全肝容积CT灌注成像对乙型肝炎、乙型肝炎肝硬化肝储备功能评价的研究

目的 探讨全肝容积CT灌注成像(VCTP)中乙型肝炎、乙型肝炎肝硬化肝脏左叶、右叶及全肝灌注参数在评价肝脏储备功能中的价值。方法 前瞻性纳入泰安市中心医院影像科2012年11月—2014年2月间,经临床、其它检查证实为乙型肝炎的患者26例(肝炎组)、代偿期乙型肝炎肝硬化的患者24例(代偿组)、失代偿期乙型肝炎肝硬化的患者22例(失代偿组)和对照组(肝功能正常)30例。采用西门子SOMATON Definition AS+128螺旋CT行全肝容积灌注成像,对每组病例的血流量(BF)、血容量(BV)、肝动脉灌注量(ALP)、门静脉灌注量(PVP)及肝动脉灌注指数(HPI)共5个灌注指标进行分析。各组肝脏不同CT灌注参数值的比较采用单因素方差分析,以P<0.05为差异有统计学意义。结果 对照组、肝炎组、代偿组及失代偿组单因素方差分析结果显示,随着肝脏病变程度的加重,肝右叶、肝左叶及全肝灌注参数中的BF、BV、PVP值均逐渐减小,HPI却逐渐增加,4组间总体比较,差异具有统计学意义(P值均＜0.05)。肝脏右叶、左叶及全肝灌注参数对肝功能的评价是一致的,肝脏右叶、左叶灌注参数的走势无明显差异。全肝、肝右叶、肝左叶的灌注参数ALP组间比较差异无统计学意义(P值均＞0.05)。结论 全肝VCTP能反映乙型肝炎、乙型肝炎肝硬化的血流动力学变化,肝脏右叶、左叶灌注参数BF、BV、PVP都是随病变程度的加重而减小,肝脏右叶、左叶及全肝灌注参数对肝功能的评价是一致的。     

Erectile dysfunction in patients with liver disease related to chronic hepatitis B

Background/Aims

Despite sexual function making an important contribution to the quality of life, data on erectile function are relatively scant in patients with chronic liver disease. We evaluated the prevalence of and risk factors for erectile dysfunction (ED) in patients with liver disease related to hepatitis B, especially among those with chronic hepatitis B (CHB) or early-stage cirrhosis.

Methods

In total, 69 patients (35 with CHB and 34 with hepatitis-B-related liver cirrhosis [HBV-LC]) aged 40-59 years were analyzed. Child-Pugh classes of A and B were present in 30 (88.2%) and 4 (11.8%) of the patients with HBV-LC, respectively. The erectile function of the patients was evaluated using the Korean version of IIEF-5.

Results

The prevalence of any ED was 24.6% for all patients, and 8.6% and 41.2% for those with CHB and HBV-LC, respectively (P=0.002). While there was only one (2.9%) CHB patient for each stage of ED, mild, moderate, and severe ED stages were seen in three (8.8%), one (2.9%), and ten (29.4%) of the HBV-LC patients, respectively. Multiple regression analysis identified the type of liver disease (P=0.010), hypertension (P=0.022), score on the Beck Depression Inventory (P =0.044), and the serum albumin level (P=0.014) as significant independent factors for the presence of ED.

Conclusions

The prevalence of ED was significantly higher in patients with early-stage HBV-LC than in those with CHB. Therefore, screening male patients with early viral cirrhosis for ED and providing appropriate support are needed, especially when the cirrhosis is accompanied by hypertension, depression, or a depressed level of serum albumin.     

Adefovir dipivoxil alone or in combination with ongoing lamivudine in patients with decompensated liver disease and lamivudine-resistant hepatitis B virus

The purpose of this prospective study was to evaluate the efficacy and safety of adefovir dipivoxil with or without ongoing lamivudine in decompensated lamivudine-resistant chronic hepatitis B patients. Forty-six hepatitis B e antigen (HBeAg)-positive patients with decompensated liver function and lamivudine-resistant hepatitis B virus (HBV) were assigned to adefovir dipivoxil monotherapy (n=18) or combination therapy with ongoing lamivudine (n=28) according to their own preference. After 24 weeks of treatment, 83% of monotherapy and 86% of combination therapy showed serum HBV DNA below detection limit (<0.5 pg/mL). Alanine aminotransferase (ALT) normalized in 78% and 82% respectively. Median Child-Pugh-Turcotte (CPT) score or Model for End-Stage Liver Disease (MELD) score reduced significantly by 3 or 5 point in monotherapy and 2 or 2 point in combination therapy respectively. There were no significant differences in rate of undetectable serum HBV DNA, median change of ALT and median reduction of CPT or MELD scores between the two groups. In conclusion, both adefovir dipivoxil monotherapy and combination therapy with ongoing lamivudine result in comparable virologic, biochemical, and clinical improvements in HBeAg-positive patients with decompensated liver function and lamivudine-resistant HBV. Combination with lamivudine showed no additional benefit over monotherapy during 24 weeks of treatment in these patients.     

The value of preoperative magnetic resonance imaging in predicting postoperative recovery in patients with cervical spondylosis myelopathy: a meta-analysis

This meta-analysis was designed to elucidate whether preoperative signal intensity changes could predict the surgical outcomes of patients with cervical spondylosis myelopathy on the basis of T1-weighted and T2-weighted magnetic resonance imaging images. We searched the Medline database and the Cochrane Central Register of Controlled Trials for this purpose and 10 studies meeting our inclusion criteria were identified. In total, 650 cervical spondylosis myelopathy patients with (+) or without (-) intramedullary signal changes on their T2-weighted images were examined. Weighted mean differences and 95% confidence intervals were used to summarize the data. Patients with focal and faint border changes in the intramedullary signal on T2 magnetic resonance imaging had similar Japanese Orthopaedic Association recovery ratios as those with no signal changes on the magnetic resonance imaging images of the spinal cord did. The surgical outcomes were poorer in the patients with both T2 intramedullary signal changes, especially when the signal changes were multisegmental and had a well-defined border and T1 intramedullary signal changes compared with those without intramedullary signal changes. Preoperative magnetic resonance imaging including T1 and T2 imaging can thus be used to predict postoperative recovery in cervical spondylosis myelopathy patients.     

409例肝硬化和重型肝炎病例的MELD评分结果的构成分析

目的应用两种评分方法对409例肝硬化及重型肝炎患者进行评估比较，分析血清肌酐、血清胆红素及凝血酶原时间国际标准化比值（INR）对MELD评分结果的影响程度。方法统计409例肝硬化及重型肝炎患者的相关资料，应用Child和MELD评分法分别计算后应用Chiss软件进行统计学分析。结果随着A、B、C、D各个级别的病情的加重，MELD评分明显升高。各个级别的血清胆红素、INR之间存在明显差异；各个级别的血清肌酐之间无明显差异。结论血清胆红素及凝血酶原时间国际标准化比值（INR）的变化及不同能够明显影响到评分结果，而血清肌酐的结果对评分结果的影响不显著。MELD应与多因素分析及临床经验有机结合，才是符合临床实际的判断严重肝病预后的较科学手段。     

The histopathology of the liver in older patients with hepatitis B virus surface antigenaemia

Summary The histopathology of the liver and the detectability of intrahepatic hepatitis B virus (HBV) markers were studied in 34 autopsy cases in elderly patients (mean age 73.9 years, range 60–91 years) who had had a history of positive HBV surface antigenaemia prior to death. Seven of 14 persistent HBV carrier cases (group A) in which long-lasting HBV surface antigen (HBsAg) carriage in the sera had been confirmed by sequential assays, and 5 out of 15 HBV-infected people (group C, single assay) showed significant primary liver damages including chronic hepatitis, toxic hepatitis, liver cirrhosis and hepatocellular carcinoma. In 5 cases (group B), one of which was type B liver cirrhosis, HBsAg became negative and HBsAb appeared during the follow-up period (up to 33 months). Among confirmed HBV carriers, HBsAg and HBV core antigen were most frequently found in the liver of cirrhotic cases with and without hepatocellular carcinoma (5 of 6), whereas these were rarely detected in those with nonspecific changes or slight hepatitic activity (1 of 7). All 5 cases in group B were negative for histological HBV-related antigens and the findings in group C were variously interpreted. Post-mortem cases of the aged HBV carriers who survived their mean life expectancy represent an important population in which to study the natural history of HBV carriers.     

原发性肝癌与乙型肝炎肝硬化HBV DNA水平、HBV基因型的比较研究

目的 比较原发性肝癌与乙型肝炎肝硬化患者的血清HBV DNA水平、HBV基因型差别。方法 对210例原发性肝癌（HCC）患者及220例乙型肝炎肝硬化（HBV LC）患者的血清HBVDNA水平及HBV基因型进行分析,比较病毒学和基因型差异。结果 210例HCC患者和220例HBV LC患者HBV DNA检测阳性率分别为84.3％（177/210）、94.5％（ 208/220）;HBV DNA定量为（5.06±1.01） log10拷贝/ml和（5.36±1.13）log10拷贝/ml,HBV LC患者均高于HCC患者（P＜0.01）;HCC组和HBV LC组均以C基因型为主,两组B,C基因型分布无明显差异。结论 HCC患者血清HBV DNA水平低于HBV LC患者。两组HBV基因型分布无明显差异,均以C基因型为多。     

乙型肝炎肝硬化患者乙型肝炎病毒DNA水平与肝纤维化程度的关系

目的 探讨乙型肝炎肝硬化患者乙型肝炎病毒(HBV)DNA水平与肝纤维化程度的关系及其临床意义.方法 回顾性分析2004年至2006年本科室收治的263例乙型肝炎肝硬化住院患者的临床资料.所有患者均进行肝功能Child-Pugh分级,检测HBV DNA、HBV血清标志物、透明质酸(HA)、人Ⅲ型前胶原(Hpc-Ⅲ)、Ⅳ型胶原(Ⅳ-C)、层粘蛋白(LN);行腹部超声检测脾大小、门静脉内径、脾静脉内径;胃镜检查食管静脉曲张程度,并记录常见并发症.根据HBV DNA水平分为4组:G1组,HBV DNA＜103拷贝/ml;G2组,HBV DNA 103～＜105拷贝/ml;G3组,HBV DNA 105～＜107拷贝/ml;G4组,HBV DNA≥107拷贝/ml.比较各组间Child-Pugh分级、肝纤维化血清指标和门脉高压指标的差异以及各组肝硬化常见并发症的发生情况.结果 263例患者中217例(82.5%)HBV DNA阳性.不同HBV DNA水平患者之间的Child-Pugh评分分级、HA、Hpc-Ⅲ、Ⅳ-C、LN比较,差异无统计学意义(均P＞0.05).4组患者之间脾大小、门静脉内径、脾静脉内径及食管静脉曲张程度比较,差异无统计学意义(均P＞0.05).4组患者并发症如消化道出血、继发感染、腹水、肝性脑病、肝癌等发生率差异也无统计学意义(均P＞0.05).结论 绝大部分乙型肝炎肝硬化患者HBV DNA阳性,但血清HBV DNA水平高低与肝硬化严重程度及并发症的发生率无明显关联.     

Fas介导的细胞凋亡在乙型肝炎肝组织中分布状况初探

细胞凋亡可能是某些因素通过基因发动的一种细胞死亡过程。据认为,该过程主要通过Ｆａｓ抗原介导。为调查Ｆａｓ抗原表达与慢性乙型肝炎组织损伤的关系,本研究分别用免疫组化、原位末端标记法观察Ｆａｓ抗原表达及核ＤＮＡ断裂在慢性乙型肝炎肝组织中的分布状况。结果发现,Ｆａｓ抗原表达在活动性炎症区明显多于非炎症区,且主要位于汇管区及小叶内的炎症浸润区,５６例慢性乙型肝炎患者中,Ｆａｓ抗原阳性者４６例,阳性率８２％。直线相关回归分析提示,核ＤＮＡ断裂与Ｆａｓ表达明显相关。结果表明,Ｆａｓ介导的细胞凋亡在慢性乙型肝炎发病机制中具有重要作用     

Effect of alcohol on the development of hepatocellular carcinoma in patients with hepatitis B virus-related cirrhosis: a cross-sectional case-control study

Background/Aims

Whether alcohol intake increases the risk of hepatocellular carcinoma (HCC) in patients with chronic hepatitis B virus (HBV) infection remains controversial. The aim of this study was to determine the effect of alcohol intake on the development of HCC.

Methods

Between January 2006 and August 2008, 146 patients with an initial diagnosis of HCC who were hospitalized in 3 major hospitals in the Incheon area were enrolled as cases. Another 146 cirrhotic patients, who matched the cases by age and sex, were enrolled as controls. All cases and controls were HBsAg positive, and had a history of lifetime alcohol intake.

Results

The cases and controls were aged 53±8 and 53±9 years (mean±SD), respectively, with each group comprising 118 males and 28 females. The basal laboratory data, distribution of Child-Pugh class, HBeAg positivity (31.5% vs. 37.7%), HBV DNA level (5.74±2.35 vs. 5.98±2.29 log₁₀ copies/mL), and proportion with a lifetime alcohol intake of more than 292 kg (30.8% vs. 34.9%) did not differ between cases and controls. The cumulative alcohol intake and the proportion of heavy drinkers did not differ between the two groups in male patients.

Conclusions

Alcohol intake might not increase the risk of HCC in patients with HBV infection.     

血清和肝组织TGF-β1与慢性乙型肝炎肝纤维化的关系

目的 探讨血清和肝组织TGF-β1水平与慢性乙肝肝纤维化程度的关系,为肝纤维化诊断提供依据.方法 以肝活检病理诊断区分131例慢性HBV感染者纤维化程度(S0～S4),用ELISA法检测血清TGF-β1水平,免疫组化法检测肝组织TGF-β1表达并半定量.分析血清TGF-β1和肝组织TGF-β1表达与肝纤维化程度的关系.结果 血清和肝组织TGF-β1均与肝纤维化程度具有非常显著性正相关(r分别是0.74和0.89,P＜0.01).血清TGF-β1各组间比较差异有统计学意义(P＜0.01).组问分割比较,S0和S1分别与S4比较差异均有统计学意义(P＜0.005);各组与S0组比较差异均有统计学意义(P＜0.005);S1组和S3组之间比较有统计学意义(P＜0.005).肝组织TGF-β1表达在S3和S4组之间比较差异无统计学意义(P＞0.05),其余组间比较差异均有统计学意义(P＜0.01).血清TGF-β1和肝组织TGF-β1表达具有非常显著性意义相关(r=0.61,P＜0.01).结论 血清TGF-β1和肝组织TGF-β1水平与慢乙肝肝纤维化程度相关,血清TGF-β1有希望成为临床判断轻度或重度肝纤维化的无创伤性诊断指标.     

Screening of brain metastasis with limited magnetic resonance imaging (MRI): clinical implications of using limited brain MRI during initial staging for non-small cell lung cancer patients

The purpose of this prospective study was to determine whether using magnetic resonance imaging (MRI) for early screening for brain metastases (BM) can improve quality of life, survival in patients with non-small cell lung cancer (NSCLC). The study group comprised 183 patients newly diagnosed with NSCLC. All patients underwent limited brain MRI and routine workups. The control group comprised 131 patients with NSCLC who underwent limited brain MRI only if they had neurologic symptoms. The incidence of BM was 20.8% (38/183) in the study group and 4.6% (6/131) in the control group. The rate of upstaging based on the MRI data was 13.5% (15/111) overall and 15.9% (11/69) in patients that had been considered initially to be resectable surgically. There was no significant difference in survival outcome between the groups. Patients who had BM alone had a greater overall survival time (49 weeks) than those who had multiple systemic metastases (27 weeks; p=0.0307). In conclusions, limited brain MRI appears to be a useful, cost-effective method to screen for BM at the time of initial staging. And it may facilitate timely treatment of patients with NSCLC and improve their survival and quality of life.     

The refit model for end-stage liver disease-Na is not a better predictor of mortality than the refit model for end-stage liver disease in patients with cirrhosis and ascites

Background/Aims

The modification of the Model for End-Stage Liver Disease (MELD) scoring system (Refit MELD) and the modification of MELD-Na (Refit MELDNa), which optimized the MELD coefficients, were published in 2011. We aimed to validate the superiority of the Refit MELDNa over the Refit MELD for the prediction of 3-month mortality in Korean patients with cirrhosis and ascites.

Methods

We reviewed the medical records of patients admitted with hepatic cirrhosis and ascites to the Konkuk University Hospital between January 2006 and December 2011. The Refit MELD and Refit MELDNa were compared using the predictive value of the 3-month mortality, as assessed by the Child-Pugh score.

Results

In total, 530 patients were enrolled, 87 of whom died within 3 months. Alcohol was the most common etiology of their cirrhosis (n=271, 51.1%), and the most common cause of death was variceal bleeding (n=20, 23%). The areas under the receiver operating curve (AUROCs) for the Child-Pugh, Refit MELD, and Refit MELDNa scores were 0.754, 0.791, and 0.764 respectively; the corresponding values when the analysis was performed only in patients with persistent ascites (n=115) were 0.725, 0.804, and 0.796, respectively. The significant difference found among the Child-Pugh, Refit MELD, and Refit MELDNa scores was between the Child-Pugh score and Refit MELD in patients with persistent ascites (P=0.039).

Conclusions

Refit MELD and Refit MELDNa exhibited good predictability for 3-month mortality in patients with cirrhosis and ascites. However, Refit MELDNa was not found to be a better predictor than Refit MELD, despite the known relationship between hyponatremia and mortality in cirrhotic patients with ascites.     

The degrees of hepatocyte cytoplasmic expression of hepatitis B core antigen correlate with histologic activity of liver disease in the young patients with chronic hepatitis B infection

Subcellular localizaton of HBcAg have been found to be related to the activity of liver disease and HBV replication. The aim of this study was to determine whether the degree of expression of HBcAg in the hepatocyte nucleus and cytoplasm reflects the level of viral replication and histological activity in chronic HBV infection. A total of 102 patients with biopsy proven chronic hepatitis B were included. There was a highly significant correlation between the levels of HBV DNA in serum and the degree of expression of HBcAg in the nucleus for HBeAg-positive(p=0.000) and negative patients(p=0.04). There was a highly significant, correlation between the degrees of expression of HBcAg in hepatocyte cytoplasm and histologic activities (p<0.01) for HBeAg-positive patients. The degrees of expression of HBcAg in the hepatocyte cytoplasm correlated positively with the lobular activities (p<0.01), but not correlated with the portal activity and fibrosis for HBeAg-negative patients. In conclusion, in the young patients with chronic B viral hepatitis, the degree of expression of HBcAg in the hepatocyte nucleus may affect viral load, and the degree of expression of HBcAg in the hepatocyte cytoplasm may affect histologic activities of liver disease.     

KIR genes and their human leukocyte antigen ligands in the progression to cirrhosis in patients with chronic hepatitis C

Natural killer (NK) cells play pivotal roles in immune responses against infection with viruses, such as hepatitis C virus (HCV), and killer cell immunoglobulin-like receptors (KIRs) are related to the activation and inhibition of NK cells. The aim of this study was to investigate the possibility that KIR genes and their human leukocyte antigen (HLA) ligands influence progression to cirrhosis in patients infected with genotype 1 of HCV. A total of 145 Brazilian patients with confirmed chronic hepatitis C grouped from F0 to F4 according to fibrosis progression to cirrhosis were evaluated. Genotyping of KIR and HLA genes was performed by polymerase chain reaction with sequence-specific oligonucleotide probes. The HLA-C2 KIR ligand was more frequent in patients than in healthy controls (74.5% vs 64.3%, p = 0.04, odds ratio (OR) = 1.6, 95% confidence interval (CI) = 1.03-2.52). Moreover, the HLA-C1C2 genotype was more frequent in patients with advanced fibrosis or cirrhosis (F3-F4 group) than in patients in the F0-F2 group (61.6% vs 44.7%, p = 0.06) and in the F4 group compared with the F0-F3 group (65.7% vs 46.7%, p = 0.05, OR = 2.19, 95% CI = 1.01-4.73). NK and KIR ligands may contribute to the development of liver damage in patients chronically infected by HCV.     

No association between the IL28B SNP and response to peginterferon plus ribavirin combination treatment in Korean chronic hepatitis C patients

Background/Aims

There are few available data regarding the association between the single nucleotide polymorphisms (SNPs) of the gene encoding interleukin 28B (IL28B) and a sustained virologic response (SVR) to peginterferon (PEG-IFN) plus ribavirin (RBV) therapy in Korean chronic hepatitis C patients.

Methods

This was a retrospective cohort study of 156 patients with chronic hepatitis C virus (HCV) infection who received combination treatment of PEG-IFN plus RBV. Blood samples from these patients were analyzed to identify the IL28B SNPs at rs12979860, rs12980275, rs8099917, and rs8103142. Association analyses were performed to evaluate the relationships between each IL28B SNP and SVRs.

Results

Seventy six patients with HCV genotype 1 and 80 with genotype non-1 were enrolled. The frequencies of rs12979860 CC and CT genotypes were 90.4% and 9.6%, respectively; those of rs12980275 AA and AG genotypes were 87.2% and 12.8%, respectively; those of rs8099917 TT and TG genotypes were 92.3% and 7.7%, respectively; and those of rs8103142 TT and CT genotypes were 90.4% and 9.6%, respectively. Among the patients with HCV genotype 1, the SVR rates were 69.7% and 80.0% for rs12979860 CC and CT, respectively (P=0.71). Among the HCV genotype non-1 patients, SVR rates were 88.0% and 100% for rs12979860 CC and CT (P=1.00), respectively.

Conclusions

Genotypes of the IL28B SNP that are known to be favorable were present in most of the Korean patients with chronic hepatitis C in this study. Moreover, the IL28B SNP did not influence the SVR rate in either the HCV genotype 1 or non-1 patients. Therefore, IL28B SNP analysis might be not useful for the initial assessment, prediction of treatment outcomes, or treatment decision-making of Korean chronic hepatitis C patients.     

Chronic liver disease and cirrhosis among patients with hepatitis B virus infection in northern Portugal with reference to the viral genotypes

The prevalence of infection with hepatitis B virus in Portugal is around 1% of the population; 20-30% of those infected typically develop cirrhosis. The study focuses on the epidemiological profile of patients with hepatitis B infection and liver damage, in particular, cirrhosis. Of the 358 individuals that comprised the study, a liver biopsy was performed in 249 to identify the presence of cirrhosis. Cirrhosis was observed in 59 patients (23.7%) The Child-Pugh classification was used to assess the prognosis of cirrhosis: 3 out of the 59 patients were classified as Child-Pugh grade C, the most severe, 17 (28.8%) as grade B, and 39 (66.2%) as grade A. Patients classified as grade B were older, drank more, and showed higher levels of AST and alkaline phosphatase when compared with individuals classified as grade A. Genotypes A and D were predominant, and no significant differences with respect to genotype distribution were observed. Analysis of the hematological parameters showed that patients classified as Child's grade B had lower levels of platelets and higher levels of prothrombin time than those classified as Child's grade A. The profile of the patients with cirrhosis, including an extended number of individual characteristics, provides useful information, however, only a prospective study could evaluate definitively if liver disease is influenced by these factors. Future studies would benefit from the analysis of the impact of genotypes on liver disease, particularly genotypes A and D, the most predominant genotypes in northern Portugal.     

Basal core promoter, precore region mutations of HBV and their association with e antigen, genotype, and severity of liver disease in patients with chronic hepatitis B in India

Spontaneous mutations of hepatitis B virus (HBV) could influence the severity of liver disease. Since the basal core promoter (BCP) and the precore (Pc) regions are important for viral replication, these regions were examined for naturally occurring mutations and were correlated with the genotype, e antigen status, and severity of liver disease. In 82 patients with histologically confirmed chronic hepatitis B, the BCP and Pc regions were sequenced and aligned with known wild-type sequences. Sequence based HBV genotyping was done and HBV DNA was quantified. Thirty-three (40%) patients had decompensated chronic liver disease and the remaining patients had chronic hepatitis B. Forty-six (56%) patients were HBeAg positive. HBV genotype A was found in 28%, D in 65%, and B/C in 7.3%. The Pc G1896A mutation was more common in HBeAg-negative (33% vs. 2%, P < 0.01) patients and was genotype D specific. The Pc G1862T mutation was detected more often in HBeAg-positive than HBeAg-negative (37% vs. 11%, P < 0.01) patients and was genotype A specific (P < 0.01). BCP mutations at the 1,762/64 nucleotide positions were common in HBeAg negative than positive (36% vs. 13%, P < 0.05) and were equally common in different genotypes. TA 1-3 region mutations of the BCP were significantly higher in HBeAg-negative as compared to HBeAg-positive patients (78% vs. 26%, P < 0.01). BCP mutations had significantly higher HBV DNA levels. It is concluded that Pc G1862T mutant is Genotype A-specific but is not always associated with e antigen. The TA 1-3 rich mutations of BCP region are also associated with the absence of e antigen in Indian patients.     

Human leukocyte antigen class II association with spontaneous recovery from hepatitis B virus infection in Koreans: analysis at the haplotype level

It has been speculated that human leukocyte antigen (HLA) alleles are associated with the outcome of hepatitis B virus (HBV) infection although the data obtained from various populations have shown some inconsistencies. A total of 464 HBVinfected Korean individuals (80 spontaneously recovered [SR] and 384 chronically infected [CI]) were selected to investigate the association of HLA class II alleles with the viral clearance and persistence. Our results showed that: 1) multiple HLA class II alleles and haplotypes were associated with viral clearance (DRB1*1302, DRB1*1502, DQB1*0302, DQB1*0609, and related-haplotypes) and persistence (DRB1*0701, DQB1*0301, and related-haplotypes); 2) DRB1*1302 and DQB1* 0609 were more strongly associated with viral clearance. And the association of DQB1*0609 (pc=0.0084; OR, 7.24) with vial clearance was much stronger than previously recognized, DRB1*1302 (pc=0.0038; OR, 4.34); and 3) linkage to a specific DPB1 allele in a haplotype strengthened the association with viral clearance, although DPB1 itself was not associated with the outcome. These results indicate the existence of multiple factors controlling viral clearance in the HLA class II gene region. Further extended investigation on the genetic factors related to the outcome of HBV infection will provide valuable insights into the understanding of the mechanisms involved.     

Interleukin 10 gene single nucleotide polymorphisms in Polish patients with chronic hepatitis C: Analysis of association with severity of disease and treatment outcome

It is suggested that interleukin 10 (IL-10), as a modulator of immune response, is likely to influence the elimination of hepatitis C virus (HCV), the progression of chronic hepatitis C (CHC) and the response to interferon-based therapy in CHC patients. The aim of the study was to analyze the association of single nucleotide polymorphisms (SNPs) of IL-10 gene with severity of liver disease (degree of inflammation and stage of fibrosis) and outcome of pegylated interferon alpha and ribavirin combined therapy (sustained virological response (SVR) and relapse) in 196 Polish CHC patients infected with HCV genotype 1. The analysis included IL-10 promoter SNPs: ?1082(A/G) rs1800896, ?819(C/T) rs1800871, ?592(C/A) rs1800872 and SNP in the 3′ UTR of IL-10 gene: +4529(A/G) rs3024498. Genotyping was performed using PCR-RFLP and HRM analysis. It was demonstrated that the ?592C allele is associated with mild hepatic inflammation. Moreover, it was found that the ?819C allele might be associated with SVR and that the ACCA haplotype and intermediate IL-10 producer ACC haplotype are associated with SVR and non-relapse. It can be concluded that IL-10 SNPs are associated with severity of disease and response to therapy and may be considered as potential prognostic and predictive markers in CHC.