-fold ULN. The abdominal ultrasonography revealed a hepatitis feature, unremarkable portal venous flow, and an extrahepatic biliary system. The liver transient elastography revealed 15.6 kPa of liver stiffness, which was in accordance with the F3-F4 fibrosis stage. These features were typical of a hepatitis B flare, the HBeAg-positive chronic hepatitis B, previously known as the immune reactive phase. A long-term nucleos(t)ide analog therapy was programmed with Tenofovir alafenamide 25 mg daily.
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Affiliation(s)
- Andreas Agung Kurniawan
- Internal Medicine Department, Faculty of Medicine, Universitas Airlangga, Surabaya, Indonesia.
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He J, Guo Y, Zhang Y, Han J, Chen J, Jia Y, Ma Z, Wu J, Zhang S, Li F, Mao R, Zhang J. Comparison of Pegylated Interferon Alfa Therapy in Combination with Tenofovir Alafenamide Fumarate or Tenofovir Disoproxil Fumarate for Treatment of Chronic Hepatitis B Patients. Infect Drug Resist 2023; 16:3929-3941. [PMID: 37361938 PMCID: PMC10290461 DOI: 10.2147/idr.s411183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 06/02/2023] [Indexed: 06/28/2023] Open
Abstract
Purpose The study aims to evaluate the effectiveness of a tenofovir alafenamide fumarate (TAF) and pegylated interferon alfa (PegIFN-α) regimen compared to a tenofovir disoproxil fumarate (TDF) and PegIFN-α therapy in patients with chronic hepatitis B (CHB). Patients and Methods Patients who were treated with PegIFN-α in combination with TAF or TDF were retrospectively enrolled. The primary outcome measured was the HBsAg loss rate. The rates of virological response, serological response for HBeAg, and normalization of alanine aminotransferase (ALT) were also calculated. The cumulative incidences of response rates were compared between the two groups using Kaplan-Meier analysis. Results A total of 114 patients were retrospectively enrolled in the study, with 33 receiving TAF plus PegIFN-α treatment and 81 receiving TDF plus PegIFN-α treatment. The HBsAg loss rate for the TAF plus PegIFN-α group was 15.2% at 24 weeks and 21.2% at 48 weeks, while the TDF plus PegIFN-α group had rates of 7.4% at 24 weeks and 12.3% at 48 weeks (P=0.204 at 24 weeks, P=0.228 at 48 weeks). In subgroup analysis of HBeAg positive patients, the TAF group had a higher HBsAg loss rate of 25% at week 48, compared to 3.8% in the TDF group (P=0.033). According to Kaplan-Meier analysis, the TAF plus PegIFN-α group achieved virological response more quickly than the TDF plus PegIFN-α group (p=0.013). There was no statistical difference in HBeAg serological rate or ALT normalization rate. Conclusion There was no significant difference in the HBsAg loss between the two groups. However, subgroup analysis revealed that TAF plus PegIFN-α treatment had a higher HBsAg loss rate than TDF plus PegIFN-α treatment in HBeAg-positive patients. Additionally, TAF plus PegIFN-α treatment demonstrated better virological suppression for CHB patients. Therefore, TAF plus PegIFN-α treatment regimen is recommended for CHB patients who aim to achieve functional cure.
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Affiliation(s)
- Jingjing He
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yifei Guo
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yao Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jiajia Han
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jingwen Chen
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Yidi Jia
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Zhenxuan Ma
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jingwen Wu
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Shenyan Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Fahong Li
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Richeng Mao
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
| | - Jiming Zhang
- Department of Infectious Diseases, Shanghai Key Laboratory of Infectious Diseases and Biosafety Emergency Response, Shanghai Institute of Infectious Diseases and Biosecurity, National Medical Center for Infectious Diseases, Huashan Hospital, Fudan University, Shanghai, People’s Republic of China
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Feng H, Dai W. Case Report: FDG-PET/CT findings in co-infection of visceral leishmaniasis and chronic hepatitis B. Front Cell Infect Microbiol 2023; 13:1175897. [PMID: 37325515 PMCID: PMC10264663 DOI: 10.3389/fcimb.2023.1175897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 05/16/2023] [Indexed: 06/17/2023] Open
Abstract
Visceral leishmaniasis is an opportunistic infection in immunocompromised patients. Herein, we report a case of an adult male patient with a persistent fever of unknown origin, along with chronic hepatitis B. The patient underwent bone marrow aspiration twice, which revealed hemophagocytosis. Abdomen enhanced CT revealed splenomegaly with a persistent strengthening of multiple nodules, and hemangiomas were diagnosed. A subsequent 18-fluoro-deoxyglucose (18F-FDG) PET/CT scan, which was implemented to search for the reason for the fever, showed diffuse splenic disease uptake, and splenic lymphoma was considered as the diagnosis. His clinical symptoms improved after receiving hemophagocytic lymphohistiocytosis (HLH) chemotherapy. However, the patient was readmitted for fever again only 2 months later. Splenectomy surgery is performed to confirm the diagnosis and classification of lymphoma. Visceral leishmaniasis was eventually diagnosed in a spleen specimen and the third bone marrow biopsy. He received treatment with lipid amphotericin B and remained recurrence-free for 1 year. In this paper, we aim to provide detailed information that will help further our understanding of the clinical symptoms and radiographic findings of visceral leishmaniasis.
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Affiliation(s)
| | - Wenli Dai
- Department of Nuclear Medicine, The First College of Clinical Medical Science, China Three Gorges University, Yichang, Hubei, China
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Umer A, Teklemariam Z, Ayele F, Mengesha MM. Prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals at Hararghe, Eastern Ethiopia. Front Glob Womens Health 2023; 4:1056488. [PMID: 37181544 PMCID: PMC10174709 DOI: 10.3389/fgwh.2023.1056488] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 03/29/2023] [Indexed: 05/16/2023] Open
Abstract
Background Hepatitis B infection is one of the world's most serious public health problems, causing significant morbidity and mortality. More than 2 billion individuals around the world have been infected with the hepatitis B virus (HBV), and approximately 400 million people are chronically infected with the virus, with more than a million dying each year from hepatitis B virus-related liver disease. A newborn infant whose mother is positive for both HBsAg and HBeAg has a 90% chance of developing chronic infection by the age of 6. Its infectivity is a 100 times that of the human immunodeficiency virus, but it receives little attention in public health. Therefore, this study was conducted to assess the prevalence of hepatitis B infection and its associated factors among pregnant mothers attending antenatal care at public hospitals in west Hararghe, eastern Ethiopia 2020. Method This institution-based cross-sectional study was conducted on 300 pregnant mothers selected by systematic random sampling from September to December 2020. Data were collected by face-to-face interview using a pretested structured questionnaire. A blood sample was collected and tested for hepatitis B surface antigen using the enzyme-linked immunosorbent assay test method. Data were entered into EpiData version 3.1 and exported to Statistical Package for the Social Science version 22 for analysis. Bivariate and multivariable logistic regressions were used to assess the association between outcome and predictor variables. P-value <0.05 was considered to be statistically significant. Results The overall seroprevalence of hepatitis B virus infection was 8% [95% confidence interval (CI): 5.3-11.0] among pregnant mothers. History of tonsillectomy [adjusted odd ratio (AOR) = 5.7; 95% CI: 1.3-23.9], tattoo (AOR = 4.3; 95% CI: 1.1, 17.0), having multiple sexual partners (AOR = 10.8; 95% CI: 2.5, 45.9), and history of contact with jaundiced patients (AOR = 5.6; 95% CI: 1.2, 25.7) were factors associated with the seroprevalence of hepatitis B virus infection among pregnant mothers. Conclusion The hepatitis B virus was highly prevalent. A history of tonsillectomy, tattooing, having multiple partners, and contact with jaundiced patients were factors associated with hepatitis B virus infection. To reduce HBV transmissions, the government should increase HBV vaccination coverage. All newborns should receive the hepatitis B vaccine as soon as possible after birth. It is also recommended that all pregnant women have HBsAg testing and antiviral prophylaxis to reduce the risk of transmission from mother to child. Hospitals, districts, regional health bureaus, and medical professionals should also educate pregnant women about hepatitis B virus transmission and prevention, both in the hospital and in the community, with a focus on modifiable risk factors.
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Affiliation(s)
- Abbas Umer
- West Hararghe Zone Health Office, Chiro, Ethiopia
| | - Zelalem Teklemariam
- School of Medical Laboratory Sciences, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
| | - Firayad Ayele
- School of Medical Laboratory Sciences, Haramaya University College of Health and Medical Sciences, Harar, Ethiopia
- Correspondence: Firayad Ayele
| | - Melkamu Merid Mengesha
- School of Public Health, College of Medicine and Health Sciences, Arba Minch University, Arba Minch, Ethiopia
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Cione E, Abrego Guandique DM, Caroleo MC, Luciani F, Colosimo M, Cannataro R. Liver Damage and microRNAs: An Update. Curr Issues Mol Biol 2022; 45:78-91. [PMID: 36661492 DOI: 10.3390/cimb45010006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2022] [Revised: 12/12/2022] [Accepted: 12/20/2022] [Indexed: 12/28/2022] Open
Abstract
One of the major organs in the body with multiple functions is the liver. It plays a central role in the transformation of macronutrients and clearance of chemicals and drugs. The serum biomarkers often used to indicate liver damage are not specifically for drug-induced liver injury (DILI) or liver injury caused by other xenobiotics, nor for viral infection. In this case, microRNAs (miRNAs) could play an exciting role as biomarkers of specific liver damage. In this review, we aimed to update the current literature on liver damage induced by drugs, as acute conditions and viral infections mediated by the hepatitis B virus (HBV) linked these two conditions to advanced research, with a focus on microRNAs as early biomarkers for liver damage. The undoubtable evidence that circulating miR-122 could be used as a human biomarker of DILI came from several studies in which a strong increase of it was linked with the status of liver function. In infancy, there is the possibility of an early miRNA detection for hepatitis B virus infection, but there are a lack of solid models for studying the HVB molecular mechanism of infection in detail, even if miRNAs do hold unrealized potential as biomarkers for early detection of hepatitis B virus infection mediated by HBV.
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11
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Yi W, Li M, Sun F, Lu H, Zeng Z, Bi X, Yang L, Lin Y, Cao X, Hu Y, Zhou M, Zhang L, Lu Y, Wan G, Xie Y. Impact of in vitro fertilization-embryo transfer on mother-to-infant transmission in women with chronic HBV infection. Liver Int 2022; 42:2167-2174. [PMID: 35758891 DOI: 10.1111/liv.15349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 04/15/2022] [Accepted: 06/24/2022] [Indexed: 02/13/2023]
Abstract
BACKGROUND AND AIMS In vitro fertilization-embryo transfer (IVF-ET) may increase the risk of mother-to-child transmission (MTCT) of hepatitis B virus (HBV). The purpose of this study was to investigate the impact and safety of IVF-ET on MTCT in women with chronic HBV infection (CHB). METHODS The data of 298 women who got pregnant by IVF-ET and their 375 children were collected retrospectively. Mothers were divided into the CHB group (n = 224) and the control group (HBsAg negative, n = 74). After birth, newborns were routinely vaccinated with the hepatitis B vaccine, and infants in the CHB group were injected with hepatitis B immunoglobulin within 2 h after birth. Demographic information, clinical data and laboratory test results were collected. The primary outcome measures were the MTCT rate of HBV, and the secondary outcome measures were the safety of the mother and infant. RESULTS There was no case of HBV MTCT in all 282 newborns born in the CHB group and 93 neonates born in the control group. Of the two groups, the birth weight (3056.74 ± 601.65 vs. 2926.24 ± 704.86, P = .083), length (49.22 ± 1.97 vs. 48.74 ± 3.09, P = .167), 5-min Apgar score (9.97 ± 0.21 vs. 9.90 ± 0.51, P = .212), days of pregnancy (265.70 ± 12.73 vs. 262.02 ± 17.50, P = .064) and neonatal malformation rate (0.71% vs. 0, P = 1.000) were similar. Two cases of neonatal malformation occurred in the CHB group. The incidences of pregnancy and childbirth complications were similar between the two groups. CONCLUSION IVF-ET does not increase the risk of MTCT in women with chronic HBV infection, and it is safe for mothers and infants.
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Affiliation(s)
- Wei Yi
- Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Minghui Li
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China
| | - Fangfang Sun
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Huihui Lu
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Zhan Zeng
- Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China
| | - Xiaoyue Bi
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Liu Yang
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yanjie Lin
- Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China
| | - Xiuzhen Cao
- Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yuhong Hu
- Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Mingfang Zhou
- Department of Obstetrics and Gynecology, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Lu Zhang
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yao Lu
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Gang Wan
- Department of Medical and Biological Statistics, Beijing Ditan Hospital, Capital Medical University, Beijing, China
| | - Yao Xie
- Department of Hepatology Division 2, Beijing Ditan Hospital, Capital Medical University, Beijing, China.,Department of Hepatology Division 2, Peking University Ditan Teaching Hospital, Beijing, China
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12
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Zhou D, Sun SR, Sun Y, Min R. Healthcare for Patients with Hepatitis B Virus: Analysis of 367 381 Inpatient Cases in China. Curr Med Sci 2022; 42:658-665. [PMID: 35451809 DOI: 10.1007/s11596-022-2575-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 12/30/2021] [Indexed: 11/03/2022]
Abstract
OBJECTIVE Hepatitis B virus (HBV) infection, which has been recognized as an international public health challenge, has caused significant morbidity for the entire world. This research focused on patients with HBV in China to examine health utilization and expenses. METHODS Patients hospitalized with HBV from 2017 to 2019 in tertiary hospitals in Hubei, a province located in central China, were selected as the study population. Healthcare information was collected from the provincial inpatient electronic system database. Univariate and regression analyses were performed to describe the basic situation of healthcare services and determine the influencing indicators of inpatient service expenditure. RESULTS A total of 367 381 cases of HBV infection were identified in the study area. Most of these cases were patients who were married (90.2%) and males (63%). With the great efforts by the universal coverage of the basic medical insurance (BMI) in China, the increasing rate of inpatient hospitalization for HBV was 3.5 times higher than that of the total inpatient health service cases in the study area. The average age of this group was 52.84±14.10 years and 11.1% of patients paid for their own medical expenditures without insurance. The average length of stay (LOS) was 11.10 days, and the average cost per patient was 15 712.05 RMB. Both values were higher than the average level in study area. Gender, marital status, career, payment type, and kind of hospitals significantly influenced healthcare utilization. Males and the elderly might incur higher healthcare costs than their counterparts. CONCLUSION The BMI operated by government has played a role in the utilization release of health services for HBV carriers. However, researchers must pay more attention to the continuing increase in the medical expenses of this group.
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Affiliation(s)
- Da Zhou
- Center for Health Information and Statistics of Hubei, Wuhan, 430079, China
| | - Shi-Ran Sun
- Department of Hepatobiliary Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China
| | - Yang Sun
- School of Politics and Management, Wuhan University, Wuhan, 430072, China
| | - Rui Min
- School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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13
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Luu NM, Nguyen TKT, Vu TT, Dinh TS, Luu NH, Do TTT, Nguyen VS, Ha TBV, Nguyen DC, Tran TH, Phung TTH, Duong XP, Khuong QL, Nguyen TTT, Saw YM, Hoang TNA, Nguyen TN. Progression of liver fibrosis and associated factors among chronic hepatitis B patients at a general hospital in Northern Vietnam. Nagoya J Med Sci 2022; 84:19-28. [PMID: 35392005 PMCID: PMC8971045 DOI: 10.18999/nagjms.84.1.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Accepted: 05/12/2021] [Indexed: 11/30/2022]
Abstract
Evaluation of liver fibrosis is necessary to make the therapeutic decision and assess the prognosis of CHB patients. The current study aimed to describe the progression and identify some influencing factors in patients with chronic hepatitis B at a General Hospital in Northern Vietnam. The longitudinal study included 55 eligible subjects diagnosed Hepatitis-B-virus. Dependent variable was the aspartate aminotransferase/platelet ratio index and we collected some demographic variables and disease related and behaviour variables. Bayesian Model Averaging was used to select variables into model. Mixed-effect linear models were used to evaluate the change of the aspartate aminotransferase/platelet ratio index over time and identify related factors. the aspartate aminotransferase/platelet ratio index differences between examinations, age of participants, working status were statistically significant. This pattern indicated that the average the aspartate aminotransferase/platelet ratio index of the population decreased by 0.005 (95% CI=-0.009; -0.001) after each patient's visit, and increased by 0.013 if the patient's age increased by 1 year (95% CI=0.005; 0.0219). For non-working patients, the aspartate aminotransferase/platelet ratio index was lower, coefficient was -0.054 (95% CI=-0.108; 0.001). Other variables such as gender, education level, time for disease detection, drinking tea, alcohol consumption, forgetting to take medicine and the aspartate aminotransferase/platelet ratio index were not significantly different. The study showed that the majority of study subjects had average the aspartate aminotransferase/platelet ratio index, and were relatively well controlled and treated during the study. Age and working status are factors that influence the the aspartate aminotransferase/platelet ratio index.
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Affiliation(s)
- Ngoc Minh Luu
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | - Thu Trang Vu
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Thai Son Dinh
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | - Ngoc Hoat Luu
- Medical Faculty, Phenikaa University, Hanoi, Vietnam
| | - Thi Thanh Toan Do
- Institute for Preventive Medicine and Public Health, Hanoi Medical University, Hanoi, Vietnam
| | | | | | | | | | | | | | - Quynh Long Khuong
- Center for Population Health Sciences, Hanoi University of Public Health, Hanoi, Vietnam
| | - Thi Thu Trang Nguyen
- Division of Public Health and Nutrition, General Department of Preventive Medicine, Ministry of Health, Hanoi, Vietnam
| | - Yu Mon Saw
- Graduate School of Medicine, Nagoya University, Nagoya, Japan
| | - Thi Ngoc Anh Hoang
- Department of Epidemiology, National Institute of Hygiene and Epidemiology, Hanoi, Vietnam
| | - Thi Nhan Nguyen
- Foreign Language Department, Hanoi Medical University, Hanoi, Vietnam
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14
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Gupta A, Ramachandran K, Paul D, Gupta E. Evaluation of three different rapid card tests for the detection of hepatitis B surface antigen. Trop Doct 2022; 52:307-310. [PMID: 35072566 DOI: 10.1177/00494755211069712] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Rapid diagnostic card tests are crucial steps on the road to hepatitis B elimination and should be incorporated into diagnostic algorithms. However, all commercial rapid diagnostic card tests are not equal and require evaluation before clinical use. Thus, we aimed to compare the performance characteristics of three different rapid diagnostic card tests with chemiluminescence-based assay (CLIA) for the detection of hepatitis B surface antigen.We concluded rapid diagnostic card tests can be used to identify patients with high signal/cut-off ratio on CLIA, but patients with signal/cut-off ratio <200 may be missed. Rapid diagnostic card tests may help pave the way for decentralised testing, but should be used only after evaluation in the community.
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Affiliation(s)
- Akshita Gupta
- Department of Clinical Virology, 80402Institute of Liver and Biliary Sciences, New Delhi, India
| | - Krithiga Ramachandran
- Department of Clinical Virology, 80402Institute of Liver and Biliary Sciences, New Delhi, India
| | - Diptanu Paul
- Department of Clinical Virology, 80402Institute of Liver and Biliary Sciences, New Delhi, India
| | - Ekta Gupta
- Department of Clinical Virology, 80402Institute of Liver and Biliary Sciences, New Delhi, India
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15
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Zhang C, Wei H, Zhu YX. Adverse pregnancy outcomes and mother-to-child transmission in patients with hepatitis B virus infection and intrahepatic cholestasis of pregnancy. Ginekol Pol 2022; 93:396-404. [PMID: 34541645 DOI: 10.5603/GP.a2021.0110] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2020] [Revised: 03/19/2021] [Accepted: 04/05/2021] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate adverse pregnancy outcomes (APOs) and mother-to-child transmission (MTCT) of intrahepatic cholestasis in pregnancy (ICP) in hepatitis B virus infection (HBV) patients. MATERIAL AND METHODS We performed a retrospective study at Beijing Youan Hospital in China from January 2010 through May 2017. A total of 232 patients were enrolled, including 106 HBV-infected ICP patients (Group H + C), 20 ICP patients (Group C) and 106 HBV-infected patients (Group H). Characteristics, APOs and MTCT rate of HBV were compared between groups. Group H + C was subdivided into 3 groups according to total bile acid (TBA) values and gestational age at diagnosis (GA). APOs were also compared within Group H + C according to TBA values and GA. RESULTS There was no difference in live birth delivery mode and APOs between Groups H + C and C. Compared with Groups H, no difference was in live birth and MTCT rates of HBV. However, cesarean section delivery and APOs rates were higher in Group H+C (p < 0.05). Compared with Group H, adverse maternal outcomes such as postpartum hemorrhage and premature birth were more likely to occur in Group H + C (p < 0.001). Adverse fetal outcomes, the proportions of amniotic fluid reaching III degrees (AFIII), NICU admission, neonatal asphyxia and SGA were significantly higher among Group H + C than Group H (p < 0.05). Contamination of the AFIII rate increased with increasing TBA (p < 0.05). The rate of preterm birth and small for gestational age (SGA) was more common in GA 28-32 w compared with GA < 28 w and > 33 w (p < 0.01). CONCLUSIONS H + C patients had more APOs than HBV patients, but the difference was not significant when compared with ICP patients. Although we did not find any difference in MTCT rate between H + C and HBV patients, active treatment to prevent neonatal asphyxia and HBV infection should be considered. Therefore, it is necessary to emphasize maternal and fetal monitoring during pregnancy and delivery.
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Djebali-Trabelsi A, Marot A, André C, Deltenre P. Large-scale screening is not useful for identifying individuals with hepatitis B or C virus infection: A prospective Swiss study. J Viral Hepat 2021; 28:1756-1758. [PMID: 34342098 DOI: 10.1111/jvh.13588] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 06/18/2021] [Accepted: 07/23/2021] [Indexed: 12/09/2022]
Affiliation(s)
- Aicha Djebali-Trabelsi
- Division of Gastroenterology and Hepatology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Astrid Marot
- Department of Gastroenterology and Hepatology, CHU UCL Namur, Université Catholique de Louvain, Yvoir, Belgium
| | - Cyril André
- Division of Immunology and Allergology, Centre Hospitalier Universitaire Vaudois, University of Lausanne, Lausanne, Switzerland
| | - Pierre Deltenre
- Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, CUB Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium.,Department of Gastroenterology and Hepatology, Clinique St-Luc, Bouge, Belgium
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17
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Zhou J, Wang FD, Wang ML, Tao YC, Wu DB, Sheng YJ, Xiao GB, Chen XB, Chen X, Chen EQ. Antiviral Therapy for Chronic HBV Infection With Persistently Normal Alanine Aminotransferase: Controversy and Consensus. Front Med (Lausanne) 2021; 8:717125. [PMID: 34527683 PMCID: PMC8435583 DOI: 10.3389/fmed.2021.717125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Accepted: 08/09/2021] [Indexed: 02/05/2023] Open
Abstract
ALT is one of the most sensitive biochemical indexes to reflect liver injury. It is generally believed that hepatitis B virus (HBV) infected patients with normal ALT levels are in either immune tolerance or low replication stage of the natural history of hepatitis B, and there is no or only mild inflammation in liver tissue, so antiviral therapy is not recommended. However, chronic HBV-infected patients with normal ALT levels are not always in a stable state. A considerable number of patients will develop active hepatitis or occult progress to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Therefore, whether antiviral therapy should be recommended for chronic HBV infection with normal ALT level has been a hot topic in clinical practice. In this paper, the definition of immune tolerance, the relationship between ALT and liver inflammation, and the benefits of antiviral therapy were reviewed, and we hope it will be helpful for clinicians to have a deeper understanding of whether antiviral therapy should be considered for chronic HBV infection with normal ALT.
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Affiliation(s)
- Jing Zhou
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Fa-Da Wang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Meng-Lan Wang
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Ya-Chao Tao
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Dong-Bo Wu
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
| | - Yun-Jian Sheng
- Department of Infection, Affiliated Hospital of Southwest Medical University, Luzhou, China
| | - Gui-Bao Xiao
- Department of Infectious Diseases, The First People's Hospital of Ziyang City, Ziyang, China
| | - Xue-Bin Chen
- Department of Infectious Diseases, People's Hospital of Deyang City, Deyang, China
| | - Xin Chen
- Department of Infectious Diseases, The Second People's Hospital of Neijiang, Neijiang, China
| | - En-Qiang Chen
- Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China
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18
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Benarji KA, Anitha A, Suresh B, Aparna V, Praveena A, Penumatsa LA. Knowledge and attitude of dental students toward hepatitis B virus and its vaccination - A cross-sectional study. J Oral Maxillofac Pathol 2021; 25:553. [PMID: 35281163 PMCID: PMC8859610 DOI: 10.4103/jomfp.jomfp_387_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2021] [Accepted: 12/02/2021] [Indexed: 12/02/2022] Open
Abstract
Objectives: To estimate the awareness of hepatitis B virus (HBV) and coverage of hepatitis B vaccination among dental students enrolled in dental colleges located in Andhra Pradesh. Materials and Methods: A cross-sectional study was conducted using a prestructured questionnaire to find out the awareness of HBV and coverage of hepatitis B vaccine among dental students. Results: A total of 2780 dental students were approached to participate in the study but only 2701 (97.1%) students (M = 900, F = 1801) gave response. Out of the total 2701 students, 79.45% were aware of HBV infection and only 51.50% of the participants received hepatitis B vaccine. 20.5% have come across HBV infected patients and 59.5% are unaware of postexposure protocol. Of all, 63.9%, 21.5% and 42% felt the mode of transmission is blood, sexual contact and oral fluids, respectively. 49.12% recommended for awareness programs on risks in HBV; 56.46% suggested mandatory Hepatitis B vaccination programs in dental colleges. Conclusions: Despite the availability and accessibility of a cost-effective hepatitis B vaccine, the vaccination coverage among dental students was low. Health education needs to be improved for all health care students especially for dental students.
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Affiliation(s)
- Kotti Ajay Benarji
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - Akkaloori Anitha
- Assistant Professor, Department of Public Health Dentistry, Govt Dental College and Hospital, Hyderabad, Telangana, India
| | - Babburi Suresh
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - V Aparna
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
| | - A Praveena
- Department of Oral Pathology and Microbiology, Drs Sudha and Nageswara Rao Siddhartha Institute of Dental Sciences, Gannvaram, Andhra Pradesh, India
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Tocco-Tussardi I, Fila A, Tralli V, Bordin P, Gazzani D, Majori S, Postiglione C, Tardivo S, Moretti F. Screening for hepatitis B virus infection among refugees diagnosed with latent tuberculosis in an Italian community. Ann Ig 2021; 33:602-614. [PMID: 34213522 DOI: 10.7416/ai.2021.2452] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Background Refugees are a growing population in the EU-27 area with specific health needs that are to be addressed in the most rapid and effective way at their arrival in the host country. Screening for Hepatitis B Virus infection is offered to specific categories and it could be useful and effective to extend its indications. The aim of this study was to define the epidemiological profile regarding Hepatitis B Virus infection in re-fugees hosted in the Asylum Seekers Centers of Verona (Italy), diagnosed with latent tuberculosis infection and eligible for chemoprophylaxis. Methods We conducted a retrospective study in 715 refugees diagnosed with latent tuberculosis infection from January 1st, 2015 to December 31st, 2017. Screening for Hepatitis B Virus infection was offered to la-tent tuberculosis infection patients who were due to commence treatment. Subjects were tested for Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies. None of the screened patients reported previous vaccination for hepatitis B. Results Among the 715 refugees diagnosed with latent tuberculosis infection, 593 were eligible for treatment for latent tuberculosis infection. Of these, 211 (35.6%) accepted to be screened for Hepatitis B Virus infection. One hundred and ninety-five of the 211 (92.4%) came from African countries, and 16 (7.6%) from Asia; the majority (80.9%) were males. Median age was 23 years (95% CI 22-24). Of the 211, 58 individuals (27.5%) were Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies positive; 74 (35.1%) were Hepatitis B surface Antigen negative and Hepatitis B core antigen total antibodies positive; and 79 (37.4%) were Hepatitis B surface Antigen and Hepatitis B core antigen total antibodies negative. Male gender and African origin were associated with a lower probability of being Hepatitis B surface Antigen- and Hepatitis B core antigen total antibodies-negative. Conclusions Screening for Hepatitis B Virus is of paramount importance not only for the control and prevention of infection, but also in terms of long-term healthcare issues. Making screening more systematic can have an important impact on public health, while always considering cost-effectiveness and promotion of awareness among ethnic groups in order to gain their compliance to treatment/vaccination.
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Affiliation(s)
- I Tocco-Tussardi
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - A Fila
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - V Tralli
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - P Bordin
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - D Gazzani
- Service of Hygiene and Public Health, Territorial Department of Prevention of Verona, Verona, Italy
| | - S Majori
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - C Postiglione
- Service of Hygiene and Public Health, Territorial Department of Prevention of Verona, Verona, Italy
| | - S Tardivo
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
| | - F Moretti
- Department of Diagnostics and Public Health, University of Verona and Integrated University Hospital of Verona, Verona, Italy
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Stasi C, Tiengo G, Sadalla S, Zignego AL. Treatment or Prophylaxis against Hepatitis B Virus Infection in Patients with Rheumatic Disease Undergoing Immunosuppressive Therapy: An Update. J Clin Med 2021; 10:jcm10122564. [PMID: 34200522 PMCID: PMC8227638 DOI: 10.3390/jcm10122564] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Revised: 05/31/2021] [Accepted: 06/07/2021] [Indexed: 12/20/2022] Open
Abstract
Chronic hepatitis B virus (HBV) flares or reactivations are serious causes of morbidity or mortality in rheumatologic patients undergoing immunosuppressive therapy. The recent insights in the pathogenesis of rheumatic diseases led to the use of new immunosuppressive therapies indicated in case of failure, partial response, or intolerance of conventional synthetic disease-modifying anti-rheumatic drugs. Based on these premises, this review examines and discusses the main rheumatologic treatments that could require the initiation of prophylactic treatment or close monitoring of occult HBV infection in patients beginning antiviral therapy at the first signs of HBV reactivation, or antiviral treatment in chronic HBV-infected patients. We searched for relevant studies published in the last five years. Studies suggested that the presence of HBV infection is common in rheumatic patients and HBV reactivation during these immunosuppressant treatments is quite frequent in these kinds of patients. Therefore, before starting an immunosuppressive therapy, patients should be screened for HBsAg, anti-HBs, and anti-HBc and, on the basis of markers positivity, they should be carefully characterized for HBV infection phases. In conclusion, screening of HBV infection in patients undergoing immunosuppressive therapy with subsequent HBV monitoring, prophylaxis or treatment consistently reduces the risk of clinical consequences.
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Affiliation(s)
- Cristina Stasi
- MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence and CRIA-MASVE Center for Research and Innovation, Careggi University Hospital, 50134 Florence, Italy; (G.T.); (A.L.Z.)
- Epidemiology Unit, Regional Health Agency of Tuscany, 50141 Florence, Italy
- Correspondence:
| | - Giacomo Tiengo
- MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence and CRIA-MASVE Center for Research and Innovation, Careggi University Hospital, 50134 Florence, Italy; (G.T.); (A.L.Z.)
| | - Sinan Sadalla
- Department of Medical and Surgical Sciences, University of Bologna, 40126 Bologna, Italy;
| | - Anna Linda Zignego
- MASVE Interdepartmental Hepatology Center, Department of Experimental and Clinical Medicine, University of Florence and CRIA-MASVE Center for Research and Innovation, Careggi University Hospital, 50134 Florence, Italy; (G.T.); (A.L.Z.)
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Wang T, Zhou W, Jiang R, Lai J, Jiang P, Chen X, Li B. Predictive factors associated with disease recurrence in patients with severe intrahepatic cholestasis of pregnancy: a retrospective study of 118 cases. J Matern Fetal Neonatal Med 2021; 35:6807-6814. [PMID: 33998381 DOI: 10.1080/14767058.2021.1925645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
PURPOSE To compare the clinical characteristics of pregnant women and perinatal outcomes with or without recurrent severe intrahepatic cholestasis of pregnancy (sICP), and identify possible factors associated with disease recurrence. METHODS A retrospective study of 164,603 deliveries was performed to identify pregnant women diagnosed with sICP in the previous pregnancy from January 2012 to December 2020. Eligible patients were divided into two subgroups according to the status of disease recurrence in the second pregnancy: recurrent severe ICP (r-sICP) and non-recurrent severe ICP (nr-sICP). Demographics, clinical characteristics, maternal and perinatal outcomes, and potential factors linked to disease recurrence were analyzed. RESULTS Totally 118 patients were enrolled and respectively classified into the r-sICP group (n = 63) and the nr-sICP group (n = 55). The proportion of hepatitis B virus (HBV) infection (HBsAg+, HBeAg+, HBcAb+) and early-onset ICP (<28 weeks) in the r-sICP group in the previous pregnancy were higher than those in the nr-sICP group. In the second delivery, neonatal outcomes in the r-sICP group were worse than those in the nr-sICP group. Logistic regression analysis of predictive factors for disease recurrence in the second delivery revealed that the combination of HBV infection and early-onset ICP in the previous delivery had the steepest receiver-operating characteristic (ROC) curve value 0.720 (95%CI: 0.629-0.812). CONCLUSION Patients with sICP displayed a higher recurrence rate in the second pregnancy. Being <28 weeks at the time of ICP diagnosis and having HBV infection in the previous delivery appear to be independent predictive factors for disease recurrence of sICP.
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Affiliation(s)
- Ting Wang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Weixiao Zhou
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Ruoan Jiang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Jianbo Lai
- Department of Psychiatry, the First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Peiyue Jiang
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Xinning Chen
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
| | - Baohua Li
- Department of Obstetrics and Gynecology, Women's Hospital, Zhejiang University School of Medicine, Hangzhou, China
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22
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Pollicino T, Caminiti G. HBV-Integration Studies in the Clinic: Role in the Natural History of Infection. Viruses 2021; 13:368. [PMID: 33652619 DOI: 10.3390/v13030368] [Citation(s) in RCA: 41] [Impact Index Per Article: 13.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2021] [Revised: 02/21/2021] [Accepted: 02/22/2021] [Indexed: 02/06/2023] Open
Abstract
Hepatitis B virus (HBV) infection is a major global health problem causing acute and chronic liver disease that can lead to liver cirrhosis and hepatocellular carcinoma (HCC). HBV covalently closed circular DNA (cccDNA) is essential for viral replication and the establishment of a persistent infection. Integrated HBV DNA represents another stable form of viral DNA regularly observed in the livers of infected patients. HBV DNA integration into the host genome occurs early after HBV infection. It is a common occurrence during the HBV life cycle, and it has been detected in all the phases of chronic infection. HBV DNA integration has long been considered to be the main contributor to liver tumorigenesis. The recent development of highly sensitive detection methods and research models has led to the clarification of some molecular and pathogenic aspects of HBV integration. Though HBV integration does not lead to replication-competent transcripts, it can act as a stable source of viral RNA and proteins, which may contribute in determining HBV-specific T-cell exhaustion and favoring virus persistence. The relationship between HBV DNA integration and the immune response in the liver microenvironment might be closely related to the development and progression of HBV-related diseases. While many new antiviral agents aimed at cccDNA elimination or silencing have been developed, integrated HBV DNA remains a difficult therapeutic challenge.
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23
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Chang S, Wang LHC, Chen BS. Investigating Core Signaling Pathways of Hepatitis B Virus Pathogenesis for Biomarkers Identification and Drug Discovery via Systems Biology and Deep Learning Method. Biomedicines 2020; 8:biomedicines8090320. [PMID: 32878239 PMCID: PMC7555687 DOI: 10.3390/biomedicines8090320] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2020] [Revised: 08/19/2020] [Accepted: 08/21/2020] [Indexed: 12/17/2022] Open
Abstract
Hepatitis B Virus (HBV) infection is a major cause of morbidity and mortality worldwide. However, poor understanding of its pathogenesis often gives rise to intractable immune escape and prognosis recurrence. Thus, a valid systematic approach based on big data mining and genome-wide RNA-seq data is imperative to further investigate the pathogenetic mechanism and identify biomarkers for drug design. In this study, systems biology method was applied to trim false positives from the host/pathogen genetic and epigenetic interaction network (HPI-GEN) under HBV infection by two-side RNA-seq data. Then, via the principal network projection (PNP) approach and the annotation of KEGG (Kyoto Encyclopedia of Genes and Genomes) pathways, significant biomarkers related to cellular dysfunctions were identified from the core cross-talk signaling pathways as drug targets. Further, based on the pre-trained deep learning-based drug-target interaction (DTI) model and the validated pharmacological properties from databases, i.e., drug regulation ability, toxicity, and sensitivity, a combination of promising multi-target drugs was designed as a multiple-molecule drug to create more possibility for the treatment of HBV infection. Therefore, with the proposed systems medicine discovery and repositioning procedure, we not only shed light on the etiologic mechanism during HBV infection but also efficiently provided a potential drug combination for therapeutic treatment of Hepatitis B.
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Affiliation(s)
- Shen Chang
- Laboratory of Automatic Control, Signal Processing and Systems Biology, Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan;
| | - Lily Hui-Ching Wang
- Institute of Molecular and Cellular Biology, National Tsing Hua University, Hsinchu 30013, Taiwan;
| | - Bor-Sen Chen
- Laboratory of Automatic Control, Signal Processing and Systems Biology, Department of Electrical Engineering, National Tsing Hua University, Hsinchu 30013, Taiwan;
- Correspondence:
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24
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Fan W, Liao W, Luo Y, You B, Yu J, Li C. Clinical prediction for outcomes of patients with acute-on-chronic liver failure associated with HBV infection: A new model establishment. Open Med (Wars) 2020; 15:714-722. [PMID: 33336028 PMCID: PMC7712409 DOI: 10.1515/med-2020-0207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2020] [Revised: 03/03/2020] [Accepted: 06/09/2020] [Indexed: 12/16/2022] Open
Abstract
Objective The acute-on-chronic liver failure associated with hepatitis B virus (HBV-ACLF) was a type of clinical syndrome with rapid deterioration of liver function. It was characterized by short-term elevated bilirubin, ascites, prolonged clotting time, hepatic encephalopathy, organ failures, and high short-term mortality. It was important to predict and evaluate the disease early. This study intended to comprehensively analyze the prognostic factors of patients with ACLF associated with HBV DNA infection through clinical manifestations and laboratory tests, and to establish a corresponding prediction and evaluation model for further clinical guidance. Methods A total of 220 patients were first diagnosed with HBV-ACLF and admitted to and treated at the Department of Infectious Diseases of the First Affiliated Changhai Hospital of the Second Military Medical University from 2009 to 2018. These patients' records were collected and divided into two groups: (1) 120 patients who were improved and discharged were classified as good prognosis group and (2) 100 patients who died or underwent liver transplantation were classified as poor prognosis group. By analyzing baseline characteristics and clinical indicators of the two groups, the main potential factors affecting prognosis were identified and the corresponding prognostic evaluation model was established. This model's advantages and disadvantages were compared with classic prognostic scoring systems. Results The proportion of ascites and the proportion of hepatic encephalopathy of poor prognosis group were significantly higher than those of good prognosis group. The total bilirubin, creatinine, white blood cell count, and NEU (%) levels of poor prognosis group were significantly higher than those of good prognosis group, and the international normalized ratio, albumin (ALB), alanine aminotransferase, Na, Cl, RBC, and PLT levels of poor prognosis group were significantly lower than those of good prognosis group. A new prediction model LR(p) = 1/(1 + e -Z ) was established, where z = 10.0127 + 0.3687 × NEUT (%) - 0.0082 × PLT + 1.8157 × hepatic encephalopathy. The area under receiver operating characteristic (ROC) curve was 0.89, specificity was 80.83%, and sensitivity was 81%. The newly established prognostic model was compared with other three scoring systems including model for end-stage liver disease (MELD), MELD-Na, and ALBI scores. The results showed that the specificity, sensitivity, and area under the ROC curve of the newly established model were significantly higher than the other three scoring systems. Conclusion Hepatic encephalopathy, NEU (%), and PLT levels were independent risk factors for predicting the prognosis of HBV-ACLF. The new prediction model LR(p) had better prediction accuracy than the other three scoring models of MELD, MELD-Na, and ALBI and could more accurately assess the prognosis of HBV-ACLF, but in the later stage, it was still necessary to expand the sample size for verification.
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Affiliation(s)
- Wenhan Fan
- Department of Infectious Diseases, The First Affiliated Changhai Hospital of The Second Military Medical University, Shanghai, China
| | - Wei Liao
- Department of Infectious Diseases, The First Affiliated Changhai Hospital of The Second Military Medical University, Shanghai, China
| | - Yiping Luo
- School of Basic Medical Sciences, The Second Military Medical University, Shanghai, China
| | - Benming You
- Department of Medicinal Materials, The First Affiliated Changhai Hospital of The Second Military Medical University, Shanghai 200433, China
| | - Jiao Yu
- Department of Infectious Diseases, The First Affiliated Changhai Hospital of The Second Military Medical University, Shanghai, China
| | - Chengzhong Li
- Department of Infectious Diseases, The First Affiliated Changhai Hospital of The Second Military Medical University, Shanghai, China
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25
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Hyun C, McMenamin J, Ko O, Kim S. Efficacy of a Mobile Texting App (HepTalk) in Encouraging Patient Participation in Viral Hepatitis B Care: Development and Cohort Study. JMIR Mhealth Uhealth 2020; 8:e15098. [PMID: 32234704 PMCID: PMC7160703 DOI: 10.2196/15098] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 02/10/2020] [Accepted: 02/29/2020] [Indexed: 01/05/2023] Open
Abstract
Background Chronic hepatitis B virus (HBV) infection is a major cause of liver-related morbidity and mortality among Asian Americans in the United States. Despite the available resources, a majority of HBV-infected individuals are not able to access adequate health care owing to numerous barriers. Objective This study aimed to assess the efficacy of a newly developed mobile texting app (HepTalk) in overcoming these barriers and improving patient engagement and health care access among HBV-infected and nonimmune individuals. Methods HepTalk was employed for two-way communication between participants and patient navigators. A total of 82 Korean American participants who were either HBV infected or nonimmune to HBV, identified from a community hepatitis B campaign in New York, were enrolled in the study. After informed consent was obtained, both the frequency and themes of the text messages were evaluated. The effects of this communication on linkage to care at the end of the 6-month intervention period were analyzed and discussed. Results On average, patient navigators sent and received 14 and 8 messages per participant, respectively, during the 6-month period. The themes of the messages were similar to the following 4 categories: finding providers, scheduling appointments with providers, health education, and financial issues. Of the 82 participants, 78 were linked to care within 6 months (a 95% linkage rate). Conclusions HepTalk may be employed as an effective and strategic tool to facilitate communicative interaction between patients and patient navigators or health care providers, thereby improving patient engagement and health care access.
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Affiliation(s)
- Chul Hyun
- The Center for Viral Hepatitis, Englewood, NJ, United States
| | | | - Okhyun Ko
- Korean Community Services Public Health and Research Center, New York, NY, United States
| | - Soonsik Kim
- Korean Community Services Public Health and Research Center, New York, NY, United States
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26
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Mak JSM, Lao TT, Leung MBW, Chung CHS, Chung JPW, Cheung LP, Li TC. Ovarian HBV replication following ovulation induction in female hepatitis B carriers undergoing IVF treatment: A prospective observational study. J Viral Hepat 2020; 27:110-117. [PMID: 31519044 DOI: 10.1111/jvh.13210] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2019] [Revised: 08/14/2019] [Accepted: 08/15/2019] [Indexed: 01/15/2023]
Abstract
Hepatitis B virus (HBV) can be found in ovarian tissues. This study compared HBV DNA levels in follicular fluid collected during oocyte retrieval with paired serum samples in HBV carriers after ovarian stimulation during IVF treatment for infertility. Sixty-four HBV carrier women referred to the Assisted Reproductive Units of two Hong Kong hospitals were recruited. At oocyte retrieval, the follicular fluid aspirated from the first follicle was collected for study. In 22 women, the first follicular fluid sample from both ovaries was similarly collected and studied. These women were also tested for liver function test and HBeAg. In 28 (43.8%) women, HBV DNA was detected in follicular fluid and the level correlated with serum levels (Spearman's correlation P < .001). There was concordant detection of HBV DNA in both ovaries, and the levels were significantly correlated (Spearman's correlation P = .029). In 40% of women with FF HBV DNA, the follicular fluid:serum ratio was >1.0, suggesting stimulation of HBV replication. These women also had significantly different liver function test results. Increased HBV replication exists in 40% of women with HBV DNA detected in follicular undergoing ovarian stimulation during IVF treatment.
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Affiliation(s)
- Jennifer Sze Man Mak
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Terence T Lao
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Maran Bo Wah Leung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Cathy Hoi Sze Chung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jacqueline Pui Wah Chung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Lai Ping Cheung
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Tin-Chiu Li
- Assisted Reproduction Technology Unit, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong
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27
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Guo D, Xu P, Guan C, Xu Y, Yang Y, Xu J, Zhou R, Chen B. Hepatitis B virus infection and 1q21 amplification in multiple myeloma. Oncol Lett 2019; 18:6196-6206. [PMID: 31788095 DOI: 10.3892/ol.2019.10926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2018] [Accepted: 02/27/2019] [Indexed: 11/05/2022] Open
Abstract
Hepatitis B virus (HBV) is a hepatotropic and a lymphotropic virus. An association between HBV and hematologic malignancies has been determined previously; however, the association between HBV infection and multiple myeloma (MM) remains controversial. The present study aimed to assess the prevalence of HBV infection in patients with MM, and investigate their characteristics and prognostic significance. The clinical data of 165 patients with MM who had received at least four cycles of chemotherapy between April 2008 and February 2017 at Nanjing Drum Tower Hospital (Nanjing, China) were collected. HBV markers were determined using ELISA. The rates of acute or chronic HBV infection and resolved HBV infection in patients with MM were 12.12 and 26.06%, respectively. The gain of 1q21 was significantly more prevalent in the patients who were classified as HBV-positive compared with the patients who were classified as HBV-negative (54 vs. 38.2%; P=0.048), and the level of alanine transaminase in patients who were classified as HBV-positive was significantly increased compared with the non-infected group (63.29 vs. 24.66 U/l; P=0.043). Lactate dehydrogenase, serum creatinine and serum calcium levels were additionally determined to be significant risk factors of overall survival. The progression-free survival (PFS) of patients who were classified as HBV-positive was decreased compared with patients who were classified as HBV-negative (18.97 vs. 29.67 months; P=0.006), and being HBV-positive was determined to be an independent prognostic factor of PFS. HBV infection may contribute to MM progression through 1q21 amplification, and improved monitoring of HBV markers in patients with MM may be required.
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Affiliation(s)
- Dan Guo
- Department of Hematology, Affiliated Hospital of Nantong University, Nantong, Jiangsu, 226001, P.R. China.,Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Peipei Xu
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Chaoyang Guan
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yong Xu
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Yonggong Yang
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Jingyan Xu
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Rongfu Zhou
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
| | - Bing Chen
- Department of Hematology, Nanjing Drum Tower Hospital, Clinical College of Nanjing Medical University, Nanjing, Jiangsu 210029, P.R. China
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28
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Li N, Fan X, Wang X, Zhang X, Zhang K, Han Q, Lv Y, Liu Z. Genetic association of polymorphisms at the intergenic region between PRDM1 and ATG5 with hepatitis B virus infection in Han Chinese patients. J Med Virol 2019; 92:1198-1205. [PMID: 31729038 DOI: 10.1002/jmv.25629] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Accepted: 11/12/2019] [Indexed: 12/21/2022]
Abstract
Chronic hepatitis B virus (HBV) infection is related to chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC), and the interplay between the virus and host immune response leads to different outcomes of the infection. PR domain zinc finger protein 1 (PRDM1) and autophagy-related protein 5 (ATG5) are involved in immune response and HBV infection. An intergenic region between PRDM1 and ATG5 (PRDM1-ATG5 region) has been identified, and single-nucleotide polymorphisms (SNPs) in this region were shown to be involved in immune regulation. This study investigated the functionally relevant rs548234, rs6937876, and rs6568431 polymorphisms at the PRDM1-ATG5 region in a Han Chinese population (403 patients with chronic HBV infection [171 chronic hepatitis, 119 cirrhosis, and 113 HCC], 70 infection resolvers, and 196 healthy controls). The frequencies of the rs6568431 allele A in HBV patients (P = .005) and genotype CA in infection resolvers (P = .005) were significantly higher than in healthy controls. In the dominant model, HCC patients had significantly higher frequencies of rs548234 genotypes CC + TC than cirrhosis patients (P = .009). Rs548234 was an independent factor for HCC in comparison with either cirrhosis (P = .005) or all chronic HBV infection without HCC (P = .018). Functional annotation showed evidence of the role of the SNPs in gene regulation. In conclusion, through this study it is revealed for the first time that rs6568431 may be associated with susceptibility to HBV infection and that rs548234 may be associated with HCC risk in chronic HBV infection, supporting the presence of HBV-related disease-causing regulatory polymorphisms in the PRDM1-ATG5 intergenic region.
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Affiliation(s)
- Na Li
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiude Fan
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoyun Wang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Xiaoge Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Kun Zhang
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Qunying Han
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Yi Lv
- Department of Hepatobiliary Surgery, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
| | - Zhengwen Liu
- Department of Infectious Diseases, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.,Institute of Advanced Surgical Technology and Engineering, Xi'an Jiaotong University, Xi'an, Shaanxi, China
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29
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Dai Y, Che F, Jiang X, Cui D, Zhou H, Xu X, Sun C, Cheng J. Clinical characteristics and association analysis of persistent low-level HBsAg expression in a physical examination population with HBV infection. Exp Ther Med 2019; 19:19-32. [PMID: 31853269 PMCID: PMC6909745 DOI: 10.3892/etm.2019.8217] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2019] [Accepted: 08/05/2019] [Indexed: 02/07/2023] Open
Abstract
Certain patients with hepatitis B virus (HBV) infection present with persistently low levels of serum hepatitis B surface antigen (HBsAg) and have been indicated to have low rates of HBV nucleic acid replication. To explore the serological and molecular epidemiological characteristics of HBV population with low-level HBsAg in the present study, associated serum markers and virologic genotype detection were performed accordingly. Determination of HBV markers was performed using a chemiluminescence immunoassay from which 2,544 out of 45,256 adults who underwent routine health examination were tested positive for HBsAg. HBV DNA was detected by real-time fluorescent quantitative PCR. The patients were divided into low-level and high-level groups, according to their HBsAg levels (cut-off value, 10 IU/ml). The prevalence and levels of HBsAg positivity and HBV DNA in patients with HBV infection were analyzed by age, sex, serological pattern and clinical type. The fibrosis status of patients with low-level HBsAg was assessed by determining the aspartate aminotransferase-to-platelet ratio (APRI), and sequencing was employed to determine serotypes and genotypes. HBV-infected patients with low-level HBsAg (<10 IU/ml) accounted for 15.41% of the 2,544 HBsAg-positive patients, and the prevalence of HBsAg positivity exhibited a tendency to increase with age. The male-to-female ratio was ~1.9:1, and the average age was 54.98±16.28 years among HBV-infected patients with low-level HBsAg. The major serological pattern and clinical types were HBsAg/antibody against hepatitis Be antigen (anti-HBe)/antibody against hepatitis B core antigen (anti-HBc)-positive (94.90%) and chronic asymptomatic (ASC) (97.95%), respectively. HBV DNA exhibited a low-level of replication and the prevalence of HBV DNA positivity assessed by the routine method and by the enrichment method was 27.74% (97/392) and 45.92% (180/392), respectively. No significant differences among the age groups were identified in the different HBsAg level groups (P>0.05). The prevalence of HBV DNA positivity was associated with HBsAg only in patients with serological pattern HBV-M2 (HBsAg/anti-HBe/anti-HBc-positive) in the low-level HBsAg group (odds ratio: 1.30; 95% CI: 1.15–1.47; P<0.05). The APRI had no association with age, HBsAg, HBV DNA level or liver function index in ASC patients in the low-level HBsAg group (P>0.05). The prevalence of the serotype adw and genotype B was 85.53 and 89.47%, respectively. Further improvement in the systematic study of populations with low-level HBsAg has important clinical and epidemiological significance for improving the detection of HBV serological markers, elucidating the mechanisms leading to low-level HBsAg, overcoming immune tolerance to eliminate HBV infection and preventing HBV transmission.
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Affiliation(s)
- Yuzhu Dai
- Department of Clinical Laboratory, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China.,Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Feihu Che
- Department of Clinical Laboratory, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Xiaoxiao Jiang
- Department of Respiration, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Dawei Cui
- Department of Laboratory Medicine, Key Laboratory of Clinical In Vitro Diagnostic Techniques of Zhejiang Province, The First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang 310003, P.R. China
| | - Huajun Zhou
- Department of Clinical Laboratory, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Xujian Xu
- Department of Biotechnology, University of Tokyo, Tokyo 1138656, Japan
| | - Changgui Sun
- Department of Clinical Laboratory, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China
| | - Jun Cheng
- Department of Clinical Laboratory, The 903rd Hospital of The PLA, Hangzhou, Zhejiang 310013, P.R. China.,Department of Medical Laboratory, Faculty of Graduate Studies, Jiangsu University, Zhenjiang, Jiangsu 212013, P.R. China.,Department of Medical Laboratory, Faculty of Graduate Studies, Bengbu Medical College, Bengbu, Anhui 233000, P.R. China
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Apata IW, Nguyen DB, Khudyakov Y, Mixson-Hayden T, Rosenberg J, Zahn M, Greenko J, Clement E, Portney AE, Kulkarni PA, Comer M, Adams E, Kamili S, Patel PR, Moorman AC. Hepatitis B Virus Mutant Infections in Hemodialysis Patients: A Case Series. Kidney Med 2019; 1:347-53. [PMID: 32734215 DOI: 10.1016/j.xkme.2019.07.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Rationale & Objective Hepatitis B virus (HBV) transmission in hemodialysis units has become a rare event since implementation of hemodialysis-specific infection control guidelines: performing hemodialysis for hepatitis B surface antigen (HBsAg)-positive patients in an HBV isolation room, vaccinating HBV-susceptible (HBV surface antibody and HBsAg negative) patients, and monthly HBsAg testing in HBV-susceptible patients. Mutations in HBsAg can result in false-negative HBsAg results, leading to failure to identify HBsAg seroconversion from negative to positive. We describe 4 unique cases of HBsAg seroconversion caused by mutant HBV infection or reactivation in hemodialysis patients. Study Design Following identification of a possible HBsAg seroconversion and mutant HBV infection, public health investigations were launched to conduct further HBV testing of case patients and potentially exposed patients. A case patient was defined as a hemodialysis patient with suspected mutant HBV infection because of false-negative HBsAg testing results. Confirmed case patients had HBV DNA sequences demonstrating S-gene mutations. Setting & Participants Case patients and patients potentially exposed to the case patient in the respective hemodialysis units in multiple US states. Results 4 cases of mutant HBV infection in hemodialysis patients were identified; 3 cases were confirmed using molecular sequencing. Failure of some HBsAg testing platforms to detect HBV mutations led to delays in applying HBV isolation procedures. Testing of potentially exposed patients did not identify secondary transmissions. Limitations Lack of access to information on past HBsAg testing platforms and results led to challenges in ascertaining when HBsAg seroconversion occurred and identifying and testing all potentially exposed patients. Conclusions Mutant HBV infections should be suspected in patients who test HBsAg negative and concurrently test positive for HBV DNA at high levels. Dialysis providers should consider using HBsAg assays that can also detect mutant HBV strains for routine HBV testing.
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Goa A, Dana T, Bitew S, Arba A. Seroprevalence and associated factors of hepatitis B virus infection among HIV-positive adults attending an antiretroviral treatment clinic at Wolaita Sodo University Referral Hospital. Hepat Med 2019; 11:137-147. [PMID: 31565003 PMCID: PMC6735655 DOI: 10.2147/hmer.s206870] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Accepted: 06/19/2019] [Indexed: 12/19/2022] Open
Abstract
Background Hepatitis B virus infection (HBV) constitutes major public health problems in sub-Saharan Africa from different infections occuring in HIV positive patients. Ethiopia is a part of sub-Saharan Africa with 1.5% adult HIV prevalence, and also belongs to the intermediate to high HBV prevalence category. Hence, this study aimed to measure the seroprevalence and associated factors of HBV infection among HIV-positive adults attending an antiretroviral treatment (ART) clinic at Wolaita Sodo University Referral Hospital. Methods An institution-based cross-sectional study was conducted from October 15 to December 10, 2017 using a systematic random sampling technique. After getting informed written consent, data were collected by a structured and interviewer-administered questionnaire. Venous blood was collected and centrifuged to separate serum. Hepatitis B surface antigen (HBsAg) was detected from serum using an advanced quality one-step rapid test kit. Data were entered into EpiData version 3.01 and exported to SPSS version 20. Summary statistics, bivariate analysis, and multivariate analyses were performed. The variables having significant association of P<0.05 in the multivariate logistic regression were taken as independent factors. OR and 95% CI were used to measure the strength of the association. Results A total of 442 study participants, 187 males and 255 females, were included in this study. Overall prevalence of HBsAg was 37 (8.4%). Family history of HBV (adjusted OR=8.83, 95% CI=2.56–30.49), multiple sexual partners (adjusted OR=7.08, 95% CI=2.29–21.9), and CD4 count <200 cells/μL (adjusted OR=15.34, 95% CI=4.77–49.3) were found to be significantly associated with HBsAg positivity. Conclusion The prevalence of HBsAg in this study was high. Family history of HBV, multiple sexual partners, and CD4 count <200 cells/μL were independently associated with HBsAg positivity. Therefore, screening for HBV is recommended before initiation of ART in HIV patients and providing appropriate treatment for co-infection. Furthermore, accurate information on risk factors for HBV transmission should be provided. ![]()
Point your SmartPhone at the code above. If you have a QR code reader the video abstract will appear. Or use: http://www.youtube.com/watch?v=Z05OsXCUwHY
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Affiliation(s)
- Abraham Goa
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Tadele Dana
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Shimelash Bitew
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
| | - Aseb Arba
- Wolaita Sodo University, College of Medicine and Health Sciences, Wolaita Sodo, Ethiopia
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Xiong M, Li J, Yang S, Zeng F, Ji Y, Liu J, Wu Q, He Q, Tang X, Jiang R, Zhou F, Chen Y, Wen W, Chen J, Hou J. Impacts of cigarette smoking on liver fibrosis and its regression under therapy in male patients with chronic hepatitis B. Liver Int 2019; 39:1428-1436. [PMID: 30920714 DOI: 10.1111/liv.14108] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2018] [Revised: 03/22/2019] [Accepted: 03/23/2019] [Indexed: 12/17/2022]
Abstract
BACKGROUND & AIMS The role of cigarette smoking in the development of chronic hepatitis B (CHB) remains poorly understood. We assessed the potential contributions of cigarette smoking to liver fibrosis and its regression after starting antiviral therapy in CHB patients. METHODS In this cohort study, 2144 consecutive male CHB patients under no antiviral therapy were evaluated and 206 patients with significant liver fibrosis (≥F2) initiating antiviral therapy had longitudinal follow-up. Liver fibrosis was measured by liver stiffness measurement using transient elastography. To adjust for imbalances between smoking history and never smoking groups, propensity score (PS) matching model with 1:1 ratios were performed. Cigarette smoking history and intensity (pack-years) were collected and documented using a standardized questionnaire. RESULTS Before PS matching, 432/2144 patients had advanced fibrosis in prevalence cohort. Patients with smoking history (n = 1002) had a greater prevalence of advanced fibrosis than those without (n = 1142) (24.4% vs 16.5%, P = 0.001). Multivariate logistic regression analysis demonstrated that smoking contributed to advanced fibrosis (OR, 1.458; 95% CI, 1.114-1.908). In longitudinal cohort, multivariate logistic regression analysis demonstrated retarded fibrosis regression in patients with history of smoking ≥10 pack-years (OR, 0.288; 95% CI, 0.1-0.825). After PS matching, patients with smoking history had higher prevalence of advanced fibrosis (22.8% vs 18%, P = 0.024) than those non-smokers. In post-PS-matching logistic regression, the effect of smoking on advanced fibrosis persisted (OR, 1.415; 95% CI, 1.047-1.912; P = 0.024). CONCLUSIONS Cigarette smoking in male CHB patients aggravated liver fibrosis prior to and delayed fibrosis regression under antiviral therapy.
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Affiliation(s)
- Ming Xiong
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Junying Li
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Shuling Yang
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fansen Zeng
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.,Department of Infectious Diseases, Guangzhou Women and Children's Medical Center, Guangzhou, China
| | - Yali Ji
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jiang Liu
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qiaoping Wu
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Qingjun He
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Xiaoting Tang
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Ronglong Jiang
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Fuyuan Zhou
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Yongpeng Chen
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Weiqun Wen
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinjun Chen
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
| | - Jinlin Hou
- Hepatology Unit, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China
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Cai Q, Liu H, Han W, Liu L, Xu Y, He Y, Li Q, Zhang M, Hu A, Zheng Y. Maternal HBsAg carriers and adverse pregnancy outcomes: A hospital-based prospective cohort analysis. J Viral Hepat 2019; 26:1011-1018. [PMID: 30972911 DOI: 10.1111/jvh.13105] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Revised: 02/15/2019] [Accepted: 03/14/2019] [Indexed: 12/19/2022]
Abstract
It is not clear whether chronic hepatitis B virus (HBV) infection during pregnancy can increase the risk of adverse pregnancy outcomes for both mothers and neonates. We conducted a hospital-based prospective cohort study on pregnant women (PW) and used an analysis strategy that was guided by directed acyclic graphs (DAGs). Maternal characteristics and major adverse pregnancy outcomes were collected both from questionnaires and hospital-based electronic medical records. Serum hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) status were determined. In total, 3329 of the 3416 pregnant women who received routine antenatal care in a hospital setting at baseline, including 346 HBsAg carriers, were available for analysis. Maternal HBsAg carrier status was associated with an increased risk of intrahepatic cholestasis pregnancy [aOR (adjusting odds ratio) = 1.70; 95% CI (confidence interval) = 1.16-2.49], premature rupture of the membranes (aOR = 1.38; 95% CI = 1.00-1.89) and large for gestational age birth aOR = 1.67; 95% CI = 1.17-2.39). The risk of intrahepatic cholestasis remained in pregnant women with either HBeAg-positive (aOR = 2.96; 95% CI = 1.33-6.62) or HBeAg-negative (aOR = 1.52; 95% CI =1.00-2.32)] status; notably, only maternal HBeAg-negative status was associated with a higher risk of large for gestational age birth (aOR = 1.91; 95% CI = 1.33-2.76). Our results implied that chronic HBV infection during pregnancy may increase the risk of intrahepatic cholestasis of pregnancy, premature rupture of membranes and large for gestational age pregnancies.
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Affiliation(s)
- Qianying Cai
- Key Laboratory for Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Haiyan Liu
- Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, China
| | - Wenhui Han
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, China
| | - Lili Liu
- Key Laboratory for Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Yunyun Xu
- Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, China
| | - Yining He
- Key Laboratory for Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Qing Li
- Department of Obstetrics and Gynecology, Anqing Municipal Hospital, Anqing, China
| | - Miao Zhang
- Key Laboratory for Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China
| | - Anqun Hu
- Department of Clinical Laboratory, Anqing Municipal Hospital, Anqing, China
| | - Yingjie Zheng
- Key Laboratory for Public Health Safety, Department of Epidemiology, School of Public Health, Fudan University, Shanghai, China.,Key Laboratory for Health Technology Assessment, National Commission of Health and Family Planning, Fudan University, Shanghai, China
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Chen D, Zhan Y, Peng J, Yao F. CD5-negative chronic lymphocytic leukemia/small lymphocytic lymphoma in a patient with gastrointestinal mantle cell lymphoma: an unusual case report. Onco Targets Ther 2019; 12:2937-2941. [PMID: 31114236 PMCID: PMC6489645 DOI: 10.2147/ott.s193014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 03/12/2019] [Indexed: 11/23/2022] Open
Abstract
Richter’s syndrome, the development of high-grade non-Hodgkin lymphoma in patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL), may be triggered by viral infections (eg, Epstein–Barr virus infection). Herein, we report an unusual case of CD5-negative CLL/SLL patient with gastrointestinal mantle cell lymphoma (MCL) and hepatitis B virus infection. CLL/SLL was diagnosed based on lymph node immunohistochemistry and bone marrow pathology. This patient was treated with seven cycles of multi-agent chemotherapy. During treatment, the hepatitis B viruses were activated. Then, after 20 months of antiviral treatment with entecavir, he developed abdominal discomfort and abdominal lymphadenopathy and was diagnosed with MCL based on intestinal biopsy. This work indicates that the hepatitis B virus in patients with CLL/SLL may accelerate the progress or transformation to MCL.
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Affiliation(s)
- Dangui Chen
- Department of Hematology, Anqing Municipal Hospital, Anqing Hospital Affiliated to Anhui Medical University, Anqing, People's Republic of China
| | - Yang Zhan
- Department of Hematology, Anqing Municipal Hospital, Anqing Hospital Affiliated to Anhui Medical University, Anqing, People's Republic of China
| | - Jun Peng
- Department of Pathology, Anqing Municipal Hospital, Anqing Hospital Affiliated to Anhui Medical University, Anqing, People's Republic of China
| | - Fusheng Yao
- Department of Hematology, Anqing Municipal Hospital, Anqing Hospital Affiliated to Anhui Medical University, Anqing, People's Republic of China
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Shen XH, Xu P, Yu X, Song HF, Chen H, Zhang XG, Wu MY, Wang XF. Discrepant Clinical Significance of CD28 +CD8 - and CD4 +CD25 high Regulatory T Cells During the Progression of Hepatitis B Virus Infection. Viral Immunol 2018; 31:548-558. [PMID: 30117787 DOI: 10.1089/vim.2018.0035] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Accumulating evidence demonstrates that CD8+CD28- regulatory T cells increase in chronic viral infection as well as tumorigenesis. However, it is still not clear about their characteristics in hepatitis B virus (HBV) infection. In addition, it is not understood whether this regulatory immune subset is distinct from CD4+CD25high regulatory T cells in the aspect of impact on or relationship to the progression of HBV infection. Hence, we investigated their dynamics and compared their correlations with clinical parameters in the chronic and advanced phases of HBV infection. The data showed that compared with healthy controls, the frequencies of CD28+CD8- and CD4+CD25high T cells increased in both chronic and advanced phases, while there is no significant difference between the two case groups. Interestingly, we found that in chronic phase, the frequency of CD8+CD28- subset was negatively correlated with the levels of alanine aminotransaminase (ALT) and aspartate aminotransferase (AST), respectively, and did not present association with HBV DNA load, whereas that of CD4+CD25high T cells was positively correlated with HBV DNA load and the levels of ALT and AST, respectively. Amazingly, in advanced phase, the frequency of CD4+CD25high T cells was negatively correlated with HBV DNA load and the levels of ALT, respectively, while there is no significant correlation between the frequency of CD8+CD28- subset and those clinical parameters. Thereby, our findings demonstrated that CD28+CD8- and CD4+CD25high regulatory T cells might exert distinct effect on modulating antiviral immune responses and mitigate immunomediated liver damage in different phases of HBV infection, which represent potential prognostic markers and therapeutic targets for HBV-infected patients based on further exploration of detailed mechanism.
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Affiliation(s)
- Xing-Hua Shen
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China .,2 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Ping Xu
- 2 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Xi Yu
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China .,3 Suzhou Science and Technology Town Hospital , Suzhou, China
| | - Hua-Feng Song
- 2 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Hui Chen
- 2 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Xue-Guang Zhang
- 4 Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University , Suzhou, China .,5 Jiangsu Key Laboratory of Clinical Immunology, Soochow University , Suzhou, China .,6 Jiangsu Key Laboratory of Gastrointestinal Tumor Immunology, The First Affiliated Hospital of Soochow University , Suzhou, China
| | - Mei-Ying Wu
- 2 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Xue-Feng Wang
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China .,5 Jiangsu Key Laboratory of Clinical Immunology, Soochow University , Suzhou, China .,6 Jiangsu Key Laboratory of Gastrointestinal Tumor Immunology, The First Affiliated Hospital of Soochow University , Suzhou, China
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Chen CJ, Yang YH, Lin MH, Lee CP, Tsan YT, Lai MN, Yang HY, Ho WC, Chen PC. Herbal medicine containing aristolochic acid and the risk of hepatocellular carcinoma in patients with hepatitis B virus infection. Int J Cancer 2018; 143:1578-1587. [PMID: 29667191 DOI: 10.1002/ijc.31544] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/11/2017] [Revised: 03/27/2018] [Accepted: 04/03/2018] [Indexed: 12/12/2022]
Abstract
It was suspected that aristolochic acid-induced mutations may be associated with hepatitis B virus (HBV), playing an important role in liver carcinogenesis. The purpose of this study was to investigate the association between the use of Chinese herbs containing aristolochic acid and the risk of hepatocellular carcinoma (HCC) among HBV-infected patients. We conducted a retrospective, population-based, cohort study on patients older than 18 years who had a diagnosis of HBV infection between January 1, 1997 and December 31, 2010 and had visited traditional Chinese medicine clinics before one year before the diagnosis of HCC or the censor dates. A total of 802,642 HBV-infected patients were identified by using the National Health Insurance Research Database in Taiwan. The use of Chinese herbal products containing aristolochic acid was identified between 1997 and 2003. Each patient was individually tracked from 1997 to 2013 to identify incident cases of HCC since 1999. There were 33,982 HCCs during the follow-up period of 11,643,790 person-years and the overall incidence rate was 291.8 HCCs per 100,000 person-years. The adjusted hazard ratios (HRs) were 1.13 (95% confidence interval [CI], 1.11-1.16), 1.21 (95% CI, 1.13-1.29), 1.37 (95% CI, 1.24-1.50) and 1.61 (95% CI, 1.40-1.84) for estimated aristolochic acid of 1-250, 251-500, 501-1,000 and more than 1,000 mg, respectively, relative to no aristolochic acid exposure. Our study found a significant dose-response relationship between the consumption of aristolochic acid and HCC in patients with HBV infection, suggesting that aristolochic acid which may be associated with HBV plays an important role in the pathogenesis of HCC.
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Affiliation(s)
- Chi-Jen Chen
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi County, Taiwan.,Graduate Institute of Data Science, Taipei Medical University, Taipei, Taiwan
| | - Yao-Hsu Yang
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi County, Taiwan.,Department of Traditional Chinese Medicine, Chang Gung Memorial Hospital, Chiayi County, Taiwan.,Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.,School of Traditional Chinese Medicine, College of Medicine, Chang Gung University, Taoyuan, Taiwan
| | - Meng-Hung Lin
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi County, Taiwan
| | - Chuan-Pin Lee
- Health Information and Epidemiology Laboratory, Chang Gung Memorial Hospital, Chiayi County, Taiwan
| | - Yu-Tse Tsan
- Division of Occupational Medicine, Department of Emergency Medicine, Taichung Veterans General Hospital, Taichung, Taiwan.,School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Ming-Nan Lai
- Department of Statistics, Feng Chia University, Taichung, Taiwan
| | - Hsiao-Yu Yang
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan
| | - Wen-Chao Ho
- Department of Public Health, China Medical University, Taichung, Taiwan
| | - Pau-Chung Chen
- Institute of Occupational Medicine and Industrial Hygiene, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Public Health, National Taiwan University College of Public Health, Taipei, Taiwan.,Department of Environmental and Occupational Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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Li SJ, Xu ST, Chen HP, Zhang MC, Xu F, Cheng SQ, Liu ZH. Clinical and morphologic spectrum of renal involvement in patients with HBV-associated cryoglobulinaemia. Nephrology (Carlton) 2018; 22:449-455. [PMID: 27062412 DOI: 10.1111/nep.12795] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2016] [Revised: 04/01/2016] [Accepted: 04/03/2016] [Indexed: 12/30/2022]
Abstract
AIM Cryoglobulinaemic glomerulonephritis related to hepatitis B virus (HBV) infection has been rarely reported. The aim of this study was to investigate the clinical features, renal biopsy findings in patients with HBV-associated cryoglobulinaemia. METHODS Twelve patients with HBV-associated cryoglobulinaemia were identified in this study. The demographic, clinical, pathological characteristics, treatment and follow-up data were analyzed. RESULTS Renal involvement was characterized by nephrotic range proteinuria with microscopic haematuria in all patients, and impaired renal function in nine patients (75%). Purpuric rash was the main extrarenal manifestation (58.3%). Type II cryoglobulinaemia was presented in three patients and type III in nine patients. Hypocomplementaemia and positive of rheumatoid factors were present in all patients. Membranoproliferative glomerulonephritis (MPGN) was observed in all kidney specimens. Seven patients also had evidence of prominent cryoglobulins thrombi on renal biopsy, but only three patients had HBV antigen deposits in renal tissues. Antiviral and steroids or immunosuppressive agents have been used in most of patients. During follow-up, two patients died, and four reaching end-stage renal disease; three patients had complete remission, and three patients had renal function improved after therapy. CONCLUSIONS Nephrotic syndrome with haematuria and renal insufficiency are the main clinical manifestation; cryoglobulinaemic glomerulonephritis are the main renal lesion in patients with HBV-Associated cryoglobulinaemia; half of patients have poor outcome even with antiviral and immunosuppressive therapy. The results of this study indicate that cryoglobulins should be detected in hepatitis B virus-Associated nephropathy in endemic area.
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Affiliation(s)
- Shi-Jun Li
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Shu-Tian Xu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Hui-Ping Chen
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Ming-Chao Zhang
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Feng Xu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Shui-Qin Cheng
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
| | - Zhi-Hong Liu
- National Clinical Research Center of Kidney Diseases, Jinling Hospital, Nanjing University School of Medicine, Nanjing, China
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Liu XQ, Wei RR, Wang CC, Chen LY, Liu C, Liu K. Relationship between PK2 and number of Kupffer cells during the progression of liver fibrosis in patients with HBV. Turk J Med Sci 2018; 48:52-61. [PMID: 29479955 DOI: 10.3906/sag-1705-32] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Background/aim: This study aimed to investigate the potential regulatory role of prokineticin 2 (PK2) in modulation of the number and function of Kupffer cells (KCs) during the progression of liver fibrosis in patients with hepatitis B virus (HBV). Materials and methods: We obtained liver tissue sections from 200 patients with HBV undergoing surgical resection in our hospital between January 2013 and July 2016. Of these 200 tissue sections, 150 were fibrosis tissues and 50 were hepatocellular carcinoma tissues. Immunohistochemical evaluations were performed to assess the expression levels of CD68 and PK2 in the sections. The clinical parameters of these 200 patients were also analyzed. Results: As a potential cytokine, PK2 was commonly expressed in KCs. In addition, a close correlation between PK2 and the number of KCs during the progression of liver fibrosis in patients with HBV was found in this study. Conclusion: PK2 is expressed in KCs and participates in the progression of liver fibrosis after HBV infection. As a potential cytokine, PK2 modulates the number of KCs during fibrosis. Thus, PK2 most likely adjusts the number of M1 cells to modulate the role of KCs in the progression of liver fibrosis after HBV infection.
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Ma X, Sun D, Li C, Ying J, Yan Y. Chronic hepatitis B virus infection and preterm labor(birth) in pregnant women-an updated systematic review and meta-analysis. J Med Virol 2018; 90:93-100. [PMID: 28851115 DOI: 10.1002/jmv.24927] [Citation(s) in RCA: 30] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2017] [Accepted: 08/18/2017] [Indexed: 12/17/2022]
Abstract
We aimed to explore whether maternal chronic hepatitis B virus (HBV) infection certainly affects preterm labor (birth) in pregnant women. Four databases were systematically searched up to May 31, 2017, without language restriction. Any study was included if it clearly defined exposure to chronic HBV infection, reported risk of preterm labor or birth in pregnant women, and reported relative risks (RRs) or odds ratios (ORs) or provided data for estimation. RRs (or ORs) with 95% confidence intervals were pooled using random-effects models. Statistical heterogeneity was assessed with Cochran's Q statistic and I2 statistic. Twenty-two observational studies involving 6 141 146 pregnant women (three prospective cohort studies, n = 1 116 799; 15 retrospective cohort studies, n = 5 022 513 and four case-control studies, n = 1834) were included. The risk of preterm labor was significantly intensified with chronic HBV infection compared with uninfected women, with substantial heterogeneity. Chronic HBV infection was also significantly associated with a 16% increase in the risk of preterm birth, with substantial heterogeneity. The risk of preterm birth significantly increased by 21% in HBsAg+/HBeAg+ pregnant women compared with uninfected pregnant women. Chronic HBV infection intensifies the risk of preterm labor and birth in pregnant women, but this conclusion should be interpreted with caution given the possibility of residual confounding and be confirmed by well-designed studies in the future.
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MESH Headings
- Adult
- Case-Control Studies
- Databases, Factual
- Female
- Hepatitis B, Chronic/complications
- Hepatitis B, Chronic/epidemiology
- Hepatitis B, Chronic/virology
- Humans
- Infant, Newborn
- Infectious Disease Transmission, Vertical/statistics & numerical data
- Observational Studies as Topic
- Obstetric Labor, Premature/epidemiology
- Obstetric Labor, Premature/etiology
- Obstetric Labor, Premature/virology
- Pregnancy
- Pregnancy Complications, Infectious/epidemiology
- Pregnancy Complications, Infectious/virology
- Premature Birth/etiology
- Prospective Studies
- Retrospective Studies
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Affiliation(s)
- Xiaosong Ma
- Department of Infection, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China
| | - Dehong Sun
- Department of Gastroenterology, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China
| | - Chuansheng Li
- Department of Infection, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China
| | - Jie Ying
- Department of Infection, People's Hospital of Xuyi, Xuyi, Jiangsu, P.R. China
| | - Youde Yan
- Department of Infection, The First Affiliated Hospital of Nanjing Medical University and Jiangsu Province Hospital, Nanjing, Jiangsu, P.R. China
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40
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Laaribi AB, Bortolotti D, Hannachi N, Mehri A, Hazgui O, Ben Yahia H, Babay W, Belhadj M, Chaouech H, Yacoub S, Letaief A, Ouzari HI, Boudabous A, Di Luca D, Boukadida J, Rizzo R, Zidi I. Increased levels of soluble HLA-G molecules in Tunisian patients with chronic hepatitis B infection. J Viral Hepat 2017; 24:1016-1022. [PMID: 28429836 DOI: 10.1111/jvh.12718] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2016] [Accepted: 04/03/2017] [Indexed: 01/08/2023]
Abstract
Hepatitis B virus (HBV) infection is a global health problem. The mechanisms of immune tolerance in HBV infection are still unclear. The host immune response plays a critical role in determining the outcome of HBV infection. Human leucocyte antigen-G (HLA-G) is involved in immunotolerogenic process and infectious diseases. This study aimed to explore the implication of soluble HLA-G (sHLA-G) and its isoforms in HBV infection. Total sHLA-G (including shedding HLA-G1 and HLA-G5) was analysed by ELISA in 95 chronic HBV patients, 83 spontaneously resolvers and 100 healthy controls (HC). To explore the presence of sHLA-G dimers, we performed an immunoprecipitation and a Western blot analysis on positive samples for sHLA-G in ELISA. The serum levels of sHLA-G were significantly increased in patients with chronic HBV patients compared to spontaneously resolvers and HC (P<.0001). Interestingly, we found an increased level of sHLA-G1 in chronic HBV patients than in spontaneously resolvers and HC (P<.001). In addition, the expression of HLA-G5 seems to be higher in the sera of chronic HBV patients than spontaneously resolvers (P=.026). The analysis of HLA-G dimers showed the presence of homodimers in 93% of chronic HBV patients, 67% in spontaneously resolvers and 60% in HC. These results provide evidence that sHLA-G may have a crucial role in the outcome of HBV infection and could be proposed as a biomarker for infection outcome. Based on its tolerogenic function, HLA-G might be considered as a new promising immunotherapeutic approach to treat the chronic infection with HBV.
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Affiliation(s)
- A B Laaribi
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia.,Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia.,Sciences Faculty of Bizerte, University of Carthage, Tunis, Tunisia
| | - D Bortolotti
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - N Hannachi
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - A Mehri
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia.,Sciences Faculty of Bizerte, University of Carthage, Tunis, Tunisia
| | - O Hazgui
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - H Ben Yahia
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - W Babay
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - M Belhadj
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - H Chaouech
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - S Yacoub
- Regional Center of Blood Transfusion, University Hospital Farhat Hached, Sousse, Tunisia
| | - A Letaief
- Department of Internal Medicine and Infectious Diseases, University Hospital Farhat Hached, Sousse, Tunisia
| | - H I Ouzari
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - A Boudabous
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
| | - D Di Luca
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - J Boukadida
- Laboratory of Microbiology and Immunology, UR12SP34, University Hospital Farhat Hached, Sousse, Tunisia
| | - R Rizzo
- Section Microbiology and Medical Genetics, Department of Medical Sciences, University of Ferrara, Ferrara, Italy
| | - I Zidi
- Laboratory of Microorganisms and Actives Biomolecules, Sciences Faculty of Tunis, University of Tunis El Manar, Tunis, Tunisia
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Zhang C, He Y, Shan KR, Tan K, Zhang T, Wang CJ, Guan ZZ. Correlations between polymorphisms in the uridine diphosphate-glucuronosyltransferase 1A and C-C motif chemokine receptor 5 genes and infection with the hepatitis B virus in three ethnic groups in China. J Int Med Res 2017; 46:739-751. [PMID: 29239247 PMCID: PMC5971517 DOI: 10.1177/0300060517730174] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/23/2022] Open
Abstract
Objective To determine whether genetic polymorphisms in the uridine diphosphate-glucuronosyltransferase 1A (UGT1A) and the C-C motif chemokine receptor 5 (CCR5) genes are associated with hepatitis B virus (HBV) infection in Yi, Yao and Han ethnic groups in the Guizhou Province of China. Methods The study enrolled subjects with and without HBV infection. Whole blood was used for DNA genotyping using standard techniques. The study determined the frequencies of several polymorphic alleles (UGT1A6 [rs2070959], UGT1A1 [rs8175347], CCR5-59029 [rs1799987] and CCR5Δ32 [rs333]) and then characterized their relationship with HBV infection. Results A total of 404 subjects were enrolled in the study: 138 from the Yao group, 101 from the Yi group and 165 from the Han group. There was a significant difference in the frequency of UGT1A1 rs8175347 polymorphisms among the three groups. The rates of 7TA carriers of UGT1A1 rs8175347 in all three groups were significantly higher than the other genotypes. Individuals with genotype AA of UGT1A6 rs2070959 in the Yi group had a higher risk for HBV infection than in the Yao and Han groups. The frequency of genotype GG in CCR5-59029 in the Yao group was significantly higher than in the Yi group. The genotypes of CCR5Δ32 were not associated with HBV infection. Conclusion These findings provide genetic and epidemiological evidence for an association of UGT1A and CCR5-59029 polymorphisms with HBV infection in Chinese Yi and Yao populations.
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Affiliation(s)
- Chan Zhang
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China.,3 Reproduction Centre of Luoyang Centre Hospital Affiliated to Zhengzhou University, Zhengzhou, Henan Province, China
| | - Yan He
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China
| | - Ke-Ren Shan
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China
| | - Kui Tan
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China
| | - Ting Zhang
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China
| | - Chan-Juan Wang
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China
| | - Zhi-Zhong Guan
- 1 The Key Laboratory of Endemic and Ethnic Diseases of the Ministry of Education of PR China (Guizhou Medical University), Guiyang, Guizhou Province, China.,2 Department of Pathology, Affiliated Hospital of Guizhou Medical University, Guiyang, Guizhou Province, China
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42
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Gao Q, Wang K, Chen K, Liang L, Zheng Y, Zhang Y, Xiang J, Tang N. HBx protein-mediated ATOH1 downregulation suppresses ARID2 expression and promotes hepatocellular carcinoma. Cancer Sci 2017; 108:1328-1337. [PMID: 28498550 PMCID: PMC5497798 DOI: 10.1111/cas.13277] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2016] [Revised: 04/10/2017] [Accepted: 05/01/2017] [Indexed: 12/11/2022] Open
Abstract
Hepatitis B virus X protein plays a crucial role in the pathogenesis of hepatocellular carcinoma. We previously showed that the tumor suppressor ARID2 inhibits hepatoma cell cycle progression and tumor growth. Here, we evaluated whether hepatitis B virus X protein was involved in the modulation of ARID2 expression and hepatocarcinogenesis associated with hepatitis B virus infection. ARID2 expression was downregulated in HBV‐replicative hepatoma cells, HBV transgenic mice, and HBV‐related clinical HCC tissues. The expression levels of HBx were negatively associated with those of ARID2 in hepatocellular carcinoma tissues. Furthermore, HBx suppressed ARID2 at transcriptional level. Mechanistically, the promoter region of ARID2 gene inhibited by HBx was located at nt‐1040/nt‐601 and contained potential ATOH1 binding elements. In addition, ectopic expression of ATOH1 or mutation of ATOH1 binding sites within ARID2 promoter partially abolished HBx‐triggered ARID2 transcriptional repression. Functionally, ARID2 abrogated HBx‐enhanced migration and proliferation of hepatoma cells, whereas depletion of ATOH1 enhanced tumorigenecity of HCC cells. Therefore, our findings suggested that deregulation of ARID2 by HBx through ATOH1 may be involved in HBV‐related hepatocellular carcinoma development.
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Affiliation(s)
- Qingzhu Gao
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Kai Wang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ke Chen
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Li Liang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yaqiu Zheng
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Yunzhi Zhang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Jin Xiang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China
| | - Ni Tang
- Key Laboratory of Molecular Biology for Infectious Diseases (Ministry of Education), Institute for Viral Hepatitis, Department of Infectious Diseases, The Second Affiliated Hospital, Chongqing Medical University, Chongqing, China.,The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases (CCID), Zhejiang University, Hangzhou, China
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43
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Gao SQ, Xu YP, He LM, Zhang H, Yang AL. The full length genomic sequence of a novel HLA-A*24 allele, HLA-A*24:353, identified in a patient with hepatitis B infection. HLA 2017; 89:304-305. [PMID: 28296275 DOI: 10.1111/tan.13008] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 02/15/2017] [Accepted: 02/16/2017] [Indexed: 11/29/2022]
Abstract
HLA-A*24:353 differs from HLA-A*24:02:01 by an amino acid exchange glutamine to glutamate at position 316.
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Affiliation(s)
- S-Q Gao
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - Y-P Xu
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - L-M He
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - H Zhang
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, China
| | - A-L Yang
- Immunogenetics Laboratory, Shenzhen Blood Center, Shenzhen, China
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44
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Zhu CH, Zhao MZ, Chen G, Qi JY, Song JX, Ning Q, Xu D. Baseline HBV load increases the risk of anti-tuberculous drug-induced hepatitis flares in patients with tuberculosis. ACTA ACUST UNITED AC 2017; 37:105-109. [PMID: 28224437 DOI: 10.1007/s11596-017-1702-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2016] [Revised: 12/14/2016] [Indexed: 10/18/2022]
Abstract
Hepatitis associated anti-tuberculous treatment (HATT) has been a main obstacle in managing patients co-infected with Mycobacterium tuberculosis and hepatitis B virus (HBV). Therefore, we evaluated the factors related to the severity of adverse effects during HATT, especially those associated with liver failure. A retrospective study was carried out at Tongji Hospital from 2007 to 2012. Increases in serum transaminase levels of >3, 5, and 10 times the upper limit of normal (ULN) were used to define liver damage as mild, moderate, and severe, respectively. Patients with elevated total bilirubin (TBil) levels that were more than 10 times the ULN (>171 μmol/L) with or without decreased (<40%) prothrombin activity (PTA) were diagnosed with liver failure. A cohort of 87 patients was analyzed. The incidence of liver damage and liver failure was 59.8% (n=52) and 25.3% (n=22), respectively. The following variables were correlated with the severity of hepatotoxicity: albumin (ALB) levels, PTA, platelet counts (PLT), and the use of antiretroviral therapies (P<0.05). Hypo-proteinemia and antiretroviral therapy were significantly associated with liver failure, and high viral loads were a significant risk factor with an odds ratio (OR) of 2.066. Judicious follow-up of clinical conditions, liver function tests, and coagulation function, especially in patients with high HBV loads and hypoalbuminemia is recommended. It may be advisable to reconsider the use of antiviral drugs failure during the course of anti-tuberculous treatment of HBV infection patients to avoid the occurrence of furious liver failure.
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Affiliation(s)
- Chun-Hui Zhu
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Man-Zhi Zhao
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Guang Chen
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jun-Ying Qi
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Jian-Xin Song
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Qin Ning
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China
| | - Dong Xu
- Department of Infectious Disease, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430030, China.
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Weis N, Cowan S, Hallager S, Dröse S, Kristensen LH, Grønbæk K, Jensen J, Gerstoft J, Madsen LG, Clausen MR, Lunding S, Tarp BD, Barfod TS, Sloth S, Holm DK, Jensen J, Krarup H. Vertical transmission of hepatitis B virus during pregnancy and delivery in Denmark. Scand J Gastroenterol 2017; 52:178-184. [PMID: 27796133 DOI: 10.1080/00365521.2016.1244704] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE In Denmark, pregnant women have been screened for hepatitis B virus (HBV) since 2005, and children born to HBV-infected mothers offered hepatitis B immunoglobulin at birth, vaccination against HBV at birth and after 1, 2 and 12 months. The purpose of this study was to determine the risk of vertical HBV transmission in children born to mothers with chronic HBV infection, to investigate the antibody response in the children and to investigate possible maternal predictive risk factors for HBV transmission. MATERIALS AND METHODS Through the Danish Database for Hepatitis B and C, we identified 589 HBV-infected women who had given birth to 686 children, of whom 370 children were born to 322 women referred to hospital. 132 (36%) children, born to 109 mothers, were included in the study; 128 children had blood samples tested for HBsAg, anti-HBc (total), anti-HBs and HBV-DNA and four children had saliva samples tested for anti-HBc. RESULTS We found vertical HBV transmission in Denmark to be 2.3% [95% CI: 0.5, 6.5], a high proportion of HBsAg-negative children with low levels of anti-HBs (18.4%) and a high proportion (15.2%) with resolved HBV infection. No maternal risk factor was statistically significantly associated with HBV vertical transmission. CONCLUSION In a HBV low prevalence setting as Denmark, despite a national vaccination program, vertical HBV transmission occurred in 2.3% of children born to HBV-infected mothers. In addition, a high proportion of the children had insufficient anti-HBs levels and a high proportion had serological signs of resolved HBV infection.
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Affiliation(s)
- Nina Weis
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark.,b Department of Clinical Medicine, Faculty of Health and Medical Sciences , University of Copenhagen , Copenhagen , Denmark
| | - Susan Cowan
- c Department of Epidemiology , Statens Serum Institut , Copenhagen , Denmark
| | - Sofie Hallager
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark
| | - Sandra Dröse
- d Department of Infectious Diseases , Odense University Hospital , Odense, Denmark
| | | | - Karin Grønbæk
- f Department of Gastroenterology , Copenhagen University Hospital , Hvidovre , Denmark
| | - Janne Jensen
- g Department of Medicine , Kolding Hospital , Denmark
| | - Jan Gerstoft
- h Department of Infectious Diseases , Copenhagen University Hospital , Rigshospitalet , Denmark
| | - Lone G Madsen
- i Department of Medicine , Køge Hospital , Køge , Denmark
| | - Mette Rye Clausen
- j Department of Hepatology , Copenhagen University Hospital , Rigshospitalet , Denmark
| | - Suzanne Lunding
- k Department of Infectious Diseases , Nordsjællands Hospital , Hillerød , Denmark
| | - Britta D Tarp
- l Diagnostic Center , Silkeborg Regional Hospital , Silkeborg , Denmark
| | - Toke S Barfod
- m Department of Infectious Diseases , Roskilde Hospital , Roskilde, Denmark
| | - Stine Sloth
- n Department of Gastroenterology , Medical Section, Copenhagen University Hospital , Herlev , Denmark
| | - Dorte Kinggaard Holm
- o Department of Clinical Immunology , Odense University Hospital , Odense , Denmark
| | - Jesper Jensen
- a Department of Infectious Diseases , Copenhagen University Hospital , Hvidovre , Denmark
| | - Henrik Krarup
- p Section of Molecular Diagnostics, Clinical Biochemistry and Department of Medical Gastroenterology , Aalborg University Hospital , Aalborg , Denmark
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Lao TT, Mak JSM, Li TC. Hepatitis B virus infection status and infertility causes in couples seeking fertility treatment-Indicator of impaired immune response? Am J Reprod Immunol 2017; 77. [PMID: 28120470 DOI: 10.1111/aji.12636] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2016] [Accepted: 01/04/2017] [Indexed: 12/31/2022] Open
Abstract
PROBLEM The relationship between hepatitis B (HBV) infection in infertile couples seeking in vitro fertilization (IVF) treatment and infertility causes is unknown. METHODS OF STUDY A total of 831 infertile couples attending our unit seeking IVF during January to December 2015 were recruited. RESULTS HBV infection was found in 6.3% and 7.3% of female and male partners, respectively, and infection in one or both partners was associated with less primary infertility (44.2% vs 55.1%, P=.038). Infected female partners had increased tubal (69.2% vs 43.2%, P<.001) and uterine (13.7% vs 3.1%, P<.001) causes and reduced idiopathic infertility, while infected male partners were associated with increased tubal (62.3% vs 43.4%, P=.004) causes and reduced endometriosis (62.3% vs 73.9%, P=.050). CONCLUSION Our results suggest HBV infection in either partner was associated with tubal infertility. HBV infection in either partner probably increases the risk of pelvic infection in female partner through impaired immune response to sexually transmitted infections, with consequent tubal damage and infertility.
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Affiliation(s)
- Terence T Lao
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
| | - Jennifer S M Mak
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
| | - Tin-Chiu Li
- Departments of Obstetrics & Gynaecology, The Chinese University of Hong Kong, Hong Kong, China.,Prince of Wales Hospital, Hong Kong, China
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47
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Kao JH, Asselah T, Dou XG, Hamed K. Telbivudine therapy for chronic hepatitis B: A journey to identify super-responders and to optimize treatment using the roadmap model. J Gastroenterol Hepatol 2017; 32:73-81. [PMID: 27515408 DOI: 10.1111/jgh.13512] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/03/2016] [Indexed: 02/06/2023]
Abstract
Hepatitis B virus (HBV) infection is one of the most serious health problems worldwide with a high risk for cirrhosis and liver cancer. Several antiviral agents have been approved for the treatment of chronic hepatitis B, leading to a rapid reduction in HBV DNA and normalization of serum alanine aminotransferase levels. Telbivudine, a potent inhibitor of HBV replication, has been shown to be well tolerated. Because of the emergence of drug resistance, optimization strategies for telbivudine therapy have been shown to improve patient responses. Optimal baseline characteristics in so-called super-responders have been used to predict the virological response. Baseline HBV DNA levels < 9 log10 copies/mL (2 × 108 IU/mL) or alanine aminotransferase levels of more than or equal to twofold the upper limit of normal in HBeAg-positive patients and HBV DNA < 7 log10 copies/mL (2 × 106 IU/mL) in HBeAg-negative patients were strong predictors for virological response. In addition, the roadmap model, based on early virological response at week 24 of therapy, is considered as a powerful tool to identify patients at risk of treatment failure (HBV DNA ≥ 300 copies/mL, i.e. 60 IU/mL) and to reduce the risk of antiviral resistance. When considering pre-treatment characteristics and on-treatment responses, telbivudine may provide physicians with a wide choice of options to effectively treat patients with chronic hepatitis B, especially those with or at risk of renal impairment, or women of childbearing age.
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Affiliation(s)
- Jia-Horng Kao
- Graduate Institute of Clinical Medicine and Hepatitis Research Center, National Taiwan University College of Medicine and Hospital, Taipei, Taiwan
| | - Tarik Asselah
- Hepatology Department, AP-HP, Beaujon Hospital, University Paris Diderot and INSERM UMR1149, Centre de Recherche sur l'inflammation, Labex INFLAMEX, Clichy, France
| | - Xiao-Guang Dou
- Department of Infectious Disease, Shengjing Hospital, China Medical University, Shenyang, China
| | - Kamal Hamed
- Novartis Pharmaceuticals Corporation, East Hanover, New Jersey, USA
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Huang ZY, Xu P, Li JH, Zeng CH, Song HF, Chen H, Zhu YB, Song YY, Lu HL, Shen CP, Zhang XG, Wu MY, Wang XF. Clinical Significance of Dynamics of Programmed Death Ligand-1 Expression on Circulating CD14 + Monocytes and CD19 + B Cells with the Progression of Hepatitis B Virus Infection. Viral Immunol 2016; 30:224-231. [PMID: 28005469 DOI: 10.1089/vim.2016.0122] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Programmed death-1 (PD-1) expression has been revealed to be upregulated on T cells and contributes to T cell exhaustion in patients with hepatitis B virus (HBV) infection. In this study, we investigated the dynamic expression of programmed death ligand-1 (PD-L1), the ligand of PD-1, on circulating CD14+ monocytes and CD19+ B cells of HBV-infected patients at the stages of chronic HBV (CHB) infection, liver cirrhosis (LC), and hepatocellular carcinoma (HCC), respectively. The results showed that compared with healthy controls, the levels of PD-L1 expression on CD14+ and CD19+ populations were both upregulated in CHB, LC, and HCC groups. Although there was no significant difference of PD-L1 expression on CD14+ population among three disease groups, further analysis demonstrated that the frequency of CD14+PD-L1+ population was negatively correlated with HBV DNA load, the levels of alanine aminotransaminase (ALT), and the levels of aspartate aminotransferase (AST), respectively, at CHB stage, while it did not present significant correlation with such parameters at LC stage and was only positively correlated with HBV DNA load at HCC stage. Similarly, the levels of PD-L1 expression on CD19+ population also did not present much difference among three disease groups. Intriguingly, the frequencies of CD19+PD-L1+ population at CHB and LCC stages were both positively correlated with the levels of ALT and AST, but they were not significantly correlated with HBV DNA load. Thereby, the current study elucidated the dynamics of PD-L1 expression on monocytes and B cells, along with the dynamic regulation of PD-1 on T cells, which had a close relationship during the progression of HBV infection. Collectively, our findings demonstrated that in the course of HBV infection development, PD-L1 expression on CD14+ monocytes and CD19+ B cells varied and significantly correlated with clinical parameters, which could be utilized as a potential clinical indicator.
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Affiliation(s)
- Zi-Yi Huang
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China .,2 Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University , Suzhou, China
| | - Ping Xu
- 3 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Jian-Hua Li
- 4 Central Blood Station of Jiaxing , Zhejiang, China
| | - Chen-Hua Zeng
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
| | - Hua-Feng Song
- 3 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Hui Chen
- 3 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Yi-Bei Zhu
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
| | - Ying-Ying Song
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
| | - Han-Lin Lu
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
| | - Chun-Ping Shen
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
| | - Xue-Guang Zhang
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China .,2 Jiangsu Institute of Clinical Immunology, The First Affiliated Hospital of Soochow University , Suzhou, China
| | - Mei-Ying Wu
- 3 The Affiliated Infectious Hospital of Soochow University , Suzhou, China
| | - Xue-Feng Wang
- 1 Department of Biochemistry and Molecular Biology, School of Biology and Basic Medical Sciences, Soochow University , Suzhou, China
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Höner zu Siederdissen C, Rinker F, Maasoumy B, Wiegand SB, Filmann N, Falk CS, Deterding K, Port K, Mix C, Manns MP, Herrmann E, Wedemeyer H, Kraft ARM, Cornberg M. Viral and Host Responses After Stopping Long-term Nucleos(t)ide Analogue Therapy in HBeAg-Negative Chronic Hepatitis B. J Infect Dis 2016; 214:1492-1497. [DOI: 10.1093/infdis/jiw412] [Citation(s) in RCA: 88] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2016] [Accepted: 08/26/2016] [Indexed: 02/06/2023] Open
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50
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Zhang G, Li N, Li Z, Zhu Q, Li F, Yang C, Han Q, Lv Y, Zhou Z, Liu Z. microRNA-4717 differentially interacts with its polymorphic target in the PD1 3' untranslated region: A mechanism for regulating PD-1 expression and function in HBV-associated liver diseases. Oncotarget. 2015;6:18933-18944. [PMID: 25895129 PMCID: PMC4662465 DOI: 10.18632/oncotarget.3662] [Citation(s) in RCA: 67] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2015] [Accepted: 02/26/2015] [Indexed: 12/14/2022] Open
Abstract
Programmed cell death-1 (PD-1) is involved in hepatitis B virus (HBV) infection, the leading cause of hepatocellular carcinoma (HCC) worldwide. Single-nucleotide polymorphism, rs10204525, located in the PD1 3' untranslated regions (UTR), is associated with chronic HBV infection. MicroRNAs (miRNAs) regulate gene expression via specific binding to the target 3'UTR of mRNA. In this study, three miRNAs were predicted to putatively interact with PD1 rs10204525 polymorphic site of allele G. One of them, miRNA-4717, was demonstrated to allele-specifically affect luciferase activity in a dose-dependent manner in cells transfected with vectors containing different rs10204525 alleles. In lymphocytes from chronic HBV patients withrs10204525 genotype GG, miR-4717 mimics significantly decreased PD-1 expression and increased (TNF)-α and interferon (IFN)-γ production. miR-4717 inhibitor significantly increased PD-1 expression and decreased TNF-α and IFN-γ production although not significantly. In lymphocytes from chronic HBV patients with rs10204525 genotype AA, no similar effects were observed. miR-4717 levels in peripheral lymphocytes from patients with HBV-related chronic hepatitis, cirrhosis and HCC were significantly decreased. In conclusion, miR-4717 may allele-specifically regulate PD-1 expression through interaction with the 3' UTR of PD1 mRNA, leading to the alteration of immune regulation and affecting the susceptibility and disease course of chronic HBV infection.
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