Epidemiology and natural history of hepatitis C virus infection among children and young people

1. Download high-res image (105KB)
2. Download full-size image

     

Global epidemiology of viral hepatitis and national needs for complete control

Introduction. The World Health Organization recognizes that viral hepatitis is not only a massive public health issue but also a huge opportunity to improve quality of life and equity at a global level. Viral hepatitis causes about 1.5 million deaths each year and significantly affects the quality of life of hundreds of millions of people. To date, frail individuals in high-income countries and people living in low-income settings are paying the heaviest tool.

Areas covered. Here we present a broad discussion on current knowledge and topical issues about the hepatitis pandemic. The report includes a structured overview of global epidemiology, including the definition of specific local epidemic profiles for each hepatitis agents (HAV, HBV, HCV, and HEV), and a perspective about the critical actions needed for achieving a complete control.

Expert commentary. The control of viral hepatitis is currently, ethically urgent and even economically convenient. There is a wide consensus that viral hepatitis can be controlled through comprehensive intervention tailored on local needs addressing the issue of viral hepatitis as a unique public health issue. These strategies should include: (1) primary prevention (including vaccination and improved infection control), (2) improving diagnosis rate, and (3) management of existing cases of infections.     

Novel vaccine concept based on back-boost effect in viral infection

A novel vaccine concept is discussed based on recent evidence of a “back-boost” effect in Influenza infection. The initial immune response to the infection is imprinted through an immune memory pathway. The immune memory in the back-boost mechanism could be used in reversed order as a “forward-boost” in the proposed vaccine concept.     

Improvement of BCG protective efficacy with a novel chimpanzee adenovirus and a modified vaccinia Ankara virus both expressing Ag85A

A replication-deficient chimpanzee adenovirus expressing Ag85A (ChAdOx1.85A) was assessed, both alone and in combination with modified vaccinia Ankara also expressing Ag85A (MVA85A), for its immunogenicity and protective efficacy against a Mycobacterium tuberculosis (M.tb) challenge in mice. Naïve and BCG-primed mice were vaccinated or boosted with ChAdOx1.85A and MVA85A in different combinations. Although intranasally administered ChAdOx1.85A induced strong immune responses in the lungs, it failed to consistently protect against aerosol M.tb challenge. In contrast, ChAdOx1.85A followed by MVA85A administered either mucosally or systemically, induced strong immune responses and was able to improve the protective efficacy of BCG. This vaccination regime has consistently shown superior protection over BCG alone and should be evaluated further.     

曲美他嗪联合黄芪注射液治疗急性病毒性心肌炎疗效观察

目的 分析曲美他嗪联合黄芪注射液对急性病毒性心肌炎患者的临床治疗效果.方法 将60例急性病毒性心肌炎患者按照随机双盲的原则均分为对照组和观察组(n=30).对照组患者治疗上给予注射用辅酶A静脉滴注,1次/d,1次300单位,三磷酸腺苷二钠片,口服,3次/d,1次2片;维生素C注射液,静脉滴注,3次/d,1次250 mg;1,6二磷酸果糖注射液静脉滴注,1次/d,1次5 g;观察组患者在上述常规治疗的基础上同时给予曲美他嗪和黄芪注射液治疗,口服,3次/d,1次1片,黄芪注射液静脉滴注,1次/d,1次30 mL.比较2组患者的临床治疗有效率及心电图改善情况.结果 对照组患者的临床治疗总有效率70.00%明显低于观察组90.00%,差异有统计学意义(P<0.05);经过治疗,对照组患者的ST-T改善情况总有效率70.00%明显差于观察组90.00%.结论 对于急性病毒性心肌炎患者在常规治疗的基础上加用曲美他嗪和黄芪注射液,不仅提高临床治疗效果,而且有助于患者心肌缺血情况的改善.     

优质护理在慢性乙型病毒性肝炎患者中的临床效果观察

目的研究优质护理策略在慢性乙型病毒性肝炎治疗中的临床效果。方法对入住该院治疗的慢性乙型病毒性肝炎患者106例进行研究,随机分为二组,在常规药物治疗的基础上,对照组给予基础护理,观察组患者给予优质护理策略,包括:宣讲教育、心理护理、饮食护理以及医护人员的管理等。结果观察组患者18个月的HBeAg转阴率、HBV DNA转阴率以及HBeAg/抗-HBe血清转化率均明显高于对照组,二组比较差异有统计学意义(P<0.05);观察组患者生活、饮食、用药等综合生活质量评分均明显高于对照组,差异有统计学意义(P<0.05);观察组临床总有效率为90.6%,明显高于对照组71.7%,二组比较差异有统计学意义(P<0.05)。结论优质护理在慢性乙型病毒性肝炎患者的治疗中具有重要的作用,改善患者疾病状态更明显,可以显著提高生存质量,临床总有效率更高,值得在临床治疗中予以关注。     

HBV病毒复制机制及慢性乙型肝炎药物靶点

乙型肝炎病毒(HBV)感染是一种严重影响公共卫生与人体健康的全球性流行性疾病,尽管乙肝防治已有很大提高,但仍缺乏高效的药物与手段。研究表明,肝损伤、肝衰竭程度与HBV及宿主免疫系统相互作用存在复杂关系。因而详细地探明HBV生命周期和感染过程,为研究HBV药物靶点和制定新的抗病毒策略提供前期坚实的基础,意义重大。该文详细介绍HBV病毒复制机制,并系统地阐述近年来新发现的和潜在的药物靶点,为制备新型的抗HBV药物提供参考。     

Molecular mechanisms implicated in SARS-CoV-2 liver tropism

The coronavirus disease 2019 (COVID-19) pandemic is caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Hepatic involvement is common in SARS-CoV-2-infected individuals. It is currently accepted that the direct and indirect hepatic effects of SARS-CoV-2 infection play a significant role in COVID-19. In individuals with pre-existing infectious and non-infectious liver disease, who are at a remarkably higher risk of developing severe COVID-19 and death, this pathology is most medically relevant. This review emphasizes the current pathways regarded as contributing to the gastrointestinal and hepatic ailments linked to COVID-19-infected patients due to an imbalanced interaction among the liver, systemic inflammation, disrupted coagulation, and the lung.