Hepatitis B Virus

Candidia spp. are responsible for contributing to the increasing global prevalence of fungal infections. Fluconazole (Diflucan^®, Pfizer) is a triazole that has established an exceptional therapeutic record for candida infections including oropharyngeal and esophageal candidiasis, vulvovaginal candidiasis, candidemia and disseminated candidiasis. It is both an oral and parenteral fungistatic agent that inhibits ergosterol synthesis in yeasts. Extensive clinical studies have demonstrated fluconazole’s remarkable efficacy, favorable pharmacokinetics and reassuring safety profile, all of which have contributed to its widespread use. Fluconazole became the first antifungal with worldwide sales exceeding billions of dollars, therefore providing an incentive for the pharmaceutical industry to develop new antifungals. This review will examine the contributions and limitations of fluconazole in the treatment of superficial and invasive candidiasis syndromes.     

乙型肝炎病毒与丙型肝炎病毒重叠感染的探讨

乙型肝炎和丙型肝炎是对人类健康危害甚大的肝炎中的两大类，乙型肝炎病毒（HBV）和丙型肝炎病毒（HCV）均可由输血，静脉和母婴垂直传播等多种途径感染人类。乙型肝炎在我国属高发区，乙型肝炎病毒感染是我国原发性肝细胞癌发生的主要原因，而乙型肝炎病毒和丙型肝炎病毒的重叠感染对肝病的慢性化，严重化，癌变起着不可忽视的作用。作者对60例HBV感染者中重叠HCV感染的检测，将有助于临床诊断和治疗。     

拔牙术中乙型、丙型肝炎病毒污染的调查及对策

目的对常规拔牙术中乙型、丙型肝炎病毒污染情况进行调查,进一步控制医源性感染。方法随机抽取500例门诊拔牙患者的术中止血棉球,分别浸入2个（A、B）盛有1ml生理盐水的无菌试管内,其浸出液分别用两种方法进行肝炎病毒检测。结果A组（HBsAg）检测到40例阳性（8．00％）,B组（IgG）检测到12例阳性（2．40％）,HBsAg和IgG检测到A组和B组同时阳性2例（0．40％）;500例门诊拔牙患者中检测到被肝炎病毒感染的有54例,占调查总人数的10．8％。结论口腔门诊乙型、丙型肝炎感染率很高,迫切要求口腔医务工作者要加强职业防护,有效防治肝炎病毒通过口腔科诊疗传播。     

甲型肝炎病毒合并戊型肝炎病毒感染136例临床分析

目的　观察分析甲型病毒性肝炎合并戊型病毒性肝炎 (甲肝合并戊肝 )的临床表现及转归预后。方法　采用ELISA方法检测患者抗HAV IgM和抗HEV。结果　甲肝合并戊肝出现发热和肝大的病例分别占 6 9.85 %和 6 3 .97% ,显著高于单纯甲型病毒性肝炎 (甲肝 )的 3 7.0 0 %和 3 5 .43 %。甲肝合并戊肝发病的平均年龄为 3 1.42± 11.2 1岁 ,显著高于甲肝的 2 3 .2 1± 9.2 3岁。结论　甲肝合并戊肝也是与甲肝类似的自限性、急性、黄疸型肝炎 ,但甲肝合并戊肝具有发病以中青年为主 ,发病年龄较甲肝偏大、发热和肝大发生率高、黄疸时间较长的特点。     

肝移植术后丙型肝炎病毒感染

目的：探讨肝移植术后丙型肝炎病毒感染的危险因素及处理对策。方法：回顾性分析2001年4月～2005年2月间，复旦大学附属中山医院15例肝移植术后丙型肝炎病毒感染的临床资料，了解相关危险因素、诊断、治疗及预后情况。结果：15例中9例肝移植术后HCV复发，血清中检测到HCVRNA，和(或)出现病理肝活检组织学改变。3例死亡皆因HCV复发不能控制所致。干扰素-α联合利巴韦林治疗4例，HCVRNA血清滴度在治疗后1周皆明显下降。结论：HCV复发是目前肝移植术后一个普遍而又处理棘手的问题。控制并减少HCV复发的危险因素，早期诊断并进行有效的预防和治疗，是提高丙肝肝移植效果的重要途径。     

乙型肝炎病毒感染孕妇产后的健康指导

我国是乙型肝炎病毒(HBV)感染的高发区,人群中乙肝表面抗原阳性率约占10%,在孕妇中的携带率为5%～10%,HBSAg阳性并伴有乙肝e抗原阳性,通过母婴传播婴儿感染率可达到90%,围生期的传播是母婴传播的主要方式。我科于2008     

固安县献血(浆)者HCV和HBV感染的血清学追踪观察

1985年固安县献浆者中发生丙型肝炎流行。1986年初,调查了该县当年(1985年)献浆村、献浆5年村和基本无献血村的献浆者和献全血者HCV和HBV的感染状况,1990年又追踪观察。结果是1986年和1990年献浆者抗-HCV阳性率分别为64.7％和43.9％。在献浆者中ALT异常的抗-HCV阳性率分别为77.5％和81.1％;ALT正常的分别为51.3％和34.3％。献浆者抗-HCV阳性率均高于献全血者和非献血成人。提出在固安县供血单位增加抗-HCV筛选献血者势在必行。另外对91例抗-HCV阳性献浆者第5年又进行了追踪观察,阴转率为30.8％,约有70％的病例转为慢性。     

乙型肝炎病毒耐药基因研究进展

核苷(酸)类似物抗病毒药物的开发和应用,为慢性乙型肝炎(CHB)的治疗带来了极大的帮助.然而在临床治疗的过程中,乙型肝炎病毒(HBV)耐药变异地产生增加了治疗失败的风险.近年来,在全球范围内对HBV耐药变异毒株的研究正在大规模的进行.该文将围绕HBV耐药基因的特点、HBV基因分型与耐药、检测耐药基因的技术和方法等方面的研究进展进行综述.     

Transfusion-Transmitted Hepatitis E Virus Infection in France

There is growing concern regarding the risk of transfusion- transmitted (TT) hepatitis E. Since the first described case in 2006, several TT hepatitis E have been reported to the French hemovigilance network. We performed a retrospective analysis of all cases of TT hepatitis E reported between 2006 and 2016. Transfusion-transmitted hepatitis E with high imputability according to phylogenetic analysis occurred in 23 patients aged 8 to 88 years and involved mostly solid organ recipients (n = 9) or patients with malignant hematological diseases (n = 9, including 4 hematopoietic allograft recipients). Involved blood products were plasma (n = 7), among which 6 had undergone pathogen reduction with solvent/detergent (n = 4) or amotosalen + ultra-violet A (UVA) (n = 2 from 1 donation) treatments, red blood concentrates (n = 7), apheresis platelets concentrates (n = 3) and whole blood pooled platelets concentrates (n = 6), among which one had underwent amotosalen + UVA treatment. Median hepatitis E virus (HEV) RNA dose infused was 5.79 [4.36–10.10] log IU. HEV infection progressed to chronic hepatitis E in 14 (61%) immunocompromised patients, 2 of whom had advanced liver fibrosis at diagnosis. Chronic hepatitis E patients cleared HEV with ribavirin treatment (n = 10), after immunosuppressive drug reduction (n = 3), or spontaneously (n = 1). One additional organ transplant recipient with associated co-morbidities died with ongoing HEV infection and multiple organ failure. The other 8 (34.8%) patients with TT hepatitis E cleared HEV within 6 months with ribavirin treatment (n = 3), reduced immunosuppression (n = 1) or spontaneously (n = 4). Red cells, platelets, and plasma transfusions may be associated with TT hepatitis E that can evolve to chronic hepatitis E in immunocompromised patients. Hepatitis E virus has emerged in France as a clinically significant TT infection risk.     

Hepatitis B Virus: A Molecular Perspective

Hepatitis B virus (HBV) is a global health problem. The HBV-mediated pathogenesis is a multistep, multi-factorial event involving crucial interplay between the chronically persisting viral factors and the host system. This triggers an immune-elicited regenerative process that eventually leads to chronic liver inflammation, scarring and formation of new tissue. Further, expression of viral antigens modulates cellular signaling, nuclear transactivation and host stress-responsive pathways that produce a cumulative effect in favor of viral survival and replication. Chronic HBV infection in India affects a sizeable population and warrants more epidemiological studies in this area. There is also an urgent need to adopt new measures to limit and manage the infection in view of our low socioeconomic status and ignorance about the disease. This review highlights the role of host and viral factors in pathogenesis and outlines their underlying mechanisms. A better understanding of the viral life cycle, mode of pathogenesis and outcome of the infection should be helpful in devising new strategies to control such wide range of HBV-associated disease and developing better interventional protocols.     

二重RT—PCR同时检测HGV与HCV RNA

庚型肝炎病毒（ＨＧＶ）与丙型肝炎病毒（ＨＣＶ）具有相近的传播途径与类似的检测方法，本文建立了二重ＲＴ－ＰＣＲ法，用于同时检测ＨＧＶ与ＨＣＶ病毒核酸，其扩增产物分别为６０９ｂｐ与２５７ｂｐ在琼脂糖或聚丙烯酰胺凝胶上的均能安全分离，ＨＧＶ产物经测序显示与报道的核酸序列同源性为８９．２％～９２．６％，该法具较好的批间重复性，二重ＰＣＲ法减轻了实验人员的操作强度，可降低测定费用近５０％，７６例样本检测显示     

乙型肝炎病毒携带者的家庭护理

乙型肝炎是严重危害人体健康的重要传染病。我国是乙型肝炎的高发区 ,人群中乙型肝炎总感染率 (HBsAg、抗 -HBs或抗HBc任何一项指标阳性即确定为已感染者 )在 60 %以上 ,HBsAg阳性率约为 10 %左右[1] 。人感染乙型肝炎病毒 (HBV)后 ,少部分人HBsAg持续阳性 ,成为无症状HBsAg携带者(ASC)。目前对于消除HBsAg尚无有效药物 ,因此HBsAg持续携带已成为人类重要传染病中一个非常特殊而又棘手的问题[2 ] 。乙型肝炎与肝硬化、肝癌的发生有密切的关系 ,因而控制HBV传播 ,有效治疗和护理病毒感染者 ,使其尽快康复 ,是当今医学研究亟待解…     

乙型肝炎病毒相关性肾炎的研究进展

1971年Combes等首次报告乙型肝炎病毒（HBV）感染引起肾病以来，引起国内外学者广泛关注。1989年我国学者正式将其命名为乙型肝炎病毒相关性。肾小球肾炎（Hepatitis Bvirus associated glomerulonephritis，HBV—GN），简称乙肝肾炎。我国是HBV感染高发区，普通人群中HBV携带率高达10％～15％，HBV—GN是常见的继发性肾病之一。近年来，随着对HBV—GN认识的逐步深入。本病的研究也有较大进展，现综述如下。     

Public Health Management of Perinatal Hepatitis B Virus

ABSTRACT Infants who are born to hepatitis B surface antigen (HbsAg)-positive women are at high risk for contracting perinatal hepatitis B virus (HBV) infection. When maternal status is known, postexposure prophylaxis (PEP) consisting of a birth dose of (HBV) vaccine and Hepatitis B Immune Globulin may be administered within 12 hr of birth to provide 90% protection. Providers' reporting of maternal HBsAg positivity or perinatal HBV should prompt public health nurses to initiate nurse case management (NCM). NCM is the most successful way to ensure that at-risk infants receive PEP and follow-up serology. Unfortunately, reporting laws vary greatly by state and the Centers for Disease Control and Prevention estimate that perinatal HBV is significantly under-reported nationally. This article discusses public health measures for preventing perinatal HBV and presents a case study that used a novel method to assess the extent of under-reporting. We discuss barriers to public health NCM and the importance of a universal HBV vaccine birth dose to protect undetected and unreported cases. Finally, we suggest implications for public health nursing practice.     

病毒性乙型肝炎感染组合分析

对 16 92例乙型肝炎感染者 (两对半中任一项阳性 )进行乙型肝炎感染组合分析。用随机分层抽样方法。检测两对半。结果表明 ,随年龄增长而由大三阳转化为小三阳的变化过程 ;汉族、彝族的组合较其他三种民族的组合复杂 ,8种以外组合近 7%。结果证明 ,新婚夫妇接种乙肝疫苗是一种重要预防手段 ;其次是新生儿 ;对于 5 0岁以上组可不要求进行乙肝疫苗接种 ;人类基因构成在种族上的不同可能导致了病毒对细胞的亲和力不同     

Molecular Biology and Inhibitors of Hepatitis A Virus

Hepatitis A virus (HAV) is a faeco‐orally transmitted picornavirus and is one of the main causes of acute hepatitis worldwide. An overview of the molecular biology of HAV is presented with an emphasis on recent findings. Immune evasion strategies and a possible correlation between HAV and atopy are discussed as well. Despite the availability of efficient vaccines, antiviral drugs targeting HAV are required to treat severe cases of fulminant hepatitis, contain outbreaks, and halt the potential spread of vaccine‐escape variants. Additionally, such drugs could be used to shorten the period of illness and decrease associated economical costs. Several known inhibitors of HAV with various mechanisms of action will be discussed. Since none of these molecules is readily useable in the clinic and since the availability of an anti‐HAV drug would be of clinical importance, increased efforts should be targeted toward discovery and development of such antivirals.