乙型和丙型肝炎病毒重叠感染的临床分析

对20例乙型和丙型肝炎病毒重叠感染患者进行临床分析,表明重叠感染与单纯乙型肝炎病毒感染两者主要生化指标 ALT 和血胆红素无显著性差异,重叠感染丙型肝炎病毒对乙型肝炎病毒并无抑制现象,重叠感染的慢性肝炎好转治愈率比单纯乙型肝炎,病毒感染者低(P<0.01);重症肝炎重叠感染者预后差;肝硬化重叠感染者好转率比单纯乙型肝炎病毒感染者低,但两者相比无显著性差异(P>0.15)。     

慢性肝病者乙型和丙型肝炎病毒重叠感染的研究

对２１３例老年慢性肝病患者的乙型肝炎病毒（ＨＢＶ）和丙型肝炎病毒（ＨＣＶ）血清标志物检测发现：ＨＢＶ感染占７３．２４％、ＨＢＶ和ＨＣＶ重叠感染占重叠感染点１５．４９％、ＨＣＶ感染占７．０４％、其它占４．２６％；ＨＢＶ阴性者ＨＣＶ检出率高于ＨＢＶ阳性者，肝癌和肝硬化患者较慢性肝炎患者高；ＨＢＶ和ＨＣＶ重叠感染患者的血清血蛋白下降显著，γ－球蛋白升高明显，肝硬化并腹水和上消化道出血者了多。结果表明，老     

乙型重叠丙型肝炎病毒与单纯乙型肝炎的临床对比分析

乙型重叠丙型肝炎病毒与单纯乙型肝炎的临床对比分析潘兆随，薛琪，方景森乙型肝炎重叠感染丙型肝炎病毒临床较多见，为了探索其重叠感染后的临床特点及其预后，本文作者进行了初步临床对比观察，现报告如下。临床资料一、一般资料本组病例均为１９９１年１月～１９９２年...     

乙型和丙型肝炎病毒重叠感染的研究

自1989年建立了检测抗ＨＣＶ的方法以来,国内外对丙型肝炎的研究发展迅速。我国属乙肝多发地区,为探讨乙型肝炎病毒感染者中丙型肝炎病毒的感染状况、相互关系及对病情、预后的影响,我们对收集的223例各型ＨＢＶ感染者的血清抗ＨＣＶ、ＨＣＶＲＮＡ和血清乙肝病毒标志检测结果和部份临床资料进行了分析。1　材料和方法1.1　研究对象　223例ＨＢＶ感染者均系1996年4月～1998年10月住院病人,其中男175例,女48例,年龄16～37岁,平均37.5岁。患者的诊断按1995年5月全国第五次传染病寄生虫病学术会议制定的病毒性肝炎诊断标准[1]。患者于入院后抽…     

经血和经性传播的人类免疫缺陷病毒感染者乙、丙型肝炎病毒重叠感染比较

我国目前传播人类免疫缺陷病毒(HIV)主要途径为经血传播,如静脉吸毒,输血等,我们曾报道了经血传播HIV和HBV/HCV重叠感染的特征[1,2 ] 。而国外报道HIV传播的主要途径为性途径,在经性途径传播的HIV感染者中HBV/HCV重叠感染状况和感染特征不甚明确,我们以HIV感染的德国男性同性恋者为研究对象,首先对其HBV/HCV重叠感染状况进行调查,并总结了经性和经血传播HIV感染者HBV/HCV重叠感染特点及差异。对象和方法一、研究对象1992年1月～2 0 0 0年12月HIV感染的德国男性同性恋者4 9例,我国经血传播HIV感染者6 2例,取静脉血3ml,- …     

甲,乙,丙型肝炎病毒重叠感染

４９３名健康献血员和１９２例ＨＢＶ感染者，用ＥＬＩＳＡ法检测抗－ＨＡＶ－ＩｇＭ和抗一ＨＣＶ，发现献血员之ＨＣＶ感染率为１．６２％。ＨＢＶ感染者的ＨＡＶ、ＨＢＶ二重感染率为１６．７％，ＨＢＶ、ＨＣＶ二重感染率为３．１３％，ＨＡＶ、ＨＢＶ、ＨＣＶ三重感染率为０．５２％。重叠感染者，３２例ＨＡＶ和ＨＢＶ二重感染者，ＨＢｅＡｇ２８例转阴，与１５３例单纯ＨＢＶ感染者５７例转阴比较，有显著性差异（ｐ〈０．０５     

丙型肝炎病毒与性传播感染

大量文献证实乙肝病毒(HBV)可经性接触感染,Alter等甚至认为30％急性乙肝是由于性传播所致。虽然丙型肝炎主要传播途径是血行感染,但人群中仍有40％～50％的丙型肝炎病毒(HCV)感染者无明显经血暴露史。目前,HCV性传播感染已日益引起人们关注。现将近3年来国外有关资料综述如下。     

丙型肝炎病毒/乙型肝炎病毒重叠感染对维持性血液透析患者HBV DNA水平及肝功能的影响

目的探讨HCV重叠感染对HBV感染的维持性血液透析（MHD）患者HBV DNA水平的影响。方法选取HBV感染血清标志物阳性的MHD患者178名,将其分为HBV合并HCV感染组（HBV＋HCV＋组,n=86）和单纯HBV感染组（HBV＋HCV-组,n=92）,同时检测两组HBV DNA水平及主要血生化指标。结果两组ALT、AST水平无明显差异（P〉0.05）,HBV＋HCV＋组HBVDNA水平较HBV＋HCV-组明显降低[（0.42±0.10）log scale/ml vs（1.25±0.28）log scale/ml,P〈0.01]。多元Logistic回归分析显示HCV感染与低HBV DNA水平独立相关（OR=0.316,95%CI：0.124～0.703,P〈0.01）。结论在HBV感染的MHD患者中,合并HCV感染能显著降低患者的HBV DNA水平,而不引起明显的肝功能损害加重。     

乙型肝炎病毒和丙型肝炎病毒不同模式重叠感染患者临床特征分析

目的 了解HBV和HCV不同模式重叠感染患者临床特征的差异.方法 回顾分析中山大学附属第三医院1999年5月至2010年5月HCV和HBV重叠感染患者186例.统计分析不同病毒学模式重叠感染患者的人口学、流行病学、实验室检查和病理学表现,数据处理采用t检验和x2检验等.结果 186例HBV和HCV重叠感染患者中,HBV...     

EB病毒重叠感染肝炎病毒的研究

EB病毒（EBV）在世界范围内广泛存在，是传染性单核细胞增多症的原因。也与伯基特氏淋巴瘤、鼻咽癌、淋巴增殖综合征、淋巴瘤及口腔绒毛苦历有关’‘-”，也可引起病毒性食道炎’“。EBV与肝炎病毒（ITV）重叠感染的报道不多。我们于1990年5月至1996年4月对此作了研究，以探讨两者重叠感染的状况及其结果。1材料和方法1.1病例和血清随机抽取160例病毒性肝炎住院患者血清，包括56例急性病毒性肝炎（AVH），20例慢性轻度肝炎（CLH），30例慢性中度肝炎（CMH），22例肝炎肝硬化（I。C），10例慢性重型肝炎（CHF）和22例原发性肝癌（…     

Reactivation of Hepatitis C Virus Superinfection in a Patient Seropositive for Hepatitis B e Antigen

During the course of chronic hepatitis B virus (HBV) infection, a patient seropositive for hepatitis B e antigen experienced four episodes of acute hepatic necroinflammation. Serum HBV-DNA concentration elevated immediately before the first and third exacerbations, whereas serum hepatitis C virus (HCV) RNA was detected during the second and fourth exacerbations. The nucleotide sequences of HCV hypervariable region derived from samples of the two exacerbations were identical. Interestingly, “de novo” seroconversion of anti-HCV antibody (Abbott HCV EIA 3.0) followed by reversions occurred in both the second and fourth exacerbations with low sample/cutoff ratios. Immunoblot analysis using a line-immunoassay (Inno-LIA HCV Ab III) revealed a single positive band (C1) developing after the second exacerbation. These data indicate that the second exacerbation in this patient was caused by newly acquired acute HCV superinfection, whereas the fourth exacerbation was likely due to reactivation of the previous HCV infection. Recognition of such a case suggests that the presence of de novo seroconversion of anti-HCV may indicate either reactivation or acute superinfection of HCV in a patient seropositive for hepatitis B e antigen. Received: December 5, 2000 · Revision accepted: September 22, 2001     

Serological Assay and Genotyping of Hepatitis C Virus in Infected Patients in Zanjan Province

Background:

Hepatitis C Virus (HCV), a public health problem, is an enveloped, single-stranded RNA virus and a member of the Hepacivirus genus of the Flaviviridae family. Liver cancer, cirrhosis, and end-stage liver are the outcomes of chronic infection with HCV. HCV isolates show significant heterogeneity in genetics around the world. Therefore, determining HCV genotypes is a vital step in determining prognosis and planning therapeutic strategies.

Objectives:

As distribution of HCV genotypes is different in various geographical regions and HCV genotyping of patients has not been investigated in Zanjan City, this study was designed for the first time, to determine HCV genotypes in the region and to promote the impact of the treatment.

Materials and Methods:

Serum samples of 136 patients were collected and analyzed for anti-HCV antibodies using ELISA (The enzyme-linked immunosorbent assay) method. Then, positive samples were exposed to RT-PCR, which was performed under standard condition. Afterwards, they investigated for genotyping using allele-specific PCR (AS-PCR), and HCV genotype 2.0 line probe assay (LiPA).

Results:

Samples indicated 216 bp bands on 2% agarose gel. Analyses of the results demonstrated that the most dominant subtype was 3a with frequency of 38.26% in Zanjan Province followed by subtypes of 1b, 1a, 2, and 4 with frequencies of 25.73%, 22.05%, 5.14%, and 4.41%, respectively. The frequency of unknown HCV genotypes was 4.41%.

Conclusions:

According to the results, it was found that HCV high prevalent genotype in Zanjan is subtype 3a. Analysis of the results provides identification of certain HCV genotypes, and these valuable findings could affect the type and duration of the treatment.     

A Review of Hepatitis B Virus and Hepatitis C Virus Immunopathogenesis

Despite the advances in therapy, hepatitis B virus (HBV) and hepatitis C virus (HCV) still represent a significant global health burden, both as major causes of cirrhosis, hepatocellular carcinoma, and death worldwide. HBV is capable of incorporating its covalently closed circular DNA into the host cell’s hepatocyte genome, making it rather difficult to eradicate its chronic stage. Successful viral clearance depends on the complex interactions between the virus and host’s innate and adaptive immune response. One encouraging fact on hepatitis B is the development and effective distribution of the HBV vaccine. This has significantly reduced the spread of this virus. HCV is a RNA virus with high mutagenic capacity, thus enabling it to evade the immune system and have a high rate of chronic progression. High levels of HCV heterogeneity and its mutagenic capacity have made it difficult to create an effective vaccine. The recent advent of direct acting antivirals has ushered in a new era in hepatitis C therapy. Sustained virologic response is achieved with DAAs in 85–99% of cases. However, this still leads to a large population of treatment failures, so further advances in therapy are still needed. This article reviews the immunopathogenesis of HBV and HCV, their properties contributing to host immune system avoidance, chronic disease progression, vaccine efficacy and limitations, as well as treatment options and common pitfalls of said therapy.     

Occult Hepatitis B Virus Infection in Patients With Chronic Hepatitis C Treated With Antiviral Therapy

Background

Occult hepatitis B virus infection (OBI) is defined as the presence of hepatitis B virus (HBV) DNA in the liver and/or in the serum of patients with negative results of hepatitis B s antigen (HBsAg) test with or without serological markers of previous viral exposure. The impact of OBI in patients with chronic hepatitis C (CHC) is still unclear.

Objectives

The Aim of this study was to assess OBI prevalence and its potential implications on treatment outcome in a cohort of patients with CHC underwent standard antiviral therapy.

Patients and Methods

Baseline serum samples from 137 HBsAg-negative CHC patients treated with pegylated-interferon and ribavirin (73 Responders/74 Non Responders),were retrospectively analyzed for HBV status.

Results

Seventy-three patients (53.3%) showed markers of previous exposure to HBV. HBV DNA was detected in 2 of 137 serum samples (1.5%), both carrying HBV antibodies. Liver biopsies and post-therapy sera were available for 35 patients (12 Responders/23 Non Responders). HBV DNA sequences were found in 13 of 35 specimens (37.1%), all of patients with HBV DNA negativity in basal and post-therapy serum samples. Among OBI-positive patients, 5 (38.5%) carried serological markers of HBV infection. Regarding therapy outcome, in the OBI-positive group there were 5 of 13 (38.5%) sustained virological responders (SVR) compared to 7 of 22 (31.8%) in the OBI-negative one.

Conclusions

Despite the high prevalence rate of liver HBV DNA in patients with CHC, SVR was not affected by occult HBV infection.     

Hepatitis C in Pakistan: a review of available data

Hepatitis C virus (HCV) infection is increasingly recognized as a major health care problem, and is found frequently in Pakistani settings. In this article we reviewed published and unpublished data related to the seroepidemiology of HCV infection in Pakistan. For this article, data from 132 published studies and three unpublished data sets published/ presented between the period 1992-2008 were utilized. Data of 1,183,329 individuals were gathered. Blood donors (982,481) and the general population (178,322) constituted the majority of these subjects. The frequency of HCV infection in blood donors and in the general population was 3.0 % (95% CI: 3.0- 3.1) and 4.7 (95% CI: 4.6 -4.8), respectively. The frequency among 6,148 pregnant females was 7.3% (95% CI = 6.7 - 8.0). The frequency in healthy children ranged from 0.4 to 4.1% (95% CI = 1.4 - 2.3). Pakistani HCV serofrequency figures are significantly higher (P < 0.0001) compared to those of the corresponding populations in surrounding countries like India, Nepal, Myanmar, Iran and Afghanistan.     

乙丁型肝炎病毒重叠感染时HDV与HBV DNA定量的相关性研究

目的:明确在乙、丁型肝炎病毒重叠感染时HDV对HBV复制和HBVM表达有无抑制作用。方法:HBV DNA定量采用聚合酶链反应法,抗HD IgM采用CIA抗体捕获法,抗HD采用EIA竞争法,HDAg采用EIA夹心法,HBVM采用酶联免疫吸附法。结果:重叠感染组和单纯乙肝组的HBV DNA定量高滴度(≥10~6cps/ml)病例数比率分别为75％和67.74％,各型肝炎(慢性肝炎、肝硬变、慢性重型肝炎)HBV DNA定量高滴度病例数比率,重叠感染分别为68.42％、71.43％、100％,单纯乙肝组分别为65.38%、66.67％、100％。两组病例HBVM主要表达模式均为HBsAg( )、HBeAg( )、抗HBc( )或HBsAg( )、抗HBe( )、抗HBc( ),重叠感染组分别为57.14％、17.86％,单纯乙肝组分别为54.84％、16.13％,两组主要表达模式的HBV DNA定量高滴度病例数比半,重叠感染组分别为87.5％、60％,单纯乙肝组分别为88.24％、60％,均无显著性差异(P>0.05)。结论:HDV对HBV的复制和HBVM表达无明显抑制作用。     

Hepatitis B Virus Vaccine for Patients with Hepatitis C Virus Infection

Summary Hepatitis C is a disease with varying rates of progression. The role of hepatitis B virus (HBV) as a cofactor in the development of hepatitis C virus (HCV)-related cirrhosis and hepatocellular carcinoma (HCC) has been suggested and the use of HBV vaccine in all HCV-infected patients has been advocated. This review presents the implications of HBV and HCV coinfection and addresses the issues of HBV vaccine immunogenicity and safety in patients with chronic HCV infection. Received: December, 1999 · Revision accepted: July 1, 2000     

丙型肝炎病毒对SMMC 7721细胞体外直接致病作用的研究

目的:探讨丙型肝炎病毒(HCV)的直接致病作用。方法:用HCV阳性血清体外感染SMMC 7721细胞,观察细胞形态的变化,并运用四甲基偶氮唑盐(MTT)法及流式细胞仪(FCM)分别检测培养细胞的存活率及凋亡率,同时用套式逆转录-聚合酶链反应(nest RT-PCR)检测其中的正、负链HCV RNA。结果:HCV感染后部分SMMC7721细胞发生皱缩、脱壁,8h细胞存活率为74.2％,细胞凋亡率为18.7％,至56h后细胞存活率回复至84.3％以上,而细胞凋亡率又降至7.4％以下;各时间组的细胞存活率显著低于未感染HCV的SMMC7721细胞,而凋亡率则显著高于未感染的SMMC 7721细胞。感染后24h细胞及上清中HCV RAN检测结果均阴性,48h后在细胞中可检出正、负链HCV RNA,96h后细胞中HCV RNA正链呈阳性、负链转为阴性。结论:1.HCV具有一定的直接致病作用;2.HCV感染SMMC7721后的复制不稳定。     

Prevalence of Occult Hepatitis B Virus in Plasma and Peripheral Blood Mononuclear Cell Compartments of Patients With Chronic Hepatitis C Infection in Tehran-Iran

Background

Occult hepatitis B virus (HBV) infection (OBI) is frequently reported in patients with chronic hepatitis C virus (HCV) infection. An association between OBI and more liver damage, cirrhosis, hepatocellular carcinoma, and reduced response to interferon therapy in patients with HCV infection is suggested.

Objectives

The aim of this study was to determine the prevalence of occult HBV, and evaluate its clinical influence on patients with chronic HCV.

Patients and Methods

A cohort study including50 patients with positive results for HCV, and negative results for HBsAg tests was performed. The patients were divided into two groups: one group had positive results for both HCV and occult HBV tests (n = 18), and the other had positive results for HCV, but negative findings for occult HBV (n = 32). All were treated with PEG-IFN alpha-2a and Ribavirin. Presence of HCV RNA was followed in these patients.

Results

HBV-DNA was detected using nested-PCR in 20% of plasma and 32.6% of peripheral blood mononuclear cell (PBMC) compartments. No significant differences were observed between patients with and without occult HBV for sex, age, duration of HCV infection, histological markers, presence of anti-HBc, HCV viral load, and HCV genotype. The response rate was significantly higher in patients with positive results for HBV-DNA test compared to those with negative findings (100% vs. 71.9 %, P < 0.05).

Conclusions

In conclusion, occult HBV was found in 36% of patients with negative results for HBsAg, but positive results for HCV. Detection of HBV-DNA in both PBMCs and plasma together in comparison with plasma alone provided more true identification of OBI.The SVR rate was significantly higher in coinfected patients than mono-infected ones.