Clinical manifestations of hepatitis B virus genotype

Eight genotypes of hepatitis B virus (HBV) have been detected by sequence divergence > 8% in the entire HBV genome of about 3,200 nucleotides (nt), and designated by capital letters from A to H in the order of documentation. They have distinct geographical distribution and influence the severity of liver disease as well as the response to antiviral therapies. Furthermore, subgenotypes have been reported for genotypes A (HBV/A), B and C, and named Aa/A1 (Asian/African type) and Ae/A2 (European type), Bj/B (Japanese type) and Ba/B2 (Asian type), and Cs/C1 (Southeast Asian type) and Ce/C2 (East Asian type). There have been increasing lines of evidence that subgenotypes of A and B influence the replication of HBV and are clinically relevant. In Japan, mass vaccination has not been performed because of the extremely high efficacy of immunoprophylaxis on babies born to carrier mothers; it has decreased the persistent HBV carrier state from 1.4% to 0.03%. However, HBV/Ae of the European type has increased in young male adults by sexual transmission because the foreign genotypes have been imported from sexual workers where the genotypes are prevalent. Here, we summarize the clinical manifestations of HBV genotypes.     

Clinical examinations based on nucleic acids of hepatitis viruses

Viral hepatitis is the most common cause of acute and chronic hepatitis. The term, viral hepatitis, generally refers to infections resulting from one of the hepatotrophic viruses: hepatitis A, B, C, D and E. As hepatitis B virus (HBV) and hepatitis C virus (HCV) mainly cause chronic hepatitis and hepatocellular carcinoma, early diagnosis, prevention and viral elimination are necessary. Eight genotypes of HBV have been detected by sequence divergence of >8% in the entire HBV genome, and designated by capital letters from A to H in the order of documentation. They have distinct geographical distribution and influence the severity of liver disease as well as the response to antiviral therapies. Similarly, HCV has at least six genotypes, of which HCV-1 and -2 are the major genotypes worldwide. Only interferon therapy can eradicate HCV at present, and the sustained virological response depends on HCV genotypes and viral loads. Here, we summarize examinations based on viral nucleic acids and the clinical manifestations of HBV and HCV genotypes.     

Early diagnosis and treatment for remission of clinically amyopathic dermatomyositis complicated by rapid progress interstitial lung disease: a report of two cases

We report two cases of clinically amyopathic dermatomyositis (CADM) complicated by rapid progress interstitial lung disease (RPILD). The diagnosis of CADM was based on Gottron’s papule and RPILD, and the absence of muscle weakness. The female patients were treated with early immunosuppressive therapies including steroid pulse therapy, resulting in significant improvement in respiratory symptoms, clinical data, and imaging. Measurement of anti-CADM-140/MDA5 antibody was useful for obtaining a definitive diagnosis of CADM in these cases.     

Associations of workplace bullying and harassment with stress reactions: a two-year follow-up study

The purpose of this prospective study was to investigate the effect of the patterning of workplace bullying and harassment over two time points (chronic, remission, onset, and never) on psychological and physical stress reactions. The subjects were 543 workers at welfare facilities for the elderly in Japan who completed a self-administered questionnaire at Time 1 (from August to September, 2009) and at Time 2 (from September to October, 2011). Workplace bullying and harassment were assessed using the Negative Acts Questionnaire (NAQ). Stress reactions were assessed using the Brief Job Stress Questionnaire. In the multiple logistic regression analyses, onset of person-related bullying was significantly (p<0.05) positively associated with both psychological and physical stress reactions at Time 2. Chronic form of person-related bullying was significantly (p<0.05) positively associated with psychological stress reaction at Time 2. Onset of sexual harassment was significantly (p<0.05) positively, and remission of sexual harassment was significantly (p<0.05) negatively associated with physical stress reaction at Time 2. Onset and chronic form of person-related bullying and onset of sexual harassment can cause stress reactions. Remission of sexual harassment can terminate physical stress reaction.