Asymptomatic primary pulmonary hypertension associated with liver cirrhosis

We report a case of asymptomatic primary pulmonary hypertension associated with liver cirrhosis (type B) and portal hypertension found by chance during a preoperative Swan-Gantz catheterization study. Our experience suggests that the actual prevalence of primary pulmonary hypertension associated with liver cirrhosis may be greater than that previously reported. During the follow-up of liver cirrhosis with portal hypertension, we should consider primary pulmonary hypertension, even if the patient is free of symptoms, and a chest X-ray check may be necessary.     

Delta-agent infection in Taiwan

Based on observations of a limited number of patients, delta (δ) infection has been reported to be infrequent in Taiwan. To further evaluate the role of δ-infection in patients with hepatitis B virus (HBV) infection, serum samples of 493 subjects with acute and chronic HBV infections collected in 1976–85 were studied for anti-δ by radioimmunoassay. Intrahepatic δ-antigen was also studied by immunofluorescence in 12 anti-δ-positive patients. The overall prevalence of δ-infection was 4.7%, consistent with previous studies. δ-Infection had an even yearly distribution in the last decade. However, there were four groups with significantly higher frequencies: (i) 24% of 41 anti-HBe-positive patients with chronic active hepatitis (CAH); (ii) 21% of 14 HBsAg carriers with prominent lobular hepatitis; (iii) two of three HBsAg carriers with intravenous drug abuse; and (iv) two of seven with fulminant hepatitis. On the other hand, δ-infection was uncommon in patients with chronic persistent hepatitis, cirrhosis, hepatocellular carcinoma, classical type B hepatitis, submassive necrosis and asymptomatic HBsAg carriers. δ-Antigen was found in only two patients with CAH; one progressed to cirrhosis, and the other had disease regression on follow-up. Overall, at least half of the δ-superinfected HBsAg-positive patients had a non-progressive course on follow-up.
It was concluded that δ-agent was introduced to Taiwan before 1976. Although it has played a role in some clinical settings of HBV infections, it is generally infrequent in Taiwan. The δ-superinfection apparent in half the patients studied seems to have a non-progressive course.     

Seroepidemiological studies on hepatitis B and D viruses infection among five ethnic groups in southern Taiwan

In order to compare the prevalence of hepatitis B virus (HBV) and hepatitis D virus (HDV) infection among five ethnic groups in Pingtung County of southern Taiwan, a total of 240 serum samples were collected from September to October, 1985, from the following five ethnic groups: Taiwanese, Hakka, Mainland Chinese, aboriginal Paiwanese, and aboriginal Rukaiese. Ages of subjects ranged from 5 to 69 years. All sera were tested for hepatitis B surface antigen (HBsAg), surface antibody (anti-HBs), and core antibody (anti-HBc) by radioimmunoassay (RIA). Hepatitis B e antigen (HBeAg) and antibody to hepatitis D antigen (anti-HDV) were also tested for those with HBsAg-positive sera. Results showed that 44.1% of all sera examined were negative for HBsAG but positive for both anti-HBs and anti-HBc; additionally, 24.6% were negative for both HBsAg and anti-HBs but positive for anti-HBc. Only 134 serum samples showed negative results for HBV markers, indicating an HBV infection rate of 88.8%. The anti-HDV positive rate was estimated to be 2.7% among HBsAg-positive subjects. The HBsAg-positive rates among Rukaiese, Paiwanese, Hakka, Taiwanese, and Mainland Chinese were 25.8, 22.5, 16.7, 12.9, and 10.0%, respectively; while the prevalence rates of HBV infection among the above five groups were 94.2, 94.6, 85.4, 87.5, and 82.5%, respectively. Differences in the HBsAg-positive rate and HBV infection rate among these ethnic groups were statistically significant. We conclude that people living in Pingtung County are more frequently infected with HBV when compared with inhabitants in northern Taiwan.     

口服生长抑素基因疫苗对小鼠免疫影响的初步研究

目的 研究口服生长抑素(SS)基因疫苗在体内表达HBsAg/SS融合蛋白情况.方法 用SS基因疫苗免疫小鼠,姬姆萨染色观察细菌在体内分布;观察小鼠质量增长情况;应用免疫组化法显示小肠乙肝表面抗原(HBsAg)和SS阳性细胞的分布及数量变化.结果 免疫后16 h空肠细菌数量达到高峰,免疫后4 d脾脏出现细菌;两试验组小鼠体质量较对照组均无显著变化;首次免疫后第3周两试验组小肠内出现HBsAg阳性细胞并维持至第7周;首次免疫后第5、7周两试验组小肠内SS阳性细胞数量比对照组极显著减少(P＜0.01).结论 口服型SS基因疫苗免疫小鼠后可在小肠表达HBsAg/SS融合蛋白,同时SS阳性细胞数量减少,推测该基因疫苗刺激机体表达蛋白后能产生SS抗体.     

CHOP方案治疗NHL合并HBV携带者肝功能损害的探讨

目的观察CHOP方案治疗非霍奇金淋巴瘤（NHL）合并HBV携带者肝功能损害及肝炎病毒活化的情况。方法62例入选患者按HBV携带与否分为HBV携带组及非HBV携带组，两组患者均以CHOP方案正规化疗，3周重复，至少2周期。第一个周期化疗前及每次化疗后第3周末检测肝功能全套，HBV携带患者于第一个周期化疗前及每2周期化疗后第3周末检测血清HBV—DNA水平，所有患者均于出现肝功能损害后依病情加用非特异性保肝药物。结果化疗4及6周期后HBV携带组患者肝损害发生率均显著高于非HBV携带患者（P〈O．05），而且HBV携带组患者中肝损害发生率随治疗时间推移有上升趋势，化疗6周期后肝损害发生率显著高于化疗2周期后（P〈0．05）；化疗后血清HBVDNA阳性率有所升高，化疗6周期后血清HBVDNA阳性率显著高于2周期化疗后（P〈0．01），与4周期化疗后比较，差异无统计学意义（P〉0．05）。结论CHOP方案治疗非霍奇金淋巴瘤合并HBV携带患者，易发生肝功能损害，HBV复燃几率增加。积极的预防和治疗必不可少。