Drug-induced liver injury by glecaprevir/pibrentasvir treatment for chronic hepatitis C infection: a systematic review and meta-analysis

Background: Glecaprevir/pibrentasvir (G/P; 300 mg/120 mg) is a new direct-acting antiviral (DAA) that exhibits anti-hepatitis C virus (HCV) pan-genotype (GT) activity for 8, 12, or 16 weeks. However, the U.S. Food and Drug Administration have received reports that using G/P causes moderate to severe liver impairment. In some cases, isolated hyperbilirubinemia and jaundice have been reported without concomitant evidence of increased transaminase levels or other hepatic decompensation events. Objective: This study aimed to analyze the incidence of drug-induced liver injury of G/P for chronic hepatitis C virus.Materials and methods: We searched databases from the inception of each database until March 2021. Data were pooled using a random-effects model. The Cochrane Risk of Bias Tool (RoB 2.0) and the OpenMeta [Analyst] software were performed for quality assessment and quantitative studies, respectively. The primary outcome was grade 3 level of drug-induced liver injury (DILI). Results: The nine studies included in the meta-analysis involved a total of 7,650 participants, and the overall sustained virologic response rate was above 95%. The most frequent drug-related laboratory abnormalities in DILI involved total bilirubin, alanine aminotransferase, aspartate aminotransferase, and hemoglobin, but these abnormalities were minimal. The cirrhosis–without cirrhosis incidence risk ratio (IRR) was 2.724 (95% confidence interval: 1.182–6.276) in the grade 3 hyperbilirubinemia subgroup analysis. No significant differences were found within the other subgroups, in HCV GTs, and in treatment duration.Conclusions: DILI was found to occur frequently with G/P treatment. Hyperbilirubinemia occurred most frequently, especially, in patients with cirrhosis. However, G/P is still the primary therapy of choice for CKD and end-stage renal disease (ESRD) patients due to a superior safety rate.     

乙肝后肝硬化患者外周血T淋巴细胞亚群及HBV-DNA含量变化分析

目的探讨乙肝后肝硬化患者外周血T淋巴细胞亚群及HBV-DNA含量变化与临床意义。方法对75例肝炎后肝硬化患者及30例正常人群进行T淋巴细胞核仁形成区嗜银蛋白(AgNORs)及HBV-DNA含量检测。结果肝硬化组与正常对照组T淋巴细胞AgNORs活性有明显差异,肝硬化组Child分级中T淋巴细胞活性逐渐降低,HBV-DNA含量间差异无统计学意义。结论随着肝硬化患者病情加重,T淋巴细胞AgNORs活性逐渐降低,HBV-DNA含量差异无统计学意义。     

乙型重型肝炎抗病毒治疗研究进展

通过抗病毒治疗降低乙型重型肝炎患者机体HBV载量,缓解过强的免疫反应,从而缓解病情,成为治疗乙型重型肝炎的一种可行性思路。但目前对此仍存在争议。文中就目前乙型重型肝炎是否行抗病毒治疗,抗病毒治疗的时机、特点以及药物的选择等方面进行了综述。     

利用基因参照品图谱分析克拉玛依地区HBV基因型

目的了解克拉玛依地区HBV基因型分布状况,比较其与GenBank HBV序列同源性以及进化树分析。方法通过对S基因区B、C、D型GenBank序列分析,研究MboⅠ酶和EarⅠ酶在不同型中具有独特的切点,利用限制性片段多态性分析(PCR_RFLP)区分各型,将各个基因型与GenBank序列进行1∶1同源性比对的进化树分析。结果272份样品有241份成功分型。C型44.8%,B型36.9%,D型4.1%,B C型10.8%,B D型3.3%。少数民族C型40.4%,B型30.7%,D型9.6%。B、C、D型的同源性分别是97.8%~98.7%,96.9%~99.3%,97.5%~99.0%。进化树分析发现,克拉玛依地区的2例D型与新疆哈密地区D型进化距离最近。结论克拉玛依地区HBV基因型B、C、D均有,以B、C型占优势,未检测到A型,D型与新疆哈密地区D型有较近的亲缘关系。     

丙型肝炎病毒感染与糖尿病

近年来,有很多流行病学调查证实了HCV感染与糖尿病的关联,这种关联在年龄大、体重超标的患者身上表现更为明显。HCV编码的蛋白,能干扰胰岛素的信号转导,这就解释了在发生肝纤维化之前,HCV感染者出现胰岛素抵抗的原因,而胰岛素抵抗也促进了肝纤维化的进程。     

γ-谷氨酞转移酶在肝脏疾病中的诊断

γ_谷氨酞转移酶(gamma_glutamyltransferase,GGT)检测在临床疾病的诊断中应用较广。GGT增高可见于胆道梗阻、病毒性肝炎、酒精肝以及肝癌等多种疾病,近年来对该酶的研究较多,尤其是肝癌特异性GGT及GGTmRNA亚型在肝癌中的诊断价值。本文就GGT在肝脏疾病诊断中的研究进展进行综述。     

1997-2005年东北林业大学新生乙型肝炎病毒感染情况

目的 为了解大学生HBV的感染状况及近9年来的变化,为今后制定更有效的预防措施提供依据.方法 对1997-2005年连续9届大学生进行HBsAg检测结果按性别、学段分别计算阳性率,用卡方检验进行比较,对感染情况用线性回归方法进行分析.结果 HBsAg阳性率线性回归分析方程为Y=-0.31X 625.98,相关系数R=-0.642.9年合计男生HBsAg阳性率为6.2%,女生阳性率为3.9%,男女生差异具有统计学意义(x2=83.83,p＜0.01).结论 HBsAg阳性率自1999年起显著下降,2003年起有所回升,男生阳性率高于女生.应积极对未感染HBV者接种乙肝疫苗.     

孕妇丙型肝炎病毒感染影响因素的病例对照研究

目的 了解孕妇人群丙型肝炎病毒(hepatitis C virus,HCV)感染的影响因素,为科学制定预防控制策略提供理论依据.方法 采用1:2配比的病例对照的研究方法,对甘肃省妇幼保健院2008-2018年兰州地区227例抗-HCV阳性的孕妇进行研究.采用条件logistic回归模型进行孕妇HCV感染影响因素的单因素...     

Unexpectedly High Prevalence of Hepatitis C Virus Infection,Southern Laos

During 2017–2019, a total of 88/753 (11.7%) of patients 5–90 years of age in hospitals in Saravan Province, Laos, were seropositive for hepatitis C virus antibodies. Viral RNA was found in 44 samples. Sequencing showed high diversity within genotype 6. We recommend exposure-risk investigations and targeted testing and treatment.     

乙型肝炎重组酵母疫苗接种6～9年的人群免疫效果研究

目的评价新生儿乙肝重组酵母疫苗普种预防HBV感染的免疫效果,探讨乙肝重组酵母疫苗免疫持久性。方法采用出生队列定群研究结合横断面调查的方法,研究乙肝重组酵母疫苗免疫人群的效果;用固相放射免疫分析法检测HBV感染标志。结果(1)HBsAg平均阳性率1.9%(95%CI 1.4~2.4%),总保护性抗体阳性率为53.2%(95%CI 51.2%~55.2%)。(2)从免疫后1年的88.2%下降到免疫后9年的44.3%。(3)疫苗保护率为89.9%,与2000年的数据比较无显著性差异。结论新生儿普种乙肝疫苗可有效预防HBV感染,免疫人群乙肝保护性抗体水平随接种年限延长呈下降趋势,但疫苗保护效果仍然稳定。