Delta virus and hepatitis B surface antigen in chronic liver diseases.

This work was carried out on 45 patients with chronic liver diseases, including 24 cases of liver cirrhosis and 21 cases of chronic hepatitis. Their ages ranged from 2 to 15 years (median 5). All cases were examined clinically and assessed biochemically for liver function tests. Serological studies were performed to detect hepatitis B surface antigen (HBsAg) and delta IgG antibody (IgG anti-HD) using Enzyme Immunoassay (EIA) technique. The study showed that IgG anti-HD was detected in 8.9% of cases with chronic liver diseases (all positive cases were with liver cirrhosis). On the other hand, HBsAg was detected in 53.3% of cases (54.2% of them with cirrhosis and 45.8% with chronic hepatitis) with no significant association between HBsAg positivity and type of hepatic illness. Moreover, IgG anti-HD was positive in only 4.2% of HBsAg positive cases, while 14.3% of HBsAg negative cases were positive for IgG anti-HD. A significant association was also found between delta positivity and serum glutamic oxaloacetic transferase level (SGOT). We concluded that chronic delta hepatitis appeared to be more severe than other types of chronic viral hepatitis, as all delta positive cases were with liver cirrhosis and had elevated SGOT levels. Screening of delta markers in addition to hepatitis B viral markers could improve the understanding of a number of obscure cases of chronic hepatic illnesses and would help in the control of HBV and consequently HDV infection in the general population.     

Pre-S2抗原与乙肝病毒血清标志物关系新探

目的探讨Pre-S2抗原（前是抗原）在乙型肝炎病毒的各类隐性、显性感染中的地位及科研、临床应用价值。方法以乙肝病毒隐性感染者（为主）及适量显性感染者作为研究对象，采用ELISA（酶联免疫吸附试验）法，同时检测感染者的Pre-S2抗原和乙肝血清标志物，然后进行各类、群感染者之间的比较、分析。结果在乙肝病毒隐性感染者人群中，乙肝e抗原阳性人员、e抗体阳性人员的Pre-S2抗原阳性率分别为93．10％、60．00％；“乙肝大三阳”人员、“小三阳”人员的Pre-S2抗原阳性率分别为92．31％、62．50％。在乙肝病毒显性感染者——急、慢性乙肝患者两类对比人群中，Pre-S2抗原的阳性率分别为90．91％、61．54％。结论Pre-S2抗原在判断乙肝病毒突变、感染者尤其是隐性感染者血清的传染性强度方面，有较高使用价值和补缺作用；在判断隐性感染者的发展转化和显性感染者的临床转归方面，亦有较大参考意义。     

乙型肝炎病毒患者血清腺苷脱氨酶的应用价值探讨

目的探讨检测乙型肝炎病毒(HBV)标志物不同阳性类型患者的血清腺苷脱氨酶(ADA)的临床应用价值。方法用速率法测定血清ADA水平;用酶联免疫吸附试验(ELISA)法测定乙型肝炎病毒血清标志物(俗称“二对半”);用荧光定量PCR检测HBVDNA。按HBV标志物阳性情况将患者分为3组:A组50例,为HBsAg、HBeAg、HBcAb阳性(俗称“大三阳”),HBVDNA阳性;B组54例,为HBsAg、HBcAb阳性,HBVDNA阳性或阴性;C组94例,为HBsAg、HBeAb、HBcAb阳性(俗称“小三阳”),HBVDNA阳性或阴性。全部患者均检测其血清ADA水平。正常对照组60例。结果血清ADA水平由高到低依次为A组、B组、C组、正常对照组,差异有显著性(P<0.05),B组和C组中的HBVDNA阳性患者均高于HBVDNA阴性患者,有显著性差异(P<0.05),A组的血清ADA水平略高于B组中的HBVDNA阳性患者,无显著性差异(P>0.05)。结论血清ADA水平是反映肝细胞损害的一个良好指标,乙型肝炎病毒患者或携带者血清ADA在一定程度上反映HBV的复制情况,其水平测定对指导临床治疗有重要意义。     

Delta virus infection in Egypt.

The present study was carried out on 124 serum samples of acute hepatitis B, 51 with chronic HBV infection, and 41 chronic HBsAg carriers. Sera were tested by ELISA for HBV markers and anti-delta (anti-HDV). Delta infection (anti-HDV) in acute HB was found to be 16.9% (21 out of 124), 23.5% in chronic HB cases (12 out of 51), and 21.9% among chronic HBsAg carriers (9 out of 41). Out of the twelve delta positive in chronic HB patients, ten (83%) were suffering from CAH (chronic active hepatitis) denoting a possible role of delta infection in deteriorating the course of the disease. A competitive inhibition of HBV replication by coexistent delta infection was demonstrated in the present study. This was reflected on anti-HBc IgM in the acute cases and on HBeAg in chronic HB cases. Anti-HBc IgM was 71.42% (15 out of 21) in delta positive acute HB patients versus 92.23% (95 out of 103) in delta negative acute HB patients. On the other hand, HBeAg percentage was 8.33% (1 out of 12) and 46.15% (18 out of 39) in delta and non-delta chronic HB patients respectively. The difference in both anti-HBc IgM and HBeAg as regards delta positive and negative patients was found to be statistically significant. Out of the twelve chronic HB cases with delta infection, four cases were negative for HBsAg (33.33%). This observation might be attributed to the clearance effect of hepatitis D virus (HDV) on HBsAg (Ischimura et al., 1988) or due to suppressing effect resulting in low undetectable HBsAg level in serum, (Sherlock, 1989). From the present study it may be concluded that delta infection is endemic in Egypt (its incidence ranged from 16.94% in acute HB to 23.53% in chronic HB infection), delta infection possibly also worsens the outcome of chronic HB patients. Delta infection may exert a competitive inhibitory effect on HBV replication.     

Hepatitis A, B, and delta infection in Ethiopia: a serologic survey with demographic data

A total of 500 individuals from five different regions of Ethiopia were studied. Demographic and clinical data were recorded and serologic tests were carried out to detect antigen and antibody markers of hepatitis B virus, hepatitis A virus, and the delta agent. Data on the economic status, number of rooms per household, number of persons per household, type of water supply, and mode of excreta disposal revealed that the majority of the population surveyed lived with economic hardship, overcrowding and poor hygiene. Only 36 persons gave a past history of jaundice. The mean carrier rate of hepatitis B surface antigen (HBsAg) was 6.2%, the mean overall hepatitis B virus marker prevalence was 42%, and in those over 14 years of age it was 76%. Among those who were positive for HBsAg, there was a tendency for hepatitis B e antigen (HBeAg) to decrease and the corresponding antibody (anti-HBe) to increase with advancing age. No woman more than 15 years of age had demonstrable hepatitis B e antigen in serum. Antibody to hepatitis A virus was detected in 84%. Three positive individuals were found to have antibody to the delta agent.     

消毒剂破坏乙、丙型病毒性肝炎血清标志物的初步观察

笔者采用氯仿、40%甲醛溶液、3%双氧水及75%乙醇与HBsAg、HBeAg和抗-HCV阳性血清作用5、15、30及60分钟后,用ELISA法检测是否转为阴性,以了解消毒剂对上述阳性血清的破坏效果。结果:氯仿对HBsAg和抗-HCV阳性血清破坏效果好;40%甲醛溶液对HBsAg、HBeAg及抗-HCV阳性血清均破坏;3%双氧水对HBeAg有破坏作用,而75%乙醇对HBsAg、HBeAg及抗-HCV阳性血清作用上述时间后,检测时仍呈阳性反应。笔者只是初步观察,有关消毒剂的浓度、效果及作用机理有待迸一步观察和探讨。     

HBeAg阳性慢性乙肝患者红细胞天然免疫粘附功能的变化及意义

目的:研究HBeAg阳性慢性乙肝患者红细胞天然免疫粘附功能(red cell nature immune adhesion function,RNIAF)的变化,探讨其临床意义。方法:选择血清HBV DNA大于106 IU/ml的60例肝功能正常、32例初次出现肝功异常及26例反复肝功异常的HBeAg阳性慢性乙肝患者作为研究对象,采用红细胞天然免疫粘附肿瘤细胞功能实验,对118例研究对象及30例正常人的RNIAF进行测定。结果:肝功能正常的HBeAg阳性慢性乙肝患者RNIAF与正常人群比较,无显著差异(P>0.05)。初次出现肝功异常的HBeAg阳性慢性乙肝患者RNIAF显著高于肝功正常的HBeAg阳性患者及正常人群(P<0.01);反复出现肝功异常的HBeAg阳性慢性乙肝患者的RNIAF则显著低于肝功正常的患者及正常人群(P<0.01)。持续肝功异常的HBeAg阳性慢性乙肝患者的RNIAF随着病程延长而逐渐下降,肝功能恢复后其RNIAF有所回升。结论:HBeAg阳性慢性乙肝患者RNIAF的变化与其疾病的不同时期及病情的严重程度密切相关,可作为判断该类患者病情变化的重要指标。     

Occult hepatitis B virus infection in Greek patients with congenital bleeding disorders

Occult Hepatitis B Infection (OBI) is a form of chronic HBV infection characterized by low level HBV DNA, without detectable HBV surface antigen (HBsAg). OBI is frequently associated with the presence of anti-HBc and in some cases also with anti-HBs. Patients, who formerly received non-inactivated factor concentrates, can potentially be considered at high risk for OBI, especially since these patients usually are HIV or HCV co-infected. This study aimed to assess the prevalence of occult HBV infection in Greek patients with hereditary bleeding disorders. The study sample comprised of 114 patients from a single haemophilia center. All patients were screened for HBV serum markers and individually tested for HBV DNA using a qualitative PCR. Presence of HBV DNA was further confirmed by quantification of viral load with an ultrasensitive in-house real time PCR. 88 and 21 patients with haemophilia A and B, respectively, 4 patients with von Willebrand Disease and 1 patient with severe factor VII deficiency were screened for the presence of OBI. Anti-HBc were detected in 53 (46.5%) subjects; 18 of them were anti-HBs(−) and 35 anti-HBs(+). Anti-HBe were present in 26 subjects. Two out of 114 patients were HBsAg(+). Of the remaining 112 HBsAg(−) patients tested, two (1.8%) were found HBsAg(−), HBV DNA(+), anti-HBc(+) and anti-HBs(−) and were identified as potential OBI cases. Both cases exhibited very low DNA levels; 38.2 IU/mL in patient A and 14.2 IU/mL in patient B. Both patients were HBeAg(−), but patient A had HBe antibodies. Patient B was also HIV/HCV co-infected. In conclusion, two cases of OBI with low HBV viraemia were identified among patients with congenital bleeding disorders. Although the incidence in our sample is moderately low (1.8%), close monitoring of these infections is of great clinical significance, especially in patients with co-infections and concomitant immunosuppression.     

Association between glucose-6-phosphate dehydrogenase deficiency and neonatal jaundice: interaction with multiple risk factors.

This nonconcurrent cohort study was carried out to evaluate the association of neonatal jaundice with glucose-6-phosphate dehydrogenase (G-6-PD) deficiency and its interactions with other risk factors. The G-6-PD enzyme activity of 12,379 neonates was screened by a semi-quantitative fluorometric assay and double-checked by a quantitative method to identify a G-6-PD deficient cohort of 333 neonates. Matched with these on birth date, sex and delivery hospital were a G-6-PD normal cohort of 653 neonates. Neonatal jaundice was defined by a peak serum bilirubin (PSB) level of > or = 15 mg/dl. A significant association between G-6-PD deficiency and neonatal jaundice was observed in male but not female neonates. There was an inverse dose-response relation between G-6-PD activity and neonatal jaundice among male neonates. Both hypoxia/asphyxia and maternal hepatitis B surface antigen (HBsAg) carrier status were associated with an increased risk of neonatal jaundice among G-6-PD deficient but not G-6-PD normal male neonates. Based on multiple regression analyses, an additively synergistic effect on PSB level and severe jaundice (PSB > or = 20 mg/dl) was observed for G-6-PD deficiency and maternal HBsAg carrier status.     

34080例患者4项感染性疾病血清标志物检测结果分析

目的调查成都市金牛区人民医院就诊患者4传染性疾病血清标志物阳性情况。方法该院检验科2014年7月至2018年5月完成34080例患者的乙肝、丙肝、梅毒、艾滋病血清标志物结果进行分析。结果所有标本HIV抗体(抗-HIV1/2)初筛阳性率为0.32%、乙型肝炎表面抗原(HBsAg)阳性率为11.34%、丙型肝炎抗体(抗-HCV)阳性率为0.42%、梅毒螺旋体抗体(抗-TP)阳性率为3.08%,其中男性抗HIV1/2、HBsAg、抗-TP阳性率均高于女性(P<0.01);四项感染性疾病血清标志物中,抗HIV1/2、HBsAg、抗-HCV以30~59岁组阳性率最高,而抗-TP以≥60岁组阳性率最高。结论成都市金牛区人民医院手术、分娩及输血前患者四项感染性疾病血清标志物阳性检出率较高,且男性阳性率高于女性。     

A seroepidemiological survey of viral hepatitis in the Yemen Arab Republic

During February 1988 a seroepidemiological survey of hepatitis A, B and D was performed in the Yemen Arab Republic. 879 sera were collected from 4 different areas; Sanaa, Hajja, Hodeidah and Taiz. The prevalence of hepatitis B surface antigen (HBsAg) was 12.7% (112/879) and some marker of hepatitis B infection was found in 45.5% (399/879) of study subjects. Only 2 (1.8%) of the 112 HBsAg positives were positive for antibody to delta hepatitis, and 9.7% (9/93) were positive for hepatitis B e antigen (HBeAg). Univariate analysis showed age, sex, qat chewing, blood transfusion, surgery and a past history of jaundice to be associated with hepatitis B infection. Using multivariate logistic regression analysis only, age (odds ratios 1.37 for HBsAg carriers and 1.51 for seropositives), a past history of jaundice (odds ratio 1.42), and combined history of blood transfusion and surgery (odds ratio 2.76) were independent predictors of infection. Hepatitis B appears to be a major health concern in the Yemen Arab Republic.     

乙肝五项定性与HBV-DNA结果相关探讨

目的：探讨ELISA检测乙肝病毒血清标志物与荧光定量PCR检测HBV-DNA结果的相关性。方法：采用ELISA方法检测285例患者乙肝病毒血清标志物（HBV-M）,同时用荧光定量PCR检测其HBV-DNA含量。结果：139例HBsAg （＋）、HBeAg（＋）、抗-HBc（＋）患者中有124例患者阳性（血清HBV-DNA含量≥103copy/ml为阳性）,阳性率为89.2%;92例HBsAg（＋）、HBeAb（＋）、抗-HBc（＋）患者中有43例阳性,阳性率为46.7%;27例HBsAg（＋）、抗-HBc（＋）患者中有10例性,阳性率为37%;10例HBsAg（＋）、HBeAg（＋）患者中有9例阳性,阳性率为90%;11例HBsAg（＋）、HBeAg（±）、抗-HBc（＋）患者中有9例阳性,阳性率81.8%,6例单独HBsAg（＋）患者中有0例阳性,阳性率为0。结论：所有分组中HBeAg（＋）组病毒复制水平最高,其与HBV-DNA含量密切相关;抗-HBe（＋）、抗-HBc（＋）患者乙肝病毒复制并非完全停止,只是其复制水平明显降低,荧光定量PCR检测HBV-DNA含量可表达HBV感染和病毒复制水平。     

阴道分泌物、精液和唾液中HBsAg的检测

本文检测了65例血液HBsAg阳性的阴道分泌物、精液和唾液的HBsAg。阴道分泌物HBsAg阳性率为57.4%(31/54),阳性率随血液HBsAg滴度上升而增高。宫颈糜烂有无对分泌物中HBsAg阳性率未见明显影响。经期及经期后不同时间内分泌物HBsAg阳性率未见明显差异。分泌物HBsAg阳性者中有22例唾液HBsAg亦阳性。精液HBsAg阳性1例,阳性率为12.5%,其唾液亦阳性。58例唾液HBsAg阳性有37例,阳性率为63.8%阳性率随血HBsAg滴度增高而升高。血HBeAg阳性组其唾液HBsAg阳性率比其阴性组为高。     

2007～2008年大连市HBsAg阳性人群HGV重叠感染状况调查

[目的]了解庚型肝炎病毒(HGV)与乙型肝炎病毒(HBV)重叠感染状况。[方法]收集2007~2008年在大连市市级以上医院肝炎门诊和病房确诊的HBsAg阳性者228例的血清,采用酶联免疫吸附试验和逆转录聚合酶链反应进行HGV感染的血清流行病学研究。[结果]检测228例HBsAg阳性者,其中单纯HBsAg阳性者144例,HBsAg、HBeAg双阳性的急性乙肝患者(简称乙肝患者)84例。抗-HGVIgG阳性率,全部调查对象为9.65%(阳性22例),其中急性乙肝患者、单纯HBsAg阳性者分别为16.67%、5.56%(P0.01);HGV RNA阳性率,22例抗-HGVIgG阳性者为86.36%,其中急性乙肝患者、单纯HBsAg阳性者分别为92.86%、6/8(P0.01)。[结论]HGV与HBV有较高的重叠感染率,乙肝患者重叠感染率高于单项HBsAg阳性者。     

2013-2016年云南省10 018例育龄人群孕前HBsAg筛查结果分析

目的 了解云南省10 018例育龄人群的乙肝病毒感染状况,为科学干预提供依据。方法 用ELISA法筛查云南省石屏县、大关县、西盟县、大姚县10 018例血清样本,采用描述性流行病学研究方法分析不同性别、年龄、民族、文化程度育龄人群的乙肝病毒感染状况。结果 10 018例,HBsAg阳性562例,阳性率5.6%。育龄男性阳性率7.5%较女性4.5%高;45~49岁阳性率8.5%排第1位,其次为30~34岁6.6%;佤族阳性率10.9%排第一位,其次拉祜族9.5%,傣族9.4%;文盲阳性率10.6%;小学阳性率6.4%;初中阳性率5.2%;不同年龄、性别、民族、文化程度HBsAg阳性率之间差异有统计学意义。HBsAg阳性562例中出现10种HBV血清学模式,以 “小三阳”(49.11%)、 “大三阳”(27.76%)为主。结论 云南省石屏县、大关县、西盟县、大姚县育龄夫妇HBsAg阳性率与年龄、性别、民族、文化程度等因素相关,需要有针对性进行预防和控制。     

Association of hepatitis C virus with liver cirrhosis and hepatocellular carcinoma compared with hepatitis B virus in Egyptian patients

Hepatocellular carcinoma (HCC) is an aggressive malignancy and carries a poor prognosis. Documentation of the wide geographical variation in its incidence has led to clear identification of several risk factors. These include hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in endemic areas. The present study investigated the association of HBV with HCV and cirrhosis, the latter is regarded as a premalignant lesion and underlies most cases with HCC. Serum samples from 94 patients with HCC (n=25) and cirrhosis (n=69) were tested for hepatitis C virus antibody (anti-HCV), hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc) and serum alphafetoprotein (AFP). Of the 94 patients, 71 (75.5%) had anti-HCV, 6 (6.4%) were positive to HBsAg, while 64 (68.1%) were positive to anti-HBc. These viral markers were more prevalent among HCC patients, 19 (76.0%) had hepatitis C antibody, 3 (12.0%) were positive to HBsAg and 22 (88.0%) were positive to anti-HBc compared with 52 (75.4%), 3 (4.3%) and 42 (60.9%), respectively in patients with cirrhosis. Regarding serum AFP measurement, 14 (56%) of patients with carcinoma and 35 (50.7%) of patients with cirrhosis demonstrated levels above 7 ng/ml. In patients with cirrhosis, elevated serum AFP and presence of anti-HCV in serum were significantly associated. In conclusion, this study shows that viral hepatitis is strongly associated with the development of cirrhosis and HCC in Egyptian patients. Hepatitis C virus seems to play a predominant role compared with hepatitis B virus.     

乙肝病毒感染与原发性肝癌关系的血清学调查

目的　了解乙肝病毒感染与原发性肝癌的关系。　方法　对 2 11例原发性肝癌病人进行乙型肝炎病毒感染血清标志物 ( HBV- M)检测 ,并与同期 2 2 0例非肝癌消化道肿瘤病人检测的 HBV- M进行对比分析。　结果　肝癌组HBV- M阳性 186例 ( 88.15 % ) ,非肝癌组 HBV- M阳性 87例 ( 3 9.5 5 % ) ,有显著差异 ( P<0 .0 0 1)。肝癌组乙肝病毒感染以“小三阳”为主 ,“小三阳”指标为阳性者占 12 1例 ( 60 .75 % ) ,明显高于非肝癌组“小三阳”阳性 3 1例 ( 3 5 .63 % )。　结论　乙肝病毒感染在原发性肝癌病因学中起着十分重要的作用     

Comparative efficacy, safety and immunogenicity of Hepavax-Gene and Engerix-B, recombinant hepatitis B vaccines, in infants born to HBsAg and HBeAg positive mothers in Vietnam: an assessment at 2 years

In a randomized, controlled trial, 105 healthy full-term infants born to HBsAg and HBeAg positive mothers received three doses (at 0, 1 and 6 months) of either a new recombinant hepatitis B vaccine (Hepavax-Gene) or Engerix-B. Both groups were also given hepatitis B specific Hepa-big immunoglobulin (HBIG) within 24h of birth. Levels of antibodies to hepatitis B surface antigen (anti-HBs) were assessed on days 30, 60, 210, 360, and 2 years post-vaccination. Efficacy and immunogenicity and safety of the two vaccines were not significantly different; both vaccines achieved >94% seroprotection within 360 days. At 2 years, only one subject (1.9%) in the Hepavax-Gene group and two subjects (3.9%) in the Engerix-B group were HBsAg positive. No serious adverse events (AEs) were observed in either group.     

Prevalence of antibodies to hepatitis C virus in hemodialysis patients and renal transplant recipients

This work was carried out to study the prevalence of hepatitis C virus (HCV) infection, its associated risk factors and possible routes of transmission in hemodialysis patients and renal transplant recipients. Ninety five patients and 15 normal controls were included in this study. Patients were classified into 3 groups: Group I (64 hemodialysis patients), Group II (16 renal transplant recipients) and Group III (15 patients with chronic renal insufficiency on conservative treatments). Each individual was subjected to full clinical examination, estimation of serum alanine aminotransferase (ALT), testing for antibodies to hepatitis C virus (anti-HCV), screening for hepatitis B surface antigen (HBsAg), antibodies to hepatitis B surface antigen (anti-HBs) and core antigen (anti-HBc) by modified ELISA technique. Anti-HCV was found in 87.5% of hemodialysis patients, 81.25% of renal transplant patients, 53.3% of the conservative group and in 13.3% of the control group. There was a significant correlation between the presence of anti-HCV and the duration on dialysis in groups I and II (p < 0.05), while no significant correlation was detected between HCV positive cases and the number of units of transfused blood in groups I and II (p > 0.05). Serum ALT was elevated in patients with HCV infection, but there was no significant correlation between the presence of anti-HCV and elevated ALT level among the examined groups of patients (p > 0.05). The prevalence of HCV infection was not correlated with the duration of renal transplantation and the type of immunosuppressive therapy (p > 0.05). Coinfection with HBV and HCV could occur, as previous infection with HBV was demonstrated. Anti-HBc was found in 51.8%, 66.7%, 37.5% of anti-HCV positive patients in groups I, II, II respectively. Anti-HBs was detected in 24.1% and 15.4% of anti-HCV positive in groups I and II. HBsAg was found only in 4.7% of anti-HCV positive hemodialysis.     

消毒剂破坏乙、丙型病毒性肝炎血清标志物的初步观察

笔者采用氯仿、４０％甲醛溶液、３％双氧水及７５％乙醇与ＨＢｓＡｇ、ＨＢｅＡｇ和抗－ＨＣＶ阳性血清作用５、１５、３０及６０分钟后，用ＥＬＩＳＡ法检测是否转为阴性，以了解消毒剂对上述阳性血清的破坏效果。结果：氯仿对ＨＢｓＡｇ和抗－ＨＣＶ阳性血清破坏效果好；４０％甲醛溶液对ＨＢｓＡｇ、ＨＢｅＡｇ及抗－ＨＣＶ阳性血清均破坏；３％双氧水对ＨＢｅＡｇ有破坏作用，而７５％乙醇对ＨＢｓＡｇ、ＨＢｅＡｇ及抗－ＨＣＶ阳性血清作用上述时间后，检测时仍呈阳性反应。笔者只是初步观察，有关消毒剂的浓度、效果及作用机理有待进一步观察和探讨。