Naturally occurring infection of Pekin duck embryos by duck hepatitis B virus.

We tested the hypothesis that duck hepatitis B virus (DHBV) is a naturally occurring congenital infection of Pekin duck embryos. Of 219 embryos, 5-25 days after being laid, sera from 30 were found to be positive for endogenous DNA polymerase activity characteristic of hepatitis B-related viruses. The presence of the duck virus was confirmed by hybridization with cloned DHBV DNA. Viral DNA was also found in the livers of embryos incubated for 12 or 18 days. Electrophoretically different forms of DHBV DNA were identified in liver extracts that were not present in serum. These additional liver forms probably represent viral replication intermediates. These observations suggest that the vertical route is a major pathway of DHBV transmission and that viral replication may be initiated by the 12th day of embryonic life.     

HBeAg血清转换延迟患者的临床病理特征

目的探讨HBV感染者延迟HBeAg血清转换与肝脏病理变化的相关性。方法分析148例慢性HBV感染者的血清HBeAg表达与肝脏病理改变和HBcAg的关系。结果本组病例中HBeAg阳性78例,肝脏病理炎症分级G≥2者,53例（67.9%）,肝脏病理纤维化分期S≥2者,29例（37.2%）,HBeAg阴性70例,G≥2者,36例（51.4%）,S≥2者,25例（35.7%）,HBeAg阳性与阴性组肝脏炎症损害差异有统计学意义,χ2=4.20,P〈0.05,纤维化程度差异无统计学意义,χ2=0.532,P〉0.05。HBeAg阳性组肝脏HBcAg阳性者有60例（76.9%）明显高于HBeAg阴性组26例（37.1%）,χ2=23.98,P〈0.01。两组均以胞浆型为主分别为58.3%,65.4%。结论免疫活动期,HBV感染者延迟HBeAg血清转换组与HBeAg阴性组比较有更明显的炎症程度,血清HBeAg表达与肝脏HBcAg表达有明显相关性。     

慢性乙型肝炎病毒感染免疫耐受期患者的临床病理特征

目的:了解HBV慢性感染免疫耐受期患者的临床及病理学特征．方法:分析HBV感染不同时期380例患者的年龄、母婴垂直传播感染途径、乙肝家族史、肝细胞内HBsAg、HBcAg表达状况及肝组织病理学特征．结果:HBV慢性感染免疫耐受期患者年龄 16岁以下占61．8％,母婴垂直传播感染者占 55．0％,有乙肝家族史患者占46．6％,免疫耐受期患者89例肝组织内HBcAg阳性表达率 78．7％,均明显高于免疫活动期及感染非活动状态患者(x2=38．73,49．08,17．2,31．69, P<0．01)．免疫耐受期16岁以下的患者肝组织内HBsAg及HBcAg阳性表达率最高,分别占64．3％(45／75)和72．9％(51／79),显著高于免疫活动期和非活动HBV携带状态患者(x2= 17．51,31．17,P<0．001)．免疫耐受期16岁以上的患者肝组织内HBsAg及HBcAg阳性表达率最低,分别占35．7％(25／75)和27．1％(19／70),显著低于免疫活动期和非活动HBV携带状态患者(x2=17．51,x2=31．17,P<0．001)．结论:HBV慢性感染免疫耐受期患者中16岁以下者,母婴垂直传播感染者及乙肝家族史者所占比例明显高;HBV在肝组织复制表达以免疫耐受期患者最多,且16岁以下的患者占多数．     

The relationship between duck hepatitis B virus infection and duck liver diseases in Qitong, China

The relationship between duck hepatitis B virus (DHBV) infection and duck liver diseases was analysed by spot and gel blot hybridization in sera and liver tissues. One hundred and forty ducks were obtained from Qitong county in China. The DHBV-infected rate was 65.7% and the incidence of duck liver diseases was 70%. The state of DHBV DNA was free in the hepatocytes. The detection rate of DHBV DNA in liver was higher than in serum. The results showed that Qitong duck liver diseases are closely correlated to DHBV infection. The incidence of Qitong duck liver diseases and the DHBV infection rate were different in various species of ducks. Qitong ducks have several hepatic pathological changes as seen in human beings. Therefore, Qitong ducks are most appropriate as an experimental model for human HBV infection.     

肝康栓抗鸭乙型肝炎病毒的实验研究

目的：用鸭乙肝模型研究肝康栓对鸭乙型肝炎病毒（DHBV）的体内抗病毒作用。方法：用DHBV阳性血清感染1日龄的樱桃谷鸭，制备鸭乙型肝炎模型。随机分成5组：肝康栓大、中、小3个剂量治疗组，生理盐水模型组和阿昔洛韦（ACV）对照组，每组12只，均连续给药4周。分别于给药前，给药14天、28天，停药7天时取血清，用real-timePCR法检测鸭血清中DHBV DNA拷贝数的变化情况。结果：肝康栓大剂量组给药14天、28天及停药7天，中剂量组给药14天、28天，小剂量组给药28天，鸭血清中DHBV DNA拷贝数的对数值均较给药前降低（〉2个对数级），差异有统计学意义（P〈0．01）。结论：肝康栓具有有效抑制鸭体内DHBV DNA复制的作用。     

Role of viral replication in extrahepatic syndromes related to hepatitis B virus infection

Approximately 20% of patients with hepatitis B virus (HBV) infection may experience extrahepatic disease. These manifestations include a viral prodrome with a serum sickness-like syndrome, polyarteritis nodosa, glomerulonephritis, as well as various neurological and dermatologic diseases amongst other manifestations. The viral pathogenesis is not well understood and has been difficult to study due to the lack of an animal model of HBV-related extrahepatic disease. Deposition of immune complexes and activation of the complement cascade has been most widely studied. However, circulating immune complexes are physiologic and occur more frequently than extrahepatic disease. Also, HBV-related extrahepatic syndromes occur in the absence of immune complex formation. Several studies support the notion that HBV replication in extrahepatic tissues may also precipitate disease but extrahepatic replication has commonly been observed without any apparent cytopathic or immune related tissue damage. It is clear that suppression of viral replication with antiviral therapy or spontaneous viral clearance positively correlates with resolution of extrahepatic disease. The use of continuous immunosuppressive therapy has largely been abandoned with the advent of robust antiviral strategies to manage disease. These data support the notion that a combination of factors including inadequate clearance immune complexes and viral replication in extrahepatic tissues play an important role in the pathogenesis. This conceptual framework is potentially significant as it emphasizes the importance of antiviral treatment in the management of extrahepatic disease.     

Liver disease associated with duck hepatitis B virus infection of domestic ducks.

The liver disease associated with duck hepatitis B viremia was investigated in naturally infected ducks from Chi-tung county in China and in both naturally and experimentally infected ducks from the United States. Liver and serum specimens of adult Chinese ducks were examined for duck hepatitis B virus (DHBV) DNA by dot and gel blot hybridization. DHBV was found in serum and (in episomal form only) in livers of 6 of 11 birds exhibiting various degrees of chronic hepatitis. In 1 bird with hepatocellular carcinoma, DHBV DNA was detected at the limit of assay sensitivity and in another not at all, contrasting with findings in humans and woodchucks. In work with California Pekin and Khaki Campbell ducks, known amounts of DHBV were injected into the egg 10 days before, or into ducklings 1 day after, hatching and the livers were examined 6 weeks later. The majority of the injected ducklings had viremia detectable by hybridization 1 or 2 weeks after injection. The presence but not the amount of viremia correlated with incidence and degree of hepatitis, determined under code. The most severe instances of hepatitis, all in Pekin ducks, resembled the hepatitis in adult Chinese ducks of Chi-tung county. Severe and moderate hepatitis were found only in indoor-caged injected animals with viremia and in some uninjected birds without viremia that had been kept in outdoor flocks. The latter hepatitis, as some hepatitis in adult Chinese ducks, may not be related to DHBV. Mild and insignificant hepatitis were also found in injected and noninjected ducklings, some of which had the vertically transmitted spontaneous viremia previously described. The good correlation of experimentally induced viremia with incidence and severity of hepatitis in the Pekin duckling provides a simple, rapid, and relatively inexpensive model to study the relation of lesions to hepatitis B family infection in nonprimates.     

Experimental transmission of duck hepatitis B virus to Pekin ducks and to domestic geese

We investigated experimental transmission of duck hepatitis B virus to its original host, the domestic Pekin duck, and to three other avian species. Intramuscular injection of a standard inoculum of duck hepatitis B virus into 2- to 5-day-old Pekin ducklings hatched from a duck hepatitis B virus-free flock resulted in viremia in 100% of 107 animals, indicating that duck hepatitis B virus infection of young progeny of a defined duck hepatitis B virus-free flock occurs reproducibly. When the same inoculum was injected into chicks and Muscovy ducklings of the same age, no evidence of viral infection was detectable. In contrast, hatchlings of two domestic breeds of geese were readily infected by duck hepatitis B virus, developing viremia at a slower rate than Pekin ducklings, but a higher average titer of viremia 4 weeks or more after injection. Neither the pattern of restriction enzyme sites in the viral DNA nor the susceptibility of ducklings to the virus were detectably altered after passage in geese. As in duck hepatitis B virus-infected young ducklings, most of the experimentally infected goslings appeared to be persistently infected and those eventually laying eggs transmitted virus to the progeny. While ducklings exhibited a fairly uniform inflammatory response to the virus, duck hepatitis B virus inoculation of the goslings resulted in both inflammation and an altered hepatocellular morphology not seen in uninjected controls. The host range of duck hepatitis B virus appears to be limited to the primary host and a close taxonomic relative, similar to other members of the hepadnavirus family, hepatitis B virus and ground squirrel hepatitis virus.     

Autoimmunity and extrahepatic manifestations in hepatitis C virus infection

Hepatitis C virus (HCV) infection is associated with various extrahepatic manifestations: mixed cryoglobulinaemia, membranoproliferative glomerulonephritis and, in southern Europe, to some extent with porphyria cutanea tarda. The association of haplotype HLA B-8 and DR-3 mixed cryoglobulinaemia and HCV infection has recently been demonstrated. Interferon alpha therapy decreases hepatitis C viraemia and improves the clinical signs and biochemical abnormalities of cryoglobulinaemia. There seems to be a south-north gradient in the prevalence of HCV-associated cryoglobulinaemia. The rare combination of hepatitis C and panarteritis nodosa has still not been confirmed. The sicca syndrome also seems to be associated with hepatitis C virus, but this is not the typical Sj?gren syndrome. Existing studies have not answered the question of whether HCV plays a pathogenic role in the development of thyroid dysfunction and autoimmune thyroiditis. There seems to be a genetic predisposition for the manifestations of thyroid disease in the case of hepatitis C infection and interferon therapy. This predominantly affects women with haplotype HLA DR-3. Before beginning interferon therapy, these patients often show thyroid autoantibodies against the thyroid peroxidase and/or thyroglobulin. It is still unclear whether the rare combination of hepatitis C with aplastic anaemia and lymphoma has pathogenic aspects. These haematological manifestations are thought to be induced by the infection of haematopoietic cells with the hepatitis C virus. In rare cases, a stimulated HCV-induced interferon gamma synthesis by haematopoietic stem cells has been shown. Although an epidemiological association of hepatitis C with lichen planus, neuropathies and other diseases has been observed, the aetiological role and the pathogenic involvement of the hepatitis C infection remains unclear. Furthermore, the question of whether these extrahepatic diseases are autoimmune has not been clarified. On the other hand, a number of autoantibodies may be observed during the course of hepatitis C. Of particular interest are liver/kidney microsomal antibodies (LKM). Their occurrence in viral hepatitis may indicate an increased risk for treatment with interferons. In the clinical setting, the presence of these diseases should suggest hepatitis C infection and hepatitis C antibodies should be tested and, if positive, hepatitis C-RNA is indicated. If there is any evidence of an aetiological association of replicative hepatitis C infection and the above-mentioned extrahepatic diseases, antiviral treatment should be considered.     

Human hepatitis B virus and hepatocellular carcinoma I. Experimental infection of tree shrews with hepatitis B virus

Tree shrews (Tupaia belangeri chinenesis) can be experimentally infected with human hepatitis B virus (HBV) by inoculation with human serum positive for HBV, the experimental infection rate being 55.21%. Successive infections have been passed through five generations among the tree shrews inoculated with HBV-positive sera from the infected animals, the average infection rate being 94.0%. The experimental infection of tree shrews with HBV may be prevented by immunization with hepatitis B vaccine, the protection rate being 88.89%. Standard serum containing HBV at 10⁸ CID (chimpanzee infection dose)/ml, was diluted 10^–6, 10^–7, 10^–8, 10^–9, and 10^–10 and produced infection rates of 80.0%, 88.8%, 66.7%, 55.6% and 42.9% respectively. Thus the CID₅₀ in tree shrews may reach a dilution of 10^–9, which shows that tree shrews are sensitive to HBV infection. These results successfully establish tree shrews as a reliable and useful animal model for research on HBV infection and its relation to hepatocarcinogenesis.Abbreviations HCC Hepatocellular carcinoma - HBV human hepatitis B virus     

Establishment and application of hepatic organoid model of hepatitis B virus infection

<正>Objective To establish the hepatic organoid of hepatitis B virus(HBV) infection on the basis of induced pluripotent stem cells (iPSC) and an inverted colloidal crystal polyethylene glycol scaffold (ICC),and to evaluate the antiviral effect of nucleoside drugs.Methods iPSC was differentiated into hepatocyte-like cells (HLC),and inoculated into ICC to construct a hepatic organoid.The relative mRNA expressions of Nanog homeobox (NANOG),     

Impact of hepatitis B virus infection on hepatic metabolic signaling pathway

A growing body of epidemiologic research has demonstrated that metabolic derangement exists in patients with hepatitis B virus(HBV) infection, indicating that there are clinical associations between HBV infection and host metabolism. In order to understand the complex interplay between HBV and hepatic metabolism in greater depth, we systematically reviewed these alterations in different metabolic signaling pathways due to HBV infection. HBV infection interfered with most aspects of hepatic metabolic responses, including glucose, lipid, nucleic acid, bile acid and vitamin metabolism. Glucose and lipid metabolism is a particular focus due to the significant promotion of gluconeogenesis, glucose aerobic oxidation, the pentose phosphate pathway, fatty acid synthesis or oxidation, phospholipid and cholesterol biosynthesis affected by HBV. These altered metabolic pathways are involved in the pathological process of not only hepatitis B, but also metabolic disorders, increasing the occurrence of complications, such as hepatocellular carcinoma and liver steatosis. Thus, a clearer understanding of the hepatic metabolic pathways affected by HBV and its pathogenesis is necessary to develop more novel therapeutic strategies targeting viral eradication.     

载脂蛋白质B mRNA编辑酶催化多肽3G抑制乙型肝炎病毒和鸭乙型肝炎病毒复制

目的了解载脂蛋白质BmRNA编辑酶催化多肽3G（APOBEC3G）对乙型肝炎病毒（HBV）和鸭乙型肝炎炎病毒（DHBV）复制的抑制作用。方法从健康人外周血单个核细胞提取RNA，逆转录聚合酶链反应扩增APOBEC3G，将产物克隆到pXF3H载体的EcoRⅠ和Hind Ⅲ酶切位点以构建真核表达质粒；以ayw亚型HBV全长质粒构建具有复制能力的1．3倍HBV质粒（pHBV1．3）。不同剂量的APOBEC3G真核表达质粒与pHBV1．3共转染HepG2细胞；酶联免疫吸附法检测细胞培养上清液的乙型肝炎表面抗原和e抗原水平，Southernblot和Northernblot分析HBV核衣壳相关DNA和RNA的水平变化。不同剂量APOBEC3G真核表达质粒与头尾相接的2倍DHBV质粒共转染LMH鸡肝癌细胞，Southernblot分析DHBV核衣壳相关DNA水平变化。结果成功构建APOBEC3G真核表达质粒和具有复制能力的1．3倍HBV质粒。APOBEC3G抑制乙型肝炎表面抗原和e抗原的分泌，转染细胞内HBV核衣壳相关RNA表达水平下降，而对核心蛋白质的表达没有影响；APOBEC3G对转染细胞内HBV和DHBV核衣壳相关DNA水平具有剂量依赖的抑制效应。结论APOBEC3G对HBV和DHBV复制具有抑制作用。     

胎盘滋养层细胞的乙型肝炎病毒感染与宫内感染机制

目的：检测HBV对胎盘、胎肝和滋养层细胞的感染情况，探讨HBV的宫内感染机制。方法：研究对象包括20例孕妇胎盘组织、6例引产胎儿胎肝组织及体外培养的胎盘滋养层细胞。ELISA法检测孕妇外周血、胎儿脐血和6个月婴儿外周血HBV标志物；荧光定量PCR法检测血清和滋养层细胞中的HBV DNA；免疫组织化学法和免疫荧光法检测胎盘、胎肝组织及滋养层细胞中HBV标志物的表达；末端脱氧核糖核酸转移酶介导的缺口标记法（TUNEL）检测胎盘和滋养层细胞凋亡情况。结果：孕妇血清HBV DNA水平与胎儿脐血HBV DNA水平相关，脐血HBV DNA阳性者其母血HBV DNA〉1.0×10^7拷贝／mL；6例胎盘组织和3例引产胎儿胎肝组织中可见HBsAg免疫组织化学染色阳性细胞，其中1例胎肝组织中发现HBcAg阳性细胞；体外培养滋养层细胞与HBV DNA阳性血清共孵育后，可检测到HBsAg的表达，亦可检测到HBV DNA。体内和体外实验均检测到HBV感染后滋养层细胞凋亡呈增加趋势，且胎盘细胞的凋亡与脐血HBV DNA水平相关。体外实验结果显示，随感染时间的延长，滋养层细胞凋亡呈增加趋势。6个月后，12例新生儿有1例血清HBsAg、HBeAg和抗-HBc阳性，6例抗-HBs阳性。结论：HBV宫内感染的机制可能是通过HBV感染胎盘屏障而使胎儿发生HBV宫内感染。HBV在胎儿组织器官内的定位和复制可能是新生儿发生慢性HBV感染的重要因素。滋养层细胞凋亡可能是胎盘屏障阻断HBV宫内传播的一种保护性机制。     

Adenovirus-expressed preS2 antibody inhibits hepatitis B virus infection and hepatic carcinogenesis

AIM: To investigate the inhibitory effect of hepatitis B virus (HBV) preS2 antibody (preS2Ab) against HBV infection and HBV-associated hepatic carcinogenesis.METHODS: An adenoviral vector carrying the full-length light and heavy chains of the HBV preS2Ab gene, Ad315-preS2Ab, was constructed. Enzyme linked immunosorbent assay (ELISA) and Western blotting analyses were used to determine the preS2Ab expression levels in vitro. Immunofluorescent techniques were used to examine the binding affinity between the expressed HBV preS2Ab and HBV-positive liver cells. ELISAs were also used to determine hepatitis B surface antigen (HBsAg) levels to assess the inhibitory effect of the preS2Ab against HBV infection in L02 cells. The inhibitory effect of preS2Ab against hepatic carcinogenesis was studied with diethylnitrosamine (DEN)-induced hepatocellular carcinomas (HCCs) in HBV transgenic mice.RESULTS: The expression of HBV preS2Ab increased with increases in the multiplicity of infection (MOI) of Ad315-preS2Ab in L02 cells, with 350.87 ± 17.37 μg/L of preS2Ab when the MOI was 100 plaque forming units (pfu)/cell. The expressed preS2Abs could recognize liver cells from HBV transgenic mice. ELISA results showed that L02 cells expressing preS2Ab produced less HBsAg after treatment with the serum of HBV patients than parental L02 cells expressing no preS2Ab. HBV transgenic mice treated with Ad315-preS2Ab had fewer and smaller cancerous nodes after induction with DEN than mice treated with a blank Ad315 vector or untreated mice. Additionally, the administration of Ad315-preS2Ab could alleviate hepatic cirrhosis and decrease the serum levels of alanine transaminase and aspartate transaminase.CONCLUSION: Adenovirus-mediated HBV preS2Ab expression could inhibit HBV infection in L02 cells, and then inhibit DEN-induced hepatocellular carcinogenesis and protect hepatic function in HBV transgenic mice.     

Human immunodeficiency virus infection and hepatitis C pathology

ABSTRACT: To investigate the possible influence of human immunodeficiency virus (HIV) infection on hepatitis C virus-related liver disease, liver morphology was evaluated in 160 HBsAg-negative patients with chronic hepatitis C, including 68 HIV-positive and 92 HIV-negative cases. No differences were detected in the severity of necro-inflammatory hepatic lesions between HIV-negative and HIV-positive patients when the CD4+ lymphocytes count exceeded 400 cells/mm³. In contrast, HIV-positive patients with CD4+ lymphocytes below 400/mm³ showed a significantly lower grade of portal inflammation and piecemeal necrosis. These results suggest that liver lesions in hepatitis C may largely depend on immunomediated mechanisms.     

Steatosis and hepatitis C virus: mechanisms and significance for hepatic and extrahepatic disease

Nonalcoholic fatty liver disease (NAFLD) and hepatitis C virus (HCV)-related liver disease are common in the general population, but their concurrence is 2- to 3-fold higher than would be expected by chance alone. In patients with chronic HCV infection, steatosis is attributable to a variable combination of the mechanisms considered to play a role in the pathogenesis of NAFLD--insulin resistance in the obese and in the lean subject--along with a direct effect of HCV on hepatic lipid metabolism that leads to triglyceride accumulation through inhibition of export proteins that are required for very low density lipoprotein (VLDL) assembly and secretion. Accumulating evidence suggests that steatosis contributes to the progression of fibrosis in HCV-related disease in a pattern similar to that observed in NAFLD. Potential mechanisms of this effect include the increased sensitivity of steatotic livers to oxidative stress and cytokine-mediated injury. Steatosis-related hepatic insulin resistance may also play a role through the profibrogenic effects of the compensatory hyperinsulinemia and provides a potential explanation for the association between HCV and type 2 diabetes mellitus. Indeed, an appreciation of the importance of fat in HCV has recently led to trials of adjuvant therapy for HCV directed at steatosis-associated disease mechanisms, with encouraging results reported for various modalities, including weight loss and antioxidants. Future therapy should be aimed at exploiting the interactions of HCV with host insulin and lipid metabolism, particularly in nonresponders to standard antiviral schedules.