乙肝病毒感染与乙肝病毒相关性肾炎间的关系分析

目的 探讨研究乙肝病毒(HBV)感染与乙肝病毒相关性肾炎之间的关系.方法 对124例资料完整的HBV相关肾炎(HBV-related glomerulonephritis,HBV-GN,)患者的血清病毒学、肾脏及肝脏病理学和常规实验室检查结果进行回顾分析研究.结果 124例血清HBsAg和/或HBeAg阳性的患者中,HBV-GN的发生率69.49％,男性发生率(45.0％)显著高于女性(24.49％),P＜0.05.血清HBeAg阳性组HBV-GN的发生率显著高于HBeAg阴性组.HBV DNA定量＞105 copies/mL组HBV-GN的发生率亦显著高于定量＜105 copies/mL组.HBV-GN患者血清HBeAg阳性与阴性组之间比较,24小时尿蛋白定量及内生肌醉清除率均无显著差异.血清HBV DNA定量＞105copies/mL组与定量＜ 105 copies/mL组之间比较24小时尿蛋白定量与内生肌酐清除率亦无显著差异.HBV-GN患者肾组织局部HBcAg沉积阳性组与阴性组相比较,24小时尿蛋白定量有显著性差异(P＜0.05),而内生肌酐清除率无显著性差异.结论 HBV感染及其复制状态与HBV-GN的发生密切相关;但HBV的复制状态可能并不明显影响HBV-GN患者肾、肝组织的病变程度.     

Clinical significance of occult hepatitis B virus infection in chronic hepatitis C patients

Background/Aims

We investigated the frequency of occult hepatitis B virus (HBV) infection in anti-hepatitis C virus (HCV)-positive individuals and the effects of occult HBV infection on the severity of liver disease.

Methods

Seventy-one hepatitis B virus surface-antigen (HBsAg)-negative patients were divided according to their HBV serological status into groups A (anti-HBc positive, anti-HBs negative; n=18), B (anti-HBc positive, anti-HBs positive; n=34), and C (anti-HBc negative, anti-HBs positive/negative; n=19), and by anti-HCV positivity (anti-HCV positive; n=32 vs. anti-HCV negative; n=39). Liver biopsy samples were taken, and HBV DNA was quantified by real-time PCR.

Results

Intrahepatic HBV DNA was detected in 32.4% (23/71) of the entire cohort, and HBV DNA levels were invariably low in the different groups. Occult HBV infection was detected more frequently in the anti-HBc-positive patients. Intrahepatic HBV DNA was detected in 28.1% (9/32) of the anti-HCV-positive and 35.9% (14/39) of the anti-HCV-negative subjects. The HCV genotype did not affect the detection rate of intrahepatic HBV DNA. In anti-HCV-positive cases, occult HBV infection did not affect liver disease severity.

Conclusions

Low levels of intrahepatic HBV DNA were detected frequently in both HBsAg-negative and anti-HCV-positive cases. However, the frequency of occult HBV infection was not affected by the presence of hepatitis C, and occult HBV infection did not have a significant effect on the disease severity of hepatitis C.     

Incidence and seroprevalence of hepatitis E virus infection in pregnant women infected with hepatitis B virus and antibody placental transfer in infants

BackgroundHepatitis E has poor outcomes in pregnant women. Superinfection of hepatitis E virus (HEV) in patients infected with hepatitis B virus (HBV) may worsen liver disease.ObjectivesTo estimate the incidence and seroprevalence of HEV infection among HBV-infected pregnant women, to investigate the transplacental transfer of maternal anti-HEV IgG, and to compare the maternal and neonatal outcomes in anti-HEV positive and negative pregnant women.Study designTotally 391 HBV-infected pregnant women were recruited from April 2012 to October 2014. Paired mothers and infants were followed up at an average 9.8 months postpartum. Anti-HEV IgG and IgM were tested by ELISA.ResultsOf the pregnant women, none was anti-HEV IgM positive and 42 (10.7%) were IgG positive. At the follow-up, 3 seronegative women converted to anti-HEV IgG positive, with an estimated incidence of 17 per 1000 person-years. No significant differences of gestational age, preterm birth rate, Apgar score and birthweight were observed between newborns of anti-HEV IgG positive and negative mothers. Of the 42 neonates born to anti-HEV IgG positive mothers, 38 (90.5%) had anti-HEV IgG in their cord blood. The neonatal and maternal anti-HEV IgG levels were positively correlated (r = 0.827, p < 0.05). All infants were negative for both anti-HEV IgM and IgG at the follow-up.ConclusionsHBV-infected pregnant women rarely have novel HEV infection during late pregnancy in Jiangsu, China. Maternal anti-HEV IgG efficiently transfers into the fetuses, and disappears in infants before 10 months old.     

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone,Southwest Ethiopia: Community based cross-sectional study

BackgroundHepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity.ObjectiveThe aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia.MethodsA community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables.ResultsA total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of hbsag among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI = [3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI = [1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.ConclusionsThe sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection.     

Sero-prevalence of Hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone,Southwest Ethiopia: community based cross-sectional study

BackgroundHepatitis B virus infection is one of the leading causes of liver diseases which occurs worldwide particularly in developing countries. It is often caused by prenatal transmission from mother to child or household transmission from a close contact during early childhood. It causes different complications like; jaundice, induces premature labor, and prematurity.ObjectiveThe aim of this study was to estimate the sero-prevalence of hepatitis B virus surface antigen and associated factors among women of reproductive age in Bench Maji Zone, South West Ethiopia.MethodsA community-based cross-sectional study was conducted from December 15th, 2016 to February 15th, 2017. Multistage sampling technique was applied to select study participants. Logistic regression analysis was applied and p-values < 0.05 was used to see the significant association between dependent and independent variables.ResultsA total of 330 participants were included in this study yielding 98.8% response rate. The sero-prevalence of HBsAg among women of reproductive age was 28(8.5%). Having multiple sexual partners (AOR = 18.73, 95% CI =3.65, 96.21) history of unprotected sex (AOR = 9.39, 95% CI =1.64, 53.77) were found to be significantly associated with sero-prevalence of HBV.ConclusionsThe sero-prevalence of HBV infection among women of reproductive age was highly endemic. Hence, behavioral education and communication programs focusing on reduction of risky sexual behaviors should be designed to reduce HBV infection.     

乙型肝炎病毒母婴传播的早期筛选

作者对100名入院产妇静脉血及100份新生儿脐血行母婴配对HBV检测,结果发现产妇HBV阳性54人,脐血HBV阳性52人,阳性率分别为54.0%、52.%.产妇及脐血HBV96.296%呈母婴配对阳性.同时发现100名产妇孕期保健卡中HBV正常60人,产时HBV阳性检出34人,再检阳性率占56.67%;不正常4人,产时HBV阳性4人,再检阳性率100%,未查36人,产时HBV阳性16人,再检阳性率44.44%,提示存有母婴传播高危因素.为提高围产期母婴保健质量,预防产时交叉感染,作者提出了建议.     

乙肝免疫球蛋白阻断乙肝病毒母婴垂直传播的研究

目的研究乙肝免疫球蛋白应用于孕妇为乙肝病毒携带者对阻断乙肝病毒母婴垂直传播的效果。方法A组123例，于孕28、32、36w分别注射HBIG200u，B组130例仅常规产前检查及监护。结果A组较B组新生儿出生时外周血HB—sAg阳性率显著降低P〈0．05。结论对乙肝病毒携带的孕妇晚期应用HBIG可以显著降低新生儿外周血HBSAg阳性率。     

乙型肝炎分子流行病学研究进展

乙肝的分子流行病学是运用先进的分子生物学技术研究乙肝流行病学的诸多问题,能够进一步从分子水平阐明乙型肝炎病毒感染的病因、致病过程及发病机制,对于疾病早期诊断、传染性的评估、病情的预测、抗病毒药物疗效的观察、疾病发展进程的监测和乙肝感染自然史的研究等方面均有重要的指导意义.针对近几年乙肝分子流行病学研究的几个热点即乙型肝炎病毒的检测、基因分型、基因系统进化分析、基因变异、基因多态性的研究进展作一回顾.虽然近年来该领域的研究迅速增多,但多数仍处于探索阶段,乙肝病毒感染、清除等诸多机制的研究仍任重而道远.     

影响HBV宫内感染的相关临床因素的探讨

目的探讨乙型肝炎病毒（HBV）宫内感染的高危因素或保护因素。方法对2006年6月至2008年2月在中山大学附属第三医院产科分娩的417例血清HBsAg阳性孕妇的新生儿进行回顾性分析。结果HBV宫内感染组33例,非感染组384例,感染组的母亲HBeAg阳性率、HBV DNA阳性率和非感染组的具有显著性差异（P〈0.05）,母亲孕晚期注射HBIG在2组中均无显著性差异（P〉0.05）;在母亲各HBV DNA水平级上分析,新生儿HBV宫内感染和母亲使用HBIG均无明显相关（P〉0.05）;结论1.HBV DNA阳性是HBV宫内感染的高危因素。2.HBsAg阳性孕妇晚孕期间肌注HBIG对HBV宫内感染未见明显的保护作用。     

Occult hepatitis B virus infection in liver transplant patients in a Brazilian referral center

Estimates of occult hepatitis B virus (HBV) infection prevalence varies amongdifferent studies depending on the prevalence of HBV infection in the studypopulation and on the sensitivity of the assay used to detect HBV DNA. Weinvestigated the prevalence of occult HBV infection in cirrhotic patients undergoingliver transplantation in a Brazilian referral center. Frozen liver samples from 68adults were analyzed using a nested polymerase chain reaction assay for HBV DNA. Thespecificity of the amplified HBV sequences was confirmed by direct sequencing of theamplicons. The patient population comprised 49 (72.1%) males and 19 (27.9%) femaleswith a median age of 53 years (range=18-67 years). Occult HBV infection was diagnosedin three (4.4%) patients. The etiologies of the underlying chronic liver disease inthese cases were alcohol abuse, HBV infection, and cryptogenic cirrhosis. Two of thepatients with cryptic HBV infection also presented hepatocellular carcinoma. Markersof previous HBV infection were available in two patients with occult HBV infectionand were negative in both. In conclusion, using a sensitive nested polymerase chainreaction assay to detect HBV DNA in frozen liver tissue, we found a low prevalence ofoccult HBV infection in cirrhotic patients undergoing liver transplant, probably dueto the low prevalence of HBV infection in our population.     

泛昔洛韦治疗HBV慢性感染的临床研究

目的：观察泛昔洛韦对HBV慢性感染抗病毒的治疗效果。方法：慢性乙型肝炎患者89例，采用随机对照分组，和单用泛昔洛韦治疗组32例，和单用α－干扰素29例和单用拉米夫定28例两个对照组，对比观察三组抗病毒治疗效果。结果：治疗组泛昔洛韦血清HBV DNA阴转率40．62％（13／32），HBeAg阴转率21．88％（7／32）；对照组α－干扰素血清HBV DNA阴转率37．93％（11／29），HBeAg阴转率41．38％（12／29）；拉米夫定血清HBV DNA阴转率67．90％（19／28），HBeAg阴转率21．43％（6／28）。治疗组HBV DNA阴转时间最短1个月，最长3个月，平均1．3个月，无1例出现严重不良反应。结论：泛昔洛韦治疗HBV慢性感染安全有效。     

Viral deletions among healthy young Chinese adults with occult hepatitis B virus infection

To investigate the mechanism and prognosis of occult hepatitis B virus (HBV) infection (OBI) at a molecular level among healthy young adults, the presence of HBV DNA in 1176 sera samples collected from healthy young people after neonatal vaccination was assessed by nested polymerase chain reaction (PCR) using specific primers designed for the X and S regions of the HBV genome. Full-length HBV DNA from 9 patients with OBI (OB1-OB9) was cloned and sequenced. Deletions in the pre-S, basal core promoter (BCP), core (C) and polymerase (P) regions were observed. The data indicate that there is still a substantial risk of OBI in China despite neonatal vaccination. All deletions that were observed in the pre-S, BCP, C and P regions play a direct or indirect role in OBI. The presence of a deletion mutation in the pre-S1 region was considered to play a pivotal role in hepatocarcinogenesis and was found to increase the risk of hepatocellular carcinoma in the cohorts studied.     

Prevalence and risk factors of Hepatitis D virus antibody among asymptomatic carriers of Hepatitis B virus: a community survey

BackgroundHepatitis D virus (HDV) can cause a chronic infection in the presence of hepatitis B surface antigen and contribute to the burden of chronic liver disease especially in regions where chronic hepatitis B virus (HBV) infection is endemic.AimTo determine the prevalence and risk factors of HDV among asymptomatic carriers of HBsAg in Cross River State, Nigeria.MethodsThis was a cross-sectional study conducted among apparently healthy adults resident in Cross River State, Nigeria. A structured questionnaire was used to collect socio-demograhic data and risk factors for HBV/HDV infection. Participants blood samples were screened for HBsAg. Samples that were HBsAg positive were further screened for anti-HDVIgM. Statistical analysis was performed using statistical package for social sciences (SPSS) version 20.ResultsA total of 90 HBsAg positive samples were assayed. The prevalence of anti-HDV IgM was 5.6% (95% CI 1.1–10.1). The HDV positive subjects were mostly females (80%), reported family size of >5 members (80%), had female circumcision (75%) and took injections from Non-certified health care practitioners (NCHCPs). None of the assessed risk factors were significantly associated with HDV infection (p >0.05).ConclusionHepatitis D virus is moderately prevalent amongst asymptomatic HBsAg carriers in Cross River State, Nigeria.     

Epidemiology and prevention of hepatitis B virus infection

Hepatitis B virus (HBV) infection has been a major global cause of morbidity and mortality. The recognition of the problem led to a worldwide effort to reduce transmission of HBV through routine infant vaccination. HBV infection is the most common cause of chronic liver diseases and hepatocellular carcinoma in Korea. After hepatitis B vaccine era, seroprevalence of hepatits B surface antigen is decreasing, particularly in children. Hepatitis B vaccine is remarkably safe and shows high immunogenicity. Universal childhood immunization with three doses of hepatitis B vaccine in the first year of life is a highly effective method for prevention and control of hepatitis B.     

IgA肾病肾组织内乙型肝炎病毒感染的发病机制研究

目的：探讨乙型肝炎病毒感染致IgA肾病肾损伤的发病机制。方法： 随机选取48例IgA肾病肾穿刺组织，参照Meadow病变分级标准分为Ⅰ-Ⅴ级5个实验组，应用Envision免疫组织化学方法检测各级肾组织内HBsAg和HBcAg；同时用直接IS-PCR技术检测其中18例IgA肾病肾组织内HBV DNA。结果： 48例IgA肾病肾组织内HBcAg和HBsAg总的阳性检出率分别为75.00%(36/48)和43.75%(21/48)；18例IgA肾病肾组织内HBV DNA阳性检出率为61.11%(11/18)；3者均表现为肾小管阳性检出率高于肾小球(P＜0.05)，但各级之间，HBcAg、HBsAg和HBV DNA检出率均无显著差异(P＞0.05)。结论： HBV参与了IgA肾病的发生，其导致肾组织损伤的机制可能主要是由细胞免疫或一系列细胞因子介导，并非病毒直接所致；肾小管上皮细胞可能是HBV感染的靶对象。     

Complete genomic sequence and phylogenetic relatedness of hepatitis B virus isolates in Cambodia

Although it is known that Cambodia is one of the high endemic area of hepatitis B virus (HBV) infection, molecular characterization of HBV circulating in this country has not been reported. In this study, pre-S gene of HBV from 12 Cambodian patients was sequenced. Phylogenetic analysis based on the pre-S gene sequence revealed that 8 out of 12 isolates (66.7%) belonged to HBV/C1 and remaining four (33.3%) were HBV/B4. Furthermore, complete genomic sequences were also determined for three Cambodian HBV isolates. They all comprised of 3,215 bp long and two of them belonged to subgenotype B4, which had recombination event with genotype C in the precore/core gene confirmed by SimPlot and BootScanning analyses. Our results showed that both HBV strains belonged to subgenotypes B4 and C1, which are circulating in this country. This is the first report on molecular characterization of the HBV prevalent in Cambodia.     

Calcium ions affect the hepatitis B virus core assembly

Previous report showed that cytosolic Ca2+ induced by hepatitis B virus X protein (HBx) promotes HBV replication. In this study, in vitro experiments showed that (i) HBV core assembly in vitro was promoted by Ca2+ through the sucrose density gradient and the analytical ultracentrifuge analysis. Also, (ii) transmission electron microscope analysis demonstrated these assembled HBV core particles were the capsids. Ex vivo experiments showed that the treatment of BAPTA-AM and cyclosporine A (CsA) reduced HBV capsids in the transfected HepG2 cells. In addition to that, the treatment of Thapsigargin (TG) increased HBV capsids in the transfected HepG2 cells. Furthermore, we investigated the increased HBV core assembly by HBx. The results show that the increased cytosolic calcium ions by HBx promote the HBV core assembly.     

中国南北两城市乙型肝炎病毒基因型与血清型的构成差异

目的对我国南北两城市530份乙型肝炎(乙肝)病毒(HBV)进行血清型和基因型分型,以了解HBV基因型和血清型分布的特点和差异。方法 对黑龙江省哈尔滨市和广东省廉江市530份乙肝病毒表面抗原(HBsAg)阳性血清进行HBV DNA基因扩增,并对扩增产物直接测序,分析HBV血清亚型和基因型。结果 哈尔滨和廉江市HBV血清型以adrq为最多,分别为87.2％和73.5％,其次为adw2,分别为12.0％和25.7％,其分布差异有非常显著意义(P<0.001);两市HBV基因型均以C型为主,分别为87.8％,73.2％,其次为B型,分别为12.2％和26.1％,其分布差异有非常显著意义(P<0.001),在廉江市仅有1例D型,1例B、C混合型。结论我国南北两城市HBV血清亚型和基因型的构成较为单纯,均只有两个类型,其比例构成差异有非常显著意义。