乙型肝炎病毒感染过程中的免疫应答

肝炎病毒感染,特别是乙型肝炎病毒( hepatitis B virus, HBV)和丙型肝炎病毒( hepatitis C virus,HCV)感染给人类健康带来了严重的威胁。目前全球约有3.5亿的HBV感染者和约1.8亿的HCV感染者,约57%的肝硬化患者和78%的原发性肝癌患者和HBV或HCV慢性感染有关[1]。我国作为HBV感染的高发国家,研究HBV的每个致病环节至关重要,本文主要针对成人HBV感染过程中的免疫应答的现有研究进行综述,并探讨HBV和宿主免疫应答之间的动态关系。     

慢性乙型病毒性肝炎药物治疗研究进展

慢性乙型肝炎(chronic hepatitis B,CHB)是一种很难治愈的传染性疾病,危害极大,已成为重大的全球性公共卫生问题.当今,全世界约有3.5亿人慢性感染乙型肝炎病毒(hepatitis B virus,HBV).HBV感染将导致肝衰竭、肝硬化甚至原发性肝细胞癌(hepatic cell carcinoma,HCC).乙肝病毒为原发性肝癌首要因素[1].每年,约有100万人死于HBV感染所致的相关疾病.我国是HBV的高流行区,总的感染人数约1.3亿,其中60％～80％的患者将发展为肝硬化,甚至HCC[2],这严重威胁了人类健康,现就治疗乙型肝炎的相关药物作一综述.     

十堰地区医院门诊人群HBsAg携带率抽样调查

<正>乙型肝炎病毒(Hepatitis B virus,HBV)感染可导致慢性肝脏损伤,是肝硬化和肝细胞肝癌最重要的病因~([1-2])。慢性乙型肝炎(chronic hepatitis B,CHB)是严重危害人类健康的一种常见病,全球60亿人口中,约1/2的人生活在HBV高流行区,约20亿人被证明有HBV感染,3~4亿人为HBV慢性感染,其中25%~40%最终将死于肝硬化和肝癌~([2-3])。根据世界卫生组织估计,全球约有2.4亿人慢性感染HBV(http://www.who.int/hiv/pub/hepatitis/hepatitis-b-guidelines/en/)。我国是病毒性肝炎的高发     

辅助性T淋巴细胞分泌的细胞因子检测及意义

前言:乙型肝炎病毒(hepatitis B virus, HBV)感染是世界性的健康问题,全球慢性HBV感染者约有3.5亿,每年大约有100 万人死于HBV引起的疾病,其中大部分在亚洲地区,目前病毒性肝炎在我国流行较为广泛.     

中医药对慢性乙型肝炎免疫调控的研究进展

正乙型肝炎病毒(hepatitis B virus,HBV)感染,不同地区的流行程度有差异。在我国,现有慢性HBV感染者约9300万人,其中慢性乙型肝炎(Chronic hepatitis B,CHB)患者约2000万人[1],并且我国由HBV感染引起的肝硬化和原发性肝癌比例分别为60%和80%。CHB主要的治疗方法有抗病毒、抗肝纤维化等。尽管目前有强效高耐药的抗病毒药物,但仍不能实现CHB的完全治愈。感染HBV后,机体的免疫应答反应不仅控制病毒复制和清除病毒,还参与     

乙型肝炎抗病毒治疗药物研究进展

乙型病毒性肝炎(viral hepatitis type B)简称乙型肝炎,是由乙型肝炎病毒(hepatitis B virus,HBV)引起,通过血液传播的疾病,是肝硬化和肝细胞癌的最常见致病因素,给人类生命和健康带来严重威胁[1].全世界大约有3.5亿人为HBV慢性感染者,每年死亡人数约为20万,位于死亡原因的第九位,远列艾滋病之前[2,3].     

慢性乙型肝炎基层诊疗指南(实践版·2020)

一、概述(一)定义慢性乙型肝炎病毒(hepatitis B virus,HBV)感染:指乙型肝炎表面抗原(HBsAg)和/或HBV脱氧核糖核酸(HBV DNA)阳性6个月以上。慢性乙型肝炎(chronic hepatitis B,CHB):指由HBV持续感染6个月以上引起的慢性肝脏炎症性疾病。     

嵌合小鼠模型在人乙肝病毒研究中的应用概况

乙型病毒性肝炎是由乙型肝炎病毒(hepatitis B virus,HBV)引起的一种世界性疾病。据统计,全世界无症状乙肝病毒携带者(HBsAg阳性携带者)超过2.8亿,我国约占1.3亿。HBV属于嗜肝DNA病毒科,含有约3200 bp的部分双链DNA基因组,其复制经过转录和逆转录两个过程,HBV感染具有高度的宿主     

输血相关乙型肝炎病毒感染预防

乙型肝炎病毒(hepatitis B virus,HBV)属嗜肝DNA病毒科(hepadnaviridae),为乙型肝炎的病原体.据世界卫生组织估计,全球HBV感染及携带者达3.5亿人之多,其中约有1.3亿人在我国,约占我国人口的10%.HBV可通过输血传播,是一种对输血安全构成严重威胁的主要病毒之一.     

乙型肝炎病毒标志物实验室检测的研究进展

<正>迄今为止,全世界大约有3.5~4.0亿慢性乙型肝炎病毒(hepatitis B virus,HBV)感染者,血清学证据表明:约占全球人口总数1/3的人既往或正在感染HBV。每年有超过100万的患者死于HBV感染相关的肝衰竭、肝硬化和肝癌[1]。我国是HBV感染的主要流行区,现有慢性HBV携带者约1.2     

HBsAg消失后的转归和免疫干预接种效果

目的观察HBsAg消失后的转归及对乙肝疫苗和乙肝疫苗加免疫激动剂干预免疫的效果。方法连续收集感染HBV后HBsAg消失，以后未出现抗-HBs者97名，年龄18～68（41．9）a，分三组。1组57（22名来自组2对乙肝疫苗无反应者）名，予CHO乙肝疫苗30gg，三角肌内注射，1次／wk，共4针；于同侧近腋皮下注射胸腺因子α1（Tα1）1．6mg，2次／wk，共4wk。2组35名，只接种乙肝疫苗，剂量、方法同1组。3组27名，仅作定期复查。结果末针后1mo五项均阴性、抗-HBe＋和抗-HBc＋、抗-HBc＋者中抗-HBs阳转者组1为12／16（75．0％）、14／19（73．1％）、14／22（63．0％）名，组2仅五项全阴性者中1名（1／10，10．0％），组3无1名，差异显著（P〈0．01）。来自组2的22名抗-HBs阳转率（59．1％）亦高于组2和3（P〈0．01）。随访4．7（2-6）a组1和3抗-HBc消失各1名，平均年消失率为0.3％。平均抗-HBs年阳转率为1．4％。组2、3各有1名出现HBsAg复阳（2．4％）。结论HBsAg消失后年抗-HBs自发性阳转率和抗-HBc消失率很低，甚至有逆转为HBsAg的可能；较大剂量乙肝疫苗加Tα1干预免疫是一有效的方法，对HBV血清学标志物全阴者效果尤佳。     

乙型肝炎血清流行病学研究——湖北省钟祥县官庄湖农场的调查

对钟祥县官庄湖农场972名居民用RPHA法检查HBsAg,PHA法检查抗HBs,ELISA法检查抗HBc,ELISA抗体夹心法检查HBeAg和ELISA竞争法检查抗HBe.结果:HBsAg、抗HBs、抗HBc阳性率分別为12.8%、13.4%、40.5%,HBsAg携带者中有63.6%HBeAg阳性,26.4%抗HBe阳性和81.4%抗HBc阳性。HBV总感染率51.3%。     

Prevaccination screening of medical and dental students. Should low levels of antibody to hepatitis B surface antigen preclude vaccination?

The prevalence of hepatitis B virus (HBV) markers in 484 medical and 329 dental students was studied. Three students (0.9%) were hepatitis B surface antigen (HBsAg) reactive, and 46 students (5.7%) were reactive for antibody to HBsAg (anti-HBs). There was no difference in anti-HBs frequency between medical and dental students, and the prevalence of this marker was not associated with year in school. Of the 46 reactors, eight (17%) were nonreproducible and 38 (83%) were reproducibly reactive when the same samples were reanalyzed. Of note, all nonreproducible reactors exhibited anti-HBs sample-negative control (S/N) ratios of less than 10, and none were positive for antibody to hepatitis B core antigen (anti-HBc). Nineteen (50%) of the reproducible reactors had anti-HBs S/N ratios equal to or greater than 10, and only 15 (39%) were anti-HBc positive. In view of these observations, we do not recommend HBV screening in a vaccine program for health students. Due to the frequency with which low-level anti-HBs reactors without anti-HBc are found to be nonreproducibly positive, we are concerned by the potential overinterpretation of such results before the formulation of decisions about the need for vaccination.     

Urban-rural comparison of HBV and HCV infection prevalence in eastern China

The present study was initiated to make and urban-rural comparison of the prevalence of cases positive to hepatitis B and C virus(HBV and HCV,respectively)infection markers in densely populated eastern half of China.For this purpose.10 survey sites were selected,i.e.,six sites in urban areas(the city group;Beijing,shangahi and four provincial capitals)and four sites in rural areas(the village group;one village each in Jilin and Shandong provinces,and two villages in Shaanxi Province),About 50 adult women per site volunteered to participate,from whom 494 valid bllod samples were collected.Positivities to HBsAg(HBsAg^ ),anti-HBs(anti-HBs^ )and antiHBc(anti-HBc^ )were examined by RIA methods.and that to anti-HCV(anti-HCV^ )by either EIA or RIA.Those positive to any one of the three HBV infection markers were taken as HBV infection-positive(HBV^ ).The prevalence of HBsAg^ ,HBV^ and anti-HBc^ was 8%,70%and 2.7% in the city group,and 8%,65% and 2.0%in the village group,and no significant difference was found between the two groups.The overall prevalence was 8% for HBsAg^ ,68% for HBV^ ,and 2.4% for anti-HVC^ ,The results were discussed in reference to some 20 papers each on HBV^ and anti-HCV^ prevalence in China published since(1991),The reviewing of these papers of anti-HCV was low(well below 5%),and that no substantial difference was found between the rural and urban populations.     

Comparative assay of Hepatitis B and C virus infection markers by different assay kits

In order to compare sensitivity of EIA and RIA assay kits for hepatitis B and C virus(HBV and HCV,respectively)infection markers,100 serum samples in total wre collected form 50 adult women each in urban and rual areas in northeast China.The number of positive cases to the three infection markers on HBV(i.e..,HBsAg^ ,anti-HBs^ ,and anti-HBc^ )and the one on HVC (anti-HCV)were examined in two laboratories,i.e.,in Laboratory A with EIA kits produced in China and in Laboratory B with RIA kits.HCV infection positivity(anti-HCV^ )was examined by EIA kits in both laboratories,but from diffeent sources in and outside of China,respectively.The assay in Laboratory A gave 2 HBsAg^ cases out of the 100 cases examined,whereas there were 9 positive cases in Labortory B,In contrast,19 cases were positive to anti-HCV when examined in Laborator A,and there were 3 cases in Laboratory B.Thus,the kits used in Laboratory A gave fewer HBsAg^ and more anti-HCV^ cases than the kits used in Laboratory B.The prevlence of antiHBs^ or anti-HBc^ and cases did not differ when assayed in the two laboratories with EIA and RIA kts,respectively,The agreement of positive and negative findings between the two set of testing were 93%,93%,93%,86%and 82% for HBsAg,anti-HBs,anti-HBc,BHV(i.e.,either positive to anyone of the three markers or negative to all three markers),and anti-HCV,respectively.The implication of the observation on epidemiology on HBV and HCV infection prevalence was discussed.     

湛江地区2487名体检者中乙肝病毒血清学标志物的检测结果

目的:了解湛江地区人群中乙肝病毒(HBV)感染情况。方法:对2 4 87名体检者应用酶联免疫吸附法(ELISA)法测定HBsAg、抗HBs、HBeAg、抗HBe、抗HBc。结果:HBsAg的阳性率为1 8.74 %。乙型肝炎病毒血清学标志物(HBVM)阳性情况主要为两种模式:即HBsAg、抗 HBe、抗HBc阳性;HBsAg、HBeAg阳性。结论:湛江地区体检者中HBsAg的阳性率较高,其中以2 0岁～4 0岁者HBsAg的阳性率最高,其人群分布与计划免疫、文化程度、卫生习惯、生活环境、性别和性格等因素有关。     

Prevalence of occult hepatitis B amongst Indian human immunodeficiency virus type 1 infected individuals—a pilot study

Background

The diagnosis of hepatitis B is routinely based on the detection of hepatitis B surface antigen (HBsAg) only. However, occult hepatitis B virus (HBV) infection (OBI), which is defined as infection with positive hepatitis B core antibody (anti-HBc) antibodies, positive DNA (deoxyribonucleic acid) PCR (polymerase chain reaction), and undetectable HBsAg, as well as anti-HBs antibodies in serum or plasma of HBV infected individuals, will remain undetected using this screening diagnostic approach of detecting HBsAg. The current study aims in studying the prevalence of the OBI amongst human immunodeficiency virus type 1 (HIV-1) infected individuals who have not been exposed to anti-retroviral therapy.

Method

Estimation of HBsAg, anti-HBs, and anti-HBc total antibody status amongst 100 HIV-1 infected study participants was carried out using enzyme-linked immunosorbent assay (ELISA) kits. Detection of HBV-DNA was carried out by in-house qualitative PCR. CD4 + T lymphocyte counts were analysed using Becton Dickinson's (BD) FACSCount™ system.

Results

The median age of the HIV-1 infected study population was 35 years (range: 22–67), with the gender distribution being 53 males and 47 females. The mean CD4 T lymphocyte count of the study participants was 210/mm³. Overall, serological evidence of HBV infection was observed in 28% of the HIV-1 infected study participants. There was 5% seropositivity for HBsAg, of which 2% were additionally positive for HBV-DNA-PCR. “Anti-HBc alone” status was seen in 18% of study participants, this being statistically higher in those with CD4 T lymphocyte counts < 200/mm³. While there was a single specimen with co-positivity for anti-HBc total antibodies and HBV-DNA, 5% of the in the study population exhibited anti-HBs antibodies positivity, with one sample exhibiting dual positivity for HBsAg and anti-HBs antibodies.

Conclusion

Occult HBV infections may contribute to chronic liver damage, and associ-ated reactivation amongst immunocompromised individuals, HIV-1 in-fected being a subset of them. “Anti-HBc” testing followed by HBV-DNA detection by PCR can be utilised for such populations to detect OBIs. Early detection of hepatitis B viraemia will be important for deciding the antiviral therapeutic protocol so as to avoid evolution of antiviral resistance in the circulating HBV strains in HIV-1 infected individuals harbouring OBIs.     

HBsAg、抗-HBe和抗-HBc阳性孕妇胎盘及其子代HBV感染状况的研究

目的探讨HBsAg、抗-HBe和抗-HBc阳性孕妇胎盘及其子代HBV感染状况。方法选取220例HBsAg、抗-HBe和抗HBc阳性孕妇作为研究对象,研究组100例,在孕28、32、36周肌注HBIG200U;对照组120例,未予用药。采用荧光定量PCR及ELISA法,分别检测2组孕妇和新生儿出生后主被动免疫预防前以及1岁时的静脉血HBV DNA水平及乙肝标志物（HBsAg、抗-HBs、HBeAg、抗-HBe和抗-HBc）。采用免疫组化SP法检测研究组和对照组各40例胎盘组织各层细胞HBsAg及HBcAg的表达。结果（1）研究组与对照组40例孕妇胎盘各层细胞HBV感染率比较差异均无显著性（P均〉0.05）。（2）研究组宫内感染率1%,对照组3.33%,2组比较差异无显著性（P〉0.05）;（3）研究组婴儿HBV慢性感染率为0,对照组0.83%,2组比较差异无显著性（P〉0.05）。结论（1）HBsAg、抗-HBe和抗HBc阳性孕妇胎盘有一定感染率,但子代宫内感染率以及出生后HBIG联合乙肝疫苗免疫后慢性感染率极低。（2）HBsAg、抗-HBe和抗HBc阳性孕妇产前注射HBIG并未明显降低子代HBV感染率。提示对HBsAg、抗-HBe和抗HBc阳性孕妇可以考虑不进行宫内阻断。     

对血站合格献血员复检HBV HCV阳性率分析

目的：了解我区献血员的管理及筛查情况。方法：随机采集了我区4个盟市血站503份合格献血员血样,并进行了相关调查,采用ELISA法复检。结果：HBsAg阳性率为1.99%（10/503）;抗-HBc阳性率15.90%(80/503);抗-HBs阳性率21.87%(110/503);抗-HCV阳性率2.19%(11/503),其中HBV、HCV双重感染的8例,HBsAg、抗-HBc双阳性3例。对抗-HBc、抗-HBs双阳性以及单纯阳性者经PCR法检测HBVDNA均为阴性。结论：说明我区血站管理及对献血员筛查工作还存在着一定的漏洞,献血员筛查抗-HBc对预防输血后乙肝无多大价值,应把重点放在选用灵敏度高的试剂进行筛查。     

浙江省农村自然人群隐匿性乙型肝炎病毒感染（OBI）情况及进化特征分析

 【摘要】目的 了解浙江省德清县农村一般人群隐匿性及实际乙型肝炎病毒(hepatitis B virus,HBV)感染情况及病毒株S基因的分子特征。方法 采用多级抽样方法进行横断面调查,在取得调查对象知情同意的基础上采集调查表信息并采血。采用Epidata 3.2软件录入调查表信息,双录入并核对;采用SPSS 18.0软件进行数据分析;对所有样品进行乙型肝炎表面抗原（hepatitis B surface antigen,HBsAg) ELISA检测及病毒载量real time PCR测定,并对HBsAg检测阳性或病毒载量测定阳性的标本进行后续HBV S基因PCR扩增和测序;采用MEGA 5.0软件对测得序列进行进化分析。结果 共调查对象1 720例,调查人群中HBsAg阳性者共162例,隐匿性乙型肝炎病毒感染(occult hepatitis B virus infection,OBI)者共4例,实际HBV感染率为9.65% (166/1 720),OBI感染率为2.57‰ (4/1 558)。显性和隐匿性病毒株病毒载量中位数及四分位数范围分别为866 (425,12 500)IU/mL和314 (216,677.5)IU/mL,前者显著高于后者。HBsAg阳性血清样本扩增得到71株显性病毒株S基因序列,HBsAg阴性血清样本扩增得到4株OBI病毒株S基因序列。OBI病毒株均为C基因型,adrq+血清型。显性HBV病毒株54株为B基因型,其中有2例标本为adw3血清型,其余52例均为adw2血清型;余17株为C基因型,adrq+血清型。OBI病毒株中C基因型的比例显著高于显性HBV病毒株中C基因型的比例。B基因型显性病毒株发生I104F、L109V、I110L、S113T、T126I、P127T、Q129R、M133L、F134L、P135A、T140A、K141I、T143M/S、V159A、Y161F、A166G和R169P突变,C基因型显性病毒株发生I126S、I126T及F158S突变。OBI病毒株发生Q129R、I126T、 M133T及F161Y突变。结论 浙江省德清县一般人群存在一定比例的OBI感染,OBI感染病毒载量较低,OBI病毒株存在氨基酸突变,C基因型为其可能的优势基因型,需重视OBI预防问题。