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1.
Jaswinder Singh Sodhi Nayeem Wani Samoon Jeelani Sajad Geelani Fehmida Akhtar Gul Javid Gh Nabi Yattoo Altaf Shah Gh Mohd Gulzar Mushtaq A. Khan Shaheena Parveen Riyaz-u Saif Abid Showkat 《Indian journal of gastroenterology》2013,32(5):291-296
Background
Prevalence of hepatitis B virus (HBV) infection is increased in patients of cancer with increased mortality. Multiple transfusions of blood and blood-related products are a potential source.Aims
This study aims to assess the incidence of hepatitis B surface antigen (HBsAg) seroconversion in cancer patients receiving transfusion of blood or blood-related products and identify possible reasons for infection in these patients.Material and Methods
Patients of cancer receiving blood products, who were HBsAg-, anti-hepatitis B core (HBc)-, and HBV DNA-negative prior to transfusion, were tested for HBsAg by ELISA at 6, 12, and 24 weeks after the last transfusion. Blood donors were screened for HBsAg by ELISA.Results
Twenty of 3,600 (0.56 %) blood donors tested positive for HBsAg and were rejected. Nine of 150 (6 %) cancer patients became HBsAg-positive posttransfusion which included seven patients who presented with acute hepatitis B and other two patients who remained HBsAg-positive without hepatitis. In 6/9 (66.6 %) patients, HBsAg positivity was related to blood transfusion as their corresponding blood donors on retesting the stored samples were positive for anti-HBc antibody and HBV DNA. In other three patients, the cause of their HBsAg positivity could not be ascertained.Conclusion
Occult HBV infection in blood donors is a potential source of posttransfusion HBV infection in recipients. Anti-HBc antibody and HBV DNA should be tested in blood donors especially when blood is given to cancer patients receiving chemotherapy. 相似文献2.
"Anti-HBc alone" in human immunodeficiency virus-positive and immuno-suppressed lymphoma patients 总被引:1,自引:0,他引:1
Yu Xuan Koo Daniel SW Tan Iain BH Tan Richard Quek Miriam Tao Soon Thye Lim 《World journal of gastroenterology : WJG》2009,15(30):3834-3835
Hepatitis B virus (HBV) infection is endemic in various parts of the world. A proportion of patients have resolved prior exposure to HBV, as evidenced by the clearance of circulating hepatitis B surface antigen and the appearance of antibody to hepatitis B core antigen (anti-HBc), which could produce protective antibody to hepatitis B surface antigen (anti-HBs). With time, anti-HBs in some patients may become negative. Such patients are described as having occult HBV infection or "anti-HBc alone". In the context of immunodeficient patients, such as HIV patients or lymphoma patients undergoing immunosuppressive immunotherapy, the lack of protective anti-HBs may increase the risk of hepatitis B reactivation. Serum HBV DNA testing may be necessary in "anti-HBc alone" patients, to detect patients at a high risk of developing HBV infection allowing appropriate prophylactic management. 相似文献
3.
Hepatitis B virus (HBV) infection is endemic in various parts of the world. A proportion of patients have resolved prior exposure to HBV, as evidenced by the clearance of circulating hepatitis B surface antigen and the appearance of antibody to hepatitis B core antigen (anti-HBc), which could produce protective antibody to hepatitis B surface antigen (anti-HBs). With time, anti-HBs in some patients may become negative. Such patients are described as having occult HBV infection or "anti-HBc alone". In the context of immunodeficient patients, such as HIV patients or lymphoma patients undergoing immunosuppressive immunotherapy, the lack of protective anti-HBs may increase the risk of hepatitis B reactivation. Serum HBV DNA testing may be necessary in "anti-HBc alone" patients, to detect patients at a high risk of developing HBV infection allowing appropriate prophylactic management. 相似文献
4.
Visagh Puthumana Udayakumar Sudhindran Surendran Uma Devi Padma 《Indian journal of gastroenterology》2018,37(1):39-43
Background
Utilization of liver grafts from hepatitis B core antibody (anti-HBc) positive donors carries the risk of reactivation of hepatitis B virus (HBV) in recipients because of post-transplant immunosuppressive therapy.Methods
This was a retrospective study of patients who had received liver grafts from anti-HBc positive live donors between 2006 and 2016 at our institute.Results
Out of 22 recipients [all males, mean age 45.4 years (range 18–64 years)], four patients were hepatitis B surface antigen (HBsAg) positive preoperatively and received entecavir post-transplantation. One among these patients who temporarily stopped entecavir had a recurrence of hepatitis B 39 months post-transplantation. Among the 13 non-immune [hepatitis B surface antibody (anti-HBs) <?10 mIU/mL] recipients, eight were prescribed lamivudine (100 mg daily) as monoprophylaxis. Four compliant patients remain negative for HBV so far. Out of the remaining four, two died secondary to sepsis unrelated to hepatitis B; two were non-compliant and developed reactivation of hepatitis B. Lamivudine was missed out in five non-immune patients; three of them developed hepatitis B reactivation while two remain negative. Anti-HBs titer was immune in five patients. Over a period of 4 to 8 years follow up, three remain immune without prophylaxis, while two expired due to causes unrelated to hepatitis B. Following the detection of hepatitis B infection, five patients have been started on tenofovir 300 mg once daily.Conclusions
Anti-HBc positive liver grafts can be safely used for live donor liver transplantation. If the recipients are immune preoperatively, they can be merely followed up without HBV prophylaxis. However, it is extremely important to prophylactically treat the non-immune recipients with an antiviral agent lifelong.5.
Akinobu Takaki Takahito Yagi Tetsuya Yasunaka Hiroshi Sadamori Susumu Shinoura Yuzo Umeda Ryuichi Yoshida Daisuke Sato Daisuke Nobuoka Masashi Utsumi Yuko Yasuda Eiichi Nakayama Yasuhiro Miyake Fusao Ikeda Hidenori Shiraha Kazuhiro Nouso Toshiyoshi Fujiwara Kazuhide Yamamoto 《Journal of gastroenterology》2013,48(12):1373-1383
Background
A combination of hepatitis B immunoglobulin and nucleos(t)ide analogues is the current standard of care for controlling hepatitis B recurrence after orthotopic liver transplantation (OLT). However, frequent immunoglobulin treatment is expensive and inconvenient. This study investigated the efficacy of hepatitis B virus (HBV) vaccination in preventing the recurrence of hepatitis B after living donor OLT.Methods
Twenty-seven patients who had undergone living donor OLT participated in the study; five had acute HBV infected liver failure (ALF-OLT) and 22 had HBV related liver cirrhosis (LC-OLT). Hepatitis B surface antigen (HBsAg)-containing vaccine was administered to them for at least 1 year after transplantation and continued once monthly for up to 36 months post-OLT. Patients who had anti-HBs antibody titers above 100 mIU/mL for a minimum of 6 months without immunoglobulin administration were defined as good responders; the others were defined as poor responders. Interferon-γ enzyme-linked immunospot assays against HBs and HBc antigens were used to assay cellular immune responses.Results
All five of the ALF-OLT patients had good responses after a median of four (range 2.5–5) vaccinations. Nine of the 22 LC-OLT patients had good responses after a median of 19 (range 11.5–30) vaccinations. Among the LC-OLT group, those with livers donated by relatively higher-aged, marital and high-titer anti-HBs antibody donors were good responders. LC-OLT patients classed as good responders showed interferon-γ responses comparable to those of the ALF-OLT patients.Conclusions
The ALF-OLT and LC-OLT patients who received livers from relatively higher-aged, marital, high-titer anti-HBs antibody donors were the best candidates for HBV vaccine administration. Boosting donors before transplantation may facilitate later vaccine response of the recipients. 相似文献6.
Catarina Meng Carolina Belino Luciano Pereira Ana Pinho Susana Sampaio Isabel Tavares Manuela Bustorff António Sarmento Manuel Pestana 《Nefrología : publicación oficial de la Sociedad Espa?ola Nefrologia》2018,38(5):545-550
Background
Hepatitis B virus (HBV) reactivation in kidney transplant recipients (KTR) involves important morbidity and mortality. Despite being more common in patients who are HBsAg-positive, it may occur in patients with clinically resolved infection (HBsAg-negative and anti-HBc-positive), in whom the presence of the protective anti-HB antibody is thought to decrease the risk of reactivation. Data regarding reactivation rates in this population are scarce.Objective
To retrospectively evaluate the risk of HBV reactivation in KTR with previously resolved infection.Material and methods
Retrospective cohort study including patients who underwent a kidney transplant between January 1994 and December 2014 with resolved HBV infection at the time of transplantation (anti-HBc seropositivity without detectable HBsAg, with or without anti-HB-positive antibodies and normal liver enzymes).Results
Out of 966 patients, 95 patients with evidence of resolved HBV infection were analyzed, of which 86 had a titer of anti-HBs >10 mIU/ml. Mean follow-up time was 93 months; 12 patients had lost anti-HBs. Two patients showed evidence of reactivation. Risk factors associated with loss of anti-HBs were elderly age (>60) and occurrence of acute graft rejection (p < 0.05).Conclusion
The risk of HBV reactivation in KTR with previously resolved infection is not negligible at 2%. Elderly age and acute rejection were associated with loss of anti-HBs, and these patients may benefit from closer monitoring of HBV DNA levels. Routine serology and/or HBV viral load monitoring in HBsAg-negative, anti-HBc-positive patients is recommended and should be emphasized in these patients. 相似文献7.
Selim HS Abou-Donia HA Taha HA El Azab GI Bakry AF 《European Journal of Internal Medicine》2011,22(2):187-190
Background
Occult HBV infection is defined by detection of HBV DNA in the serum or liver tissue of patients who test negative for HBsAg. The prevalence of occult HBV is higher in hepatitis C virus (HCV) positive patients than HCV negative patients and may have an impact on their clinical outcome. In this study, we evaluated the role of occult hepatitis B virus infection in chronic hepatitis C patients with ALT flare.Methods
Sixty HBsAg negative patients with chronic hepatitis C virus infection were included. Patients were divided into 2 groups according to their ALT level: 30 patients with normal or slightly high ALT and 30 patients with ALT flare (≥ 5 times normal values). Patients in both groups were examined for the detection of anti-HBs, anti-HBc IgM, and anti-HBc IgG. HBV DNA was detected using semi-nested PCR technique.Results
In patients with normal or slightly high ALT, HBV DNA was detected in 4 (13.3%) patients, while in those with ALT flare, HBV DNA was detected in 19 (63.3%) patients (p < 0.001). No association was found between the presence of HBV DNA and various serology markers of HBV infection.Conclusion
Presence of occult hepatitis B, with its added deleterious effect, must always be considered in chronic hepatitis C patients especially those with flare in liver enzymes; HBsAg should not be used alone for the diagnosis of HBV infection. 相似文献8.
Joy Varghese Mettu Srinivas Reddy Thomas Cherian Srinivasan Vijaya Venkataraman Jayanthi Mohamed Rela 《Indian journal of gastroenterology》2014,33(3):226-230
Background
Hepatitis B virus (HBV) recurrence after a liver transplant (LT) is a global issue. Several strategies have been adopted to prevent this recurrence. Most strategies recommend a combination of hepatitis B immunoglobulin (HBIG) and or nucleos(t)ide analogue.Aim of the Study
The aim of the study is to determine the anti-HBs response to HBIG among Indian patients who had undetectable pre-transplant HBV DNA.Methods
Seven adult HBV-related LT recipients of Indian origin with low pre-transplant HBV titres who had a liver transplant between August 2009 and June 2012 were included in the study. The protocol followed for post-liver transplant HBIG dose was titrated to achieve an anti-HBs titre of at least 100 IU/L. All recipients were on entecavir. Anti-HBs titre, and HBsAg status was checked at regular intervals. A retrospective analysis of the anti-HBs response to a loading and maintenance dose of HBIG was done.Results
Seven adult HBV-related LT recipients on post-transplant prophylaxis with HBIG and nucleoside analogue (entecavir) fulfilled the criteria for the study. The median anti-HBs response to the anhepatic and loading dose of HBIG was high at 555 IU/L. In two, the response was less than 100 IU/L. The median dose of HBIG reduced at end of 1 month to 800 IU, and the median titre was 223 IU/L. For the next 11 months, the median requirement of HBIG was 3,000 and 4,000 IU, and the titre was low at 53.8 and 60.9 IU/L at end of 6 and 12 months, respectively.Conclusions
The anti-HBs response to HBIG was variable, and titres even below 100 IU/L did not result in HBV recurrence when HBIG was given in combination with entecavir. 相似文献9.
Hsu CS Wang CC Wang PC Lin HH Tseng TC Chen CH Su WC Liu CJ Chen CL Lai MY Chen PJ Chen DS Kao JH 《Hepatology International》2010,4(3):585-593
Background
Although chronic liver disease is associated with gastroesophageal reflux disease (GERD), the impact of chronic hepatitis B virus (HBV) infection on this association remains unclear. We thus aimed to evaluate the relationship between chronic HBV infection and GERD.Methods
In this prospective population-based study, 1,001 adult subjects who underwent an upper gastrointestinal endoscopic examination in a health check-up and completed a gastroesophageal reflux questionnaire were consecutively enrolled. Endoscopic findings were classified according to the Los Angeles classification. Hepatitis B surface antigen was used as a marker of HBV infection. Univariate and multivariate approaches were used to evaluate the effects of chronic HBV infection on GERD.Results
Chronic HBV infection was associated with heartburn sensation [odds ratio (OR) 1.27, 95% confidence interval 1.01–1.61, P = 0.037], and erosive esophagitis (adjusted OR 1.75, 1.03–2.97, P = 0.037). Although male gender is a risk factor of erosive esophagitis, further analyses stratified by gender and aspartate aminotransferase to platelet ratio index (APRI) showed that chronic HBV infection was associated with erosive esophagitis in female subjects (adjusted OR 2.70, 1.14–6.39, P = 0.024) and those with APRI of more than 0.3 (adjusted OR 3.94, 1.73–8.96, P = 0.001). Moreover, higher serum aspartate aminotransferase (AST) and triglyceride (TG) levels were risk factors of erosive esophagitis in patients with chronic HBV infection.Conclusions
Our findings indicate a close association between chronic HBV infection and GERD, especially in female subjects and those with higher APRI levels. Moreover, HBV carriers with higher AST or TG levels have higher incidence of erosive esophagitis. The interactions between chronic HBV infection and GERD need further studies. 相似文献10.
Tamori A Koike T Goto H Wakitani S Tada M Morikawa H Enomoto M Inaba M Nakatani T Hino M Kawada N 《Journal of gastroenterology》2011,46(4):556-564
Background
Screening and prophylactic treatment for hepatitis B virus (HBV) reactivation is recommended for patients who receive immunosuppressive or cytotoxic therapy. The aim of this study was to clarify the prevalence of HBV reactivation in rheumatoid arthritis (RA) patients who had received more than 1?year of immunosuppressive therapy. This study also evaluated guidelines for determining HBV reactivation in patients with RA.Methods
This was a prospective non-randomized, non-controlled study. We enrolled 50 patients with RA who had antibodies against hepatitis B core antigen (anti-HBc) and who had started treatment with disease-modifying anti-rheumatic drugs, including those who had additionally received anti-tumor necrosis factor-?? (anti-TNF-??). HBV DNA levels were measured every 2?C3?months by a real-time, polymerase chain reaction-based method. Entecavir was administered to patients with HBV DNA levels >2.1 log/ml.Results
The mean observation period was 23?months (range 12?C32?months). HBV reactivation occurred in 2 of 5 patients with HBV surface antigen (HBsAg) and in 1 of 45 patients without HBsAg. In patients who received anti-TNF-?? therapy, antibodies against HBsAg decreased significantly. Entecavir therapy inhibited HBV amplification and prevented HBV-associated flares of hepatitis.Conclusions
The incidence of HBV reactivation was low in RA patients in whom HBV infection had been resolved. Screening for HBV reactivation and prophylactic therapy with entecavir were effective means of preventing HBV-associated hepatic failure in patients with HBsAg, as well as in those with only anti-HBc who received immunosuppressive therapy for RA. 相似文献11.
M. Fasano A. Saracino G. Carosi F. Mazzotta N. Marino E. Sagnelli G. B. Gaeta G. Angarano G. Verucchi P. Bellissima C. Angeletti T. Santantonio 《Infection》2013,41(1):53-59
Background
The continuing migration of individuals from geographic areas with high/medium endemicity has determined the arrival of new chronic hepatitis B virus (HBV) carriers in Italy. The magnitude of this phenomenon and clinical/virological features of HBsAg-positive migrants remain not very well defined.Aims
To evaluate the proportion of HBsAg-positive immigrants enrolled in this multicenter Società Italiana di Malattie Infettive e Tropicali (SIMIT) cross-sectional study and to compare the characteristics of chronic hepatitis B infection in migrants to those of Italian carriers.Methods
From February 1 to July 31 2008, anonymous data were obtained from all HBsAg-positive patients aged ≥18 years observed at 74 Italian centers of infectious diseases.Results
Of the 3,760 HBsAg-positive subjects enrolled, 932 (24.8 %) were immigrants, with a prevalent distribution in central to northern Italy. The areas of origin were: Far East (37.1 %), Eastern Europe (35.4 %), Sub-Saharan Africa (17.5 %), North Africa (5.5 %), and 4.5 % from various other sites. Compared to Italian carriers, migrants were significantly younger (median age 34 vs. 52 years), predominantly female (57.5 vs. 31 %), and most often at first observation (incident cases 34.2 vs. 13.3 %). HBeAg-positives were more frequent among migrants (27.5 vs. 14 %). Genotype D, found in 87.8 % of Italian carriers, was present in only 40 % of migrants, who were more frequently inactive HBV carriers, with a lower prevalence of chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). Only 27.1 % of migrants received antiviral treatment compared to 50.3 % of Italians.Conclusions
Twenty-five percent of all HBV carriers examined at Italian centers was composed of immigrants with demographic, serological, and virological characteristics that differed from those of natives and appeared to have an inferior access to treatment. 相似文献12.
Background/Aims
To investigate serological patterns of hepatitis B based on electrochemiluminescent immunoassays and the distribution characteristics of these patterns in hospitalized children and adolescents in Zhejiang, China between 2006 and 2010.Methods
Five serological markers, including hepatitis B surface antigen (HBsAg), hepatitis B e antigen (HBeAg), antibody to hepatitis B surface antigen (anti-HBs), antibody to hepatitis B e antigen (anti-HBe), and antibody to hepatitis B c antigen (anti-HBc), were chosen as a routine panel to monitor hepatitis B virus (HBV) infection and vaccination efficacy. A total of 33,187 children (21,187 boys and 12,000 girls) were selected using the following exclusion criteria: a previous diagnosis of hepatitis, age >16 years or an address outside of Zhejiang.Results
The average HBV vaccination coverage rates among 20,766 boys and 11,782 girls were 98.62% and 98.68%, respectively. Seventeen serological patterns of hepatitis B were found, and the dominant pattern was ''anti-HBs (+) alone'' (62.03%) followed by ''negative pattern'' (23.46%). The rates of the other 15 patterns ranged from 8.14% to 0.003%. Of 236 HBsAg-positive patients, the overall rate of seropositivity was 0.71%. The anti-HBs levels were grouped into 3 ranges (10-100 mIU/mL, 100-1,000 mIU/mL, and >1,000 mIU/mL) for all anti-HBs-positive children (36.08%, 43.43%, and 20.49%, respectively).Conclusions
A low HBsAg carrier rate and a relatively high anti-HBs positive rate are present in hospitalized children and adolescents in Zhejiang. The distribution of serological patterns is associated with age but is mostly independent of gender. 相似文献13.
Nunes J Marinho RT Fonseca JE Pereira da Silva JA Velosa J 《Acta reumatologica portuguesa》2011,36(2):110-118
Reactivation of infection with hepatitis B virus (HBV) is a potentially serious complication of immunosuppression, which can be identified and efficiently prevented. There have been an increasing number of cases of HBV reactivation in patients receiving immunosuppression in the context of rheumatic diseases such as rheumatoid arthritis or systemic lupus erythematosus. The recommendations in this area should be individualized taking into account two aspects: immunosuppressive regimens used (high or low risk of reactivation) and the different stages of HBV infection: chronic hepatitis B, inactive HBV carrier, occult hepatitis B infection defined by HB surface antigen (HBsAg) negative and antibody anti-HB core (anti-HBc) positive. In patients with rheumatic diseases that will start high-risk immunosuppressive drugs, we propose a universal screening with serological tests for hepatitis B (HBsAg, anti-HBs and anti-HBc). Patients with chronic hepatitis B (HBsAg positive, HBV DNA ≥ 2000 IU/ml, elevated ALT) should initiate antiviral therapy. Inactive HBV carriers (HBsAg positive, HBV DNA <2000 IU / ml, normal aminotransferases) exposed to high risk immunosuppressive therapy should undergo prophylaxis of HBV reactivation. Prophylaxis should be started 2 to 4 weeks before the beginning of immunosuppressive therapy and maintained for at least 6 to 12 months after its suspension. It is recommended to use entecavir or tenofovir as first line antiviral agents. In inactive HBsAg carriers under low-risk immunosuppressive therapy and patients with HBsAg negative/anti-HBc positive (HBV infection in the past), the strategy should be monitoring of viral reactivation with aminotransferases and HBV DNA determination in every 6 months. 相似文献
14.
Li-Fu Kuo Chuan-Mo Lee Chao-Hung Hung Jing-Houng Wang Tsung-Hui Hu Sheng-Nan Lu Chi-Sin Changchien Chien-Hung Chen 《Digestive diseases and sciences》2014,59(10):2580-2587
Background
A recent study showed that chronic hepatitis B virus (HBV) carriers with nucleos(t)ide analogue (NA)-induced hepatitis B antigen (HBeAg) seroconversion occurring before the age of 30 years have a higher risk of HBV reactivation.Aim
To compare the risk of HBV reactivation and HBeAg seroreversion between patients with spontaneous and NA-induced HBeAg seroconversion.Methods
A total of 135 and 251 non-cirrhotic patients with NA-induced and spontaneous HBeAg seroconversion, respectively, were analyzed.Results
NA-induced HBeAg seroconverters faced higher risks of HBV reactivation and HBeAg seroreversion than spontaneous HBeAg seroconverters (P < 0.001). In spontaneous HBeAg seroconverters, age at HBeAg seroconversion, sex, HBV DNA levels before HBeAg seroconversion, HBV genotype C, and pre-S deletions were independent predictors of HBV reactivation. In NA-induced HBeAg seroconverters, only age at baseline was an independent predictor of HBV reactivation. To determine whether the difference in the incidence of HBV reactivation or HBeAg seroreversion between two groups was age-specific, we analyzed these patients according to their age at HBeAg seroconversion (20–29, 30–39, and ≥40 years). Our data showed that NA-induced HBeAg seroconversion was an independent predictor of HBV reactivation and HBeAg seroreversion than spontaneous HBeAg seroconversion in patients older than 40 years at HBeAg seroconversion, but not in patients between 20–29 and 30–39 years of age.Conclusions
NA-induced HBeAg seroconverters are associated with higher risks of HBV reactivation and HBeAg seroreversion compared to spontaneous HBeAg seroconverters, especially in patients who are older than 40 years at HBeAg seroconversion. 相似文献15.
S. Taffon D. Genovese M. Blasi P. Pierotti A. Degli Esposti S. Catone P. Chionne B. Pulimanti A. Candido S. Dettori M. E. Tosti C. Argentini F. Mazzotta M. Rapicetta 《Infection》2014,42(4):675-687
Purpose
Human immunodeficiency virus (HIV-1)-infected patients frequently harbour hepatitis B and C viruses (HBV and HCV, respectively). Possible modifications of the natural history of hepatitis B may occur. The aim of this study was to characterise HBV diversity and evolutionary and mutational viral genome profiles in HIV-1/HBV coinfections.Methods
HIV-1 and HBV markers determinations (Roche, FRG; Abbott, USA) and HBV genome-length retrospective analysis were performed in follow-up isolates from patients who were either stably HBsAg-negative with a low level of HBV DNA (occult hepatitis B infection, OBI) or HBsAg-positive with a high level of HBV DNA. Phylogenetic analysis (maximum likelihood method, MEGA5), statistical analysis and evolutionary rates calculation (d S/d N) were applied.Results
Positive selection pressures in the PreS/S region and a significantly higher number of mutations in this region including the major hydrophilic region (MHR) and the “a” determinant were shown in HBsAg-negative (possibly OBI) compared to stably HBsAg-positive HIV-1/HBV subgenotypes D3/A2 coinfected patients. Mutants previously described in HIV-1/HBV coinfected patients were found. Known mutants Y100C, P127T and P120A associated to Y134H and S143T and new S mutants, which may potentially affect HBsAg expression and secretion and anti-HBs binding, were detected in baseline sera persisting up to the end of 9 years follow-up. Known mutations of BCP, Pre-C, C and X regions were also characterised. Natural mutants strictly known as being involved in diagnostic failure were not detected; however, numerous corresponding sites showed amino acid variations.Conclusions
Evolutionary and genotypic differences observed, particularly in the PreS/S region, between HBsAg-negative (OBI) and HBsAg-positive HIV-1/HBV coinfected patients, may contribute, in association with mutations of other genomic regions, to the HBsAg-negative phenotype. 相似文献16.
Pai-Jong Stacy Tsai Ann Chang Seiji Yamada Naoky Tsai Marguerite Lisa Bartholomew 《Digestive diseases and sciences》2014,59(11):2797-2803
Background
Antiviral therapy in addition to immunoprophylaxis at birth has been shown to further reduce perinatal transmission of hepatitis B virus (HBV) in highly viremic women.Aims
The aim of this study was to describe the use of tenofovir disoproxil fumarate (TDF) prophylaxis to reduce maternal HBV DNA levels and potentially vertical transmission in highly viremic women.Methods
After receiving IRB approval, we performed a retrospective chart review of mothers positive for hepatitis B surface antigen (HBsAg) who delivered between 2009 and 2012. We identified women with HBV DNA levels ≥6 log copies/mL who were treated with TDF in pregnancy.Results
There were 22 women identified. The majority were of Micronesian ethnicity. All were negative for hepatitis C antibody and HIV infection. The median gestational age of TDF initiation was 31 weeks with a median duration of treatment of 45 days. There was a reduction in median HBV DNA levels from baseline 9.0 ± 2.0 to 5.4 ± 1.1 log copies/mL after treatment. There were five (22.7 %) preterm deliveries and five (22.7 %) cesarean deliveries. All infants received immunoprophylaxis at birth. Postnatal HBsAg testing at 9–12 months was available for 13 infants, 12 of which were negative. There was one case of perinatal transmission.Conclusions
This is the second published case series to date on the use of TDF prophylaxis in HBV mono-infected, highly viremic mothers. This series suggests the use of TDF in pregnancy reduces maternal HBV DNA levels and is well tolerated. 相似文献17.
Yusheng Jie Xiangyong Li Guoli Lin Yuankai Wu Xinhua Li Zhiliang Gao Yutian Chong 《Hepatology International》2014,8(4):501-507
Purpose
To analyze the spectrum of diseases in patients with chronic hepatitis B virus (HBV) infection and their association with patient clinicopathologic characteristics and the effect of antiviral therapy on the spectrum of diseases in the study cohort.Methods
We retrospectively reviewed the clinicopathologic and virologic records of patients with chronic HBV infection hospitalized at our institution during 2011. Demographic data, hepatitis B e antigen (HBeAg) status and HBV DNA (log10 IU/ml) were obtained.Results
A total of 1,619 patients were included; 272 (17.2 %) patients received antiviral therapy for a mean duration of 24.5 ± 18.3 months, and 71.0 % (198/279) patients were compliant with their antiviral therapy. HBeAg-positive patients had a markedly higher rate of moderate and severe CHB than HBeAg-negative patients (p < 0.001) but a significantly lower rate of liver cirrhosis (p < 0.001). The rate of severe and fulminant CHB was significantly lower in patients receiving antiviral therapy than in those not receiving antiviral therapy.Conclusions
Patients receiving antiviral therapy exhibit a different spectrum of diseases from patients not receiving such therapy. 相似文献18.
Background
Hepatitis B virus (HBV) infection is still reported from adult hemodialysis units.Objectives
To determine the prevalence of anti-HBs antibody in hemodialysis patients and the correlation between levels of anti-HBs antibody with other factors.Patients and Methods
HBsAg, anti-HBs and anti-HBc antibodies level in 119 hemodialysis patients were evaluated by enzyme-linked immunosorbent assay.Results
Seroconversion (anti-HBs antibody >10 IU/L) was found in 22 patients. Minimum protective antibody level was found in patients aged ≥60 years. Statistically significant correlation was not found between anti-HBs antibody and gender. Ten (8.4%) patients had abnormal ALT and/or AST. Prevalence of HBsAg, anti-HBc antibody, HBeAg and anti-HBe antibody were found in 8 (6.72%), 24 (25.16%), 2 (1.68%) and 3 (2.52%) patients, respectively.Conclusions
Periodic assessment of anti-HBs antibody level is strongly recommended in patients undergoing hemodialysis. 相似文献19.
Shaoli You Yihui Rong Bing Zhu Aimin Zhang Hong Zang Hongling Liu Dongze Li Zhihong Wan Shaojie Xin 《Hepatology International》2013,7(2):714-720
Purpose
To investigate the etiological characteristics of patients with liver failure in the past 10 years.Methods
Clinical and investigational data in hospitalized patients with liver failure admitted from 2002 to 2011 were retrospectively analyzed. Standard definitions and criteria were used to assess disease etiology.Results
Of these 3,916 patients, 3,429 (87.6 %) had acute-on-chronic liver failure (ACLF), 114 (2.9 %) acute liver failure (ALF), and 373 (9.5 %) subacute liver failure. Viral infection was the most common cause of liver failure in the 3,295 patients (84.1 %). Hepatitis of unknown etiology was deemed responsible for 371 cases of liver failure (9.5 %). Drug-induced liver injury, alcoholic hepatitis, and autoimmune hepatitis led to 120 cases (3.1 %), 109 cases (2.8 %), and 19 cases (0.5 %), respectively. The most common cause of ACLF was HBV infection (87.3 %), while the main causes of acute and subacute liver failure were hepatitis of unknown etiology (39.4 %), viral infection (36.6 %), and drug-induced liver injury (19.3 %). Our data showed that the incidence of liver failure caused by HBV gradually decreased from 86.5 % in 2002 to 69.2 % in 2011. However, the incidence of hepatitis of unknown etiology, drug-induced liver injury, and alcoholic hepatitis was increased.Conclusions
HBV infection is the main cause of liver failure in China. However, the incidence of HBV-related liver failure has gradually decreased in the past 10 years. Hepatitis of unknown etiology has replaced HBV infection as the most common apparent cause of acute liver failure. 相似文献20.
Masataka Tsuge Eisuke Murakami Michio Imamura Hiromi Abe Daiki Miki Nobuhiko Hiraga Shoichi Takahashi Hidenori Ochi C. Nelson Hayes Hiroyuki Ginba Kazuhiro Matsuyama Hiroiku Kawakami Kazuaki Chayama 《Journal of gastroenterology》2013,48(10):1188-1204