摘要
Medicinal plants are used to cure diseases, and their replacement is frequent and affects public health. The genus Baccharis has representatives within the medicinal flora of Argentina, although the replacement of the species of this genus known under the vulgar name of "carqueja" by Baccharis spicata has been detected i n herbalists or markets of herbal products. The genotoxic safety of this species has been established in previous work of our group. The aim of this study was to evaluate the antiviral activity of an infusion made from B. spicata leaves against hepatitis B virus with the HepG2.2.15 cellular system and to determine cytotoxicity in HepG2.2,15, A549 and Vero cell lines. Infusion of B. spicata was active to inhibit HBV replication with an EC 50 of 22.54 µg/mL and a CC 50 of 190 µg/mL.
Las plantas medicinales son empleadas para la cura de enfermedades, y su sustituc ión es frecuente y afecta a la salud pública. El género Baccharis posee representantes dentro de la flora medicinal de Argentina, aunque se ha detectado la sustitución de las especies de dicho género conocidas bajo el nombre vulgar de "carqueja" por Baccha ris spicata en herboristerías o mercados de productos herb arios . Se ha establecido la seguridad genotóxica de esta especie en trabajos previos de nuestro grupo. Este estudio buscó evaluar la actividad antiviral de una infusión elaborada a partir de hojas de B. spicata frente al virus de la hepatitis B con el sistema celular HepG2.2.15 y determinar la citotoxicidad en las líneas celulares HepG2.2.15, A549 y Vero. La infusión de B. spicata fue activa para inhibir la replicación del virus con un EC 50 de 22.54 µg/mL y un CC 50 de 190 µg/mL.
Subject(s)
Baccharis/drug effects , Baccharis/chemistry , Hepatitis B/drug therapy , Plants, Medicinal/chemistry , Cell Line/metabolism , Medicine, Traditional/methods摘要
ObjectiveTo investigate the clinical features and outcomes of critically ill pregnant and parturient women with chronic hepatitis B virus （HBV） infection， and to provide clinical experience for the rescue of critically ill pregnant and parturient women and the prevention and treatment of the severe exacerbation of liver disease. MethodsA total of 41 pregnant and parturient women with chronic HBV infection who were admitted to Department of Critical Care Medicine， Nanjing Second Hospital， from March 2013 to March 2023 were enrolled in this study， and their clinical data were collected through the electronic medical record system of hospital to summarize the main causes of transfer to the intensive care unit （ICU）， the causes of death， and treatment. The independent-samples t test was used for comparison of normally distributed continuous data between two groups， and the Mann-Whitney U test was used for comparison of non-normally distributed continuous data between two groups. The chi-square test was used for comparison of categorical data between two groups. ResultsAmong the 41 patients， 13 （31.71%） did not receive regular antenatal examination and 8 （19.51%） with a high viral load （HBV DNA ≥2×105 IU/mL） did not receive antiviral therapy. Cesarean section was the main mode of delivery in 32 patients （78.05%）； 23 patients （56.10%） had premature delivery， and 5 patients died （12.20%）. The top three causes of transfer to the ICU were liver failure， postpartum hemorrhage， and hypertensive disorders of pregnancy. Liver failure mainly occurred in late pregnancy， with hepatic encephalopathy as the most common complication （28.57%） and intrahepatic cholestasis of pregnancy as the most common comorbidity （21.43%）； among the 14 patients with liver failure， 6 （42.86%） received regular antenatal examination， and 13 （92.86%） did not receive antiviral therapy before admission. The mean length of ICU stay was 3.31±1.65 days for the patients with postpartum hemorrhage， among whom the patients with severe liver disease had coagulation disorders before delivery， which were difficult to correct after 48 hours of treatment. ConclusionPregnant and parturient women with chronic HBV infection tend to have complex conditions and a relatively high mortality rate. For pregnant and parturient women with chronic HBV infection， assessment of liver status， regular antenatal examination， and timely antiviral therapy are of vital importance to reduce severe exacerbation and mortality rate.
摘要
ObjectiveTo investigate the clinical value of serum creatinine-to-cystatin C ratio （CCR） in evaluating the prognosis of hepatitis B virus-related acute-on-chronic liver failure （HBV-ACLF）. MethodsA retrospective analysis was performed for the clinical data of 130 patients with HBV-ACLF （treatment group） who were hospitalized in Department of Infectious Diseases， The First Affiliated Hospital of Soochow University， from January 2021 to November 2022. According to the treatment outcome， they were divided into survival group with 87 patients and death group with 43 patients； according to the presence or absence of infection， they were divided into infection group with 37 patients and non-infection group with 93 patients. A total of 30 individuals who underwent physical examination during the same period of time were enrolled as control group. Routine blood test results were collected on the day of admission， including white blood cell count， platelet count， neutrophil count， and lymphocyte count； serum creatinine， cystatin C， serum albumin （Alb）， and prothrombin time （PT） were observed on the day of admission and on days 5， 10， and 15 of hospitalization， and related indicators were calculated， including CCR， neutrophil-to-lymphocyte ratio （NLR）， platelet-to-lymphocyte ratio （PLR）， prognostic nutritional index （PNI）， CCR5 （CCR on day 5 after admission）， ΔCCR5 （CCR on day 5 after admission minus CCR on the day of admission）， CCR10 （CCR on day 10 after admission）， ΔCCR10 （CCR on day 10 after admission minus CCR on day 5 after admission）， CCR15 （CCR on day 15 after admission）， and ΔCCR15 （CCR on day 15 after admission minus CCR on day 10 after admission）. The above indicators were compared between the survival group and the death group and between the infection group and the non-infection group. The Mann-Whitney U test was used for comparison of continuous data between two groups， and the Kruskal-Wallis H test was used for comparison between multiple groups. The univariate and multivariate logistic regression analyses were used to investigate the influencing factors for disease prognosis； the receiver operating characteristic （ROC） curve was used to assess the value of CCR in predicting HBV-ACLF death events， and the DeLong test was used for comparison of the area under the ROC curve （AUC）. ResultsThere were significant differences in CCR， NLR， PNI， PT， and Alb at baseline between the treatment group and the healthy control group （all P<0.001）， and there were significant differences in CCR， NLR， and PT between the survival group and the death group on the day of admission （all P<0.05）. Among the 130 patients with HBV-ACLF， there were 25 in the precancerous stage， 48 in the early stage， 32 in the intermediate stage， and 25 in the advanced stage， and there were significant differences in baseline CCR， PLR， and PT between the patients in different stages of HBV-ACLF （all P<0.05）. There were significant differences in ΔCCR5 and NLR between the infection group and the non-infection group （P<0.05）， and there were significant differences in ΔCCR5， CCR10， and CCR15 between the survival group and the death group （all P<0.05）. The multivariate logistic regression analysis showed that ΔCCR5 （odds ratio ［OR］=1.175， 95% confidence interval ［CI］： 1.098 — 1.256， P<0.001）， NLR （OR=0.921， 95%CI： 0.880 — 0.964， P<0.001）， and PT （OR=0.921， 95%CI： 0.873 — 0.973， P=0.003） were independent influencing factors for the prognosis of HBV-ACLF patients. ΔCCR5 had an AUC of 0.774， a sensitivity of 0.687， and a specificity of 0.757， and the AUC of ΔCCR5+PT+NLR was 0.824， which was significantly higher than the AUC of ΔCCR5， NLR， or PT alone （all P<0.05）. ConclusionΔCCR5， NLR， and PT can reflect the condition and prognosis of patients with HBV-ACLF and are independent predictive indicators for death events in patients with HBV-ACLF. The combination ofΔCCR5， PT， and NLR has the best predictive efficiency.
摘要
【Objective】 To investigate asymptomatic infection of hepatitis B virus(HBV) among hepatitis B vaccinated donors in Shenzhen, and analyze its serological and molecular characteristics. 【Methods】 The HBsAg ELISA positive blood samples of blood donors born after 1992 were collected. HBsAg, anti-HBs, HBeAg, anti-HBe and anti-HBc were further detected by Roche electrochemiluminescence immunoassay (ECL). BCP/PC and S regions were amplified by Nested-PCRs, HBV DNA quantification were adopted by qPCR simultaneously, and the sequences were also analyzed. 【Results】 A total of 46 632 blood samples of donors(31 612 males and 15 020 females) from December 2020 to January 2022 collected, and 99 samples with HBsAg ELISA positive were screened out. After tested by ECL, Nested-PCRs, and real-time fluorescence PCR, 61 were confirmed HBsAg positive, with the positive rate at 0.13% (61/46 632), including 49 males (0.16%, 49/31 612) and 12 females (0.08%, 12/15 020). The HBsAg positive rate of males was higher than that of females (P<0.05). 50 out of 61 sequences for S region were obtained. By phylogenetic analysis, there were 46 cases of type B (92%, 46/50, 38 males and 8 females), 4 cases of type C (8%, 4/50, 3 males and 1 female). The high frequency mutations observed in S region were N40S (8/46,17.39%), G44E (7/46,15.22%), Q129H/R(6/46,13.04%), Y161F/S(7/46, 15.22%), V179A(4/46,8.70%), S53L(2/4,50%), C69T(2/4,50%) and I126S/T(2/4,50%), including the immune escape mutations Q129R and T/I126A/N/S/T. 【Conclusion】 Hepatitis B vaccination can significantly reduce the positive rate of HBsAg and increase the safety of blood transfusion. The high frequency immune escape mutations have become a potential risk of blood safety, and need to be further explored.
摘要
【Objective】 To analyze the correlation between the distribution interval of minipool nucleic acid testing(NAT) positive CT value and the resolution rate, so as to improve the retest model and reduce residual risk of blood transfusion. 【Methods】 The resolution testing results by Cobas S201 system of our blood center from January 2017 to December 2021 were retrospective analyzed, and the retest model was developed based on the distribution interval of CT values. For minipool NAT HBV positive samples from March 2022 to March 2023, synchronous detection was conducted by Cobas S201 and Panther detection system, and the detection results were statistically analyzed. 【Results】 From 2017 to 2021, 474 were minipool NAT positive, among which 324 were HBV positive, accounting for 68.35%. From 2017 to 2020, the proportion of HBV positive per year was significantly higher than that of HCV and HIV(P40, with the resolution rate at 95.8%, 56.5% and 14.8% respectively(P40, 36
摘要
<b>Objective</b> To investigate the long-term safety and effectiveness of withdrawal of hepatitis B immuneglobulin (HBIG) and/or nucleos(t)ide analogues (NAs) to prevent hepatitis B virus (HBV) reinfection in liver transplant recipients with hepatitis B-related diseases after successful vaccination. <b>Methods</b> Baseline data of 76 liver transplant recipients undergoing hepatitis B immune reconstitution after receiving hepatitis B vaccines were retrospectively analyzed. The vaccination and response, the follow-up results of respondents with HBIG and/or NAs withdrawal, and the reinfection of HBV after withdrawal of HBIG and/or NAs were analyzed. <b>Results</b> The time interval from liver transplantation to hepatitis B vaccination was 26 (20, 40) months. The time interval from vaccination to response was 15 (8,27) months. Initially, 76 recipients withdrew HBIG, and 36 recipients withdrew HBIG and NAs. During the follow-up, 12 of 76 recipients who withdrew HBIG resumed use of HBIG, and 16 of 36 recipients who withdrew HBIG and NAs resumed use of NAs. The withdrawal time of HBIG and NAs was 135 (98,150) and 133 (34,149) months, respectively. Sixteen respondents did not receive booster, and 36 respondents received boosters on a regular basis. The time interval between the first booster and HBIG withdrawal was 44 (11,87) months. No significant differences were observed in baseline data between the respondents with and without boosters (all <i>P</i>>0.05). During the follow-up, 9 recipients were lost to follow-up, 5 were re-infected with HBV, 3 died, and 1 recipient developed graft loss and underwent secondary liver transplantation. Among 5 recipients re-infected with HBV, 4 cases had virus mutation. Significant differences were found between re-infected and uninfected patients regarding withdrawal of NAs and hepatitis B e antigen (HBeAg) positive before transplantation (both <i>P</i><0.05). <b>Conclusions</b> Long-term withdrawal of HBIG is feasible and safe for recipients with successful hepatitis B immune reconstitution after liver transplantation for hepatitis B-related diseases. Nevertheless, whether antiviral drugs can be simultaneously withdrawn remains to be validated.
摘要
Objective To analyze the application value of alpha-fetoprotein (AFP) and interleukin-6 (IL-6) in prognosis prediction of hepatitis B virus (HBV) associated liver failure. Methods A total of 135 patients with HBV-related liver failure who underwent treatment at the Infection Department of the Second People's Hospital of Yibin City from July 2020 to June 2022 were selected as the study subjects (observation group). Additionally, 100 patients who underwent physical examination in the hospital during the same period with normal indicators were selected as the control group. Serum levels of AFP and IL-6 were compared between the two groups. Factors influencing the prognosis of HBV-related liver failure were analyzed. Multiple logistic regression was used to analyze the risk factors affecting the prognosis of HBV-related liver failure patients. Results The levels of serum AFP and IL-6 in the control group were lower than those in the control group, and the difference was statistically significant (P10.0 pg/mL were risk factors affecting the prognosis of HBV-related liver failure. Conclusion Serum AFP and IL-6 can predict the prognosis of patients with HBV-related liver failure, which is worthy of clinical study.
摘要
Viral hepatitis is a common infectious disease caused by a variety of hepatitis viruses,mainly including types A,B,C,D and E,among which hepatitis B virus(HBV)and hepatitis C virus(HCV)infection are more common.It is one of the important causes of liver cirrhosis and hepatocellular carcinoma.In the case of pregnancy,the interaction between pregnancy and viral infection must be considered,including the impact of the virus on fetal development,the impact on maternal health,and the progression of the disease itself caused by pregnancy,among which the prevention of mother-to-child transmission is the key to reducing the global burden of chronic viral hepatitis.In September 2023,the American College of Obstetricians and Gynecologists(ACOG)published the clinical practice guidelines for viral hepatitis in pregnancy,which replaced the 2007 version.According to the Grading of Recommendations Assessment,Development and Evaluation(GRADE),the guidelines put forward six suggestions.This paper interpreted the important recommended updates of the guidelines one by one,in order to provide help for the clinical practice of viral hepatitis during pregnancy.
摘要
Objective To study the effect of NAD(P)H:quinone oxidoreductase 1(NQO1)expression lev-el on prognosis in patients with hepatitis B virus-related hepatocellular carcinoma(HBV-HCC).Methods A total of 103 patients with HBV-HCC underwent surgical treatment in Seventh People's Hospital of Shanghai University of Traditional Chinese Medicine from March 2019 to January 2020 were enrolled.The cancer tissue and adjacent normal tissues were extracted during surgery.Immunohistochemical staining was used to detect the expression of NQO1 in tissues.The clinical and pathological data of patients were collected,and the rela-tionships between high and low expression of NQO1 and pathological characteristics were discussed.A 3-year follow-up was conducted,and the Kaplan-Meier survival curve was drawn and Log-rank test was conducted on median survival time.Then COX model analysis was used to analyze the factors affecting the prognosis of HBV-HCC patients.Results The positive rate of NQO1 in HBV-HCC tissues was 84.47％(87/103)and the high expression rate was 59.22％(61/103).The positive rate and the high expression rate of NQO1 in HBV-HCC tissues were higher than those in adjacent normal tissues(P＜0.05).There were statistically significant differences in tumor maximum diameter,number of lesions,American Joint Committee on Cancer(AJCC)staging,and vascular invasion between patients with high and low expression of NQO1(P＜0.05).The 3-year follow-up results denoted that the median survival time of patients was 37 months,and no cases were lost in follow-up.Among 103 patients,there were 34 dead cases with an overall survival rate of 66.99％(69/103)and 42 recurrence cases with a recurrence-free survival rate of 59.23％(61/103).Kaplan-Meier survival curve re-sults showed that the overall survival rate and recurrence-free survival rate were 52.46％(32/61)and 50.82％(31/61)in NQO1 high expression group,which were lower than 88.10％(37/42)and 71.43％(30/42)in NQO1 low expression group(P＜0.05).COX model analysis results showed that high expression of NQO1,tumor maximum diameter ≥5 cm,multiple lesions,AJCC stage Ⅲ to Ⅳ and vascular invasion were independ-ent risk factors for prognosis(P＜0.05).Conclusion NQO1 is highly expressed in HBV-HCC tissue,and is related to the clinicopathological characteristics of patients,so it could be used as an independent biomarker for evaluating prognosis.
摘要
Objective:To develop and validate a postoperative infection nomogram of hepatitis B-associated hepatocellular carcinoma (HCC) after hepatectomy.Methods:Clinical data of 229 patients with HCC undergoing hepatectomy at the Department of Hepatobiliary Surgery of Tianjin Third Central Hospital from January 2014 to December 2022 were retrospectively analyzed, including 174 males and 55 females, aged (58.2±11.4) years. LASSO regression analysis screened the factors associated with hepatitis B-associated HCC infection after hepatectomy, which were further incorporated into multivariate logistic regression analysis. A nomographic prediction model was established based on the results of multivariate logistic regression analysis. Concordance index (C-index), calibration curve and receiver operating characteristic (ROC) curve were used to evaluate the model, and decision curve analysis (DCA) was used to analyze the clinical applicability of the model. Internal validation of the model was performed using bootstrap method.Results:A total of nine variables were screened as factors associated with the postoperative infections using LASSO regression, including gender, smoking history, body mass index (BMI), serum level of alpha fetoprotein, resection fashion (anatomical or non-anatomical), intraoperative blood loss, surgical method (laparoscopy or open), serum level of creatinine, and postoperative biliary fistula. Multivariate logistic regression analysis showed that BMI, resection fashion, intraoperative blood loss >500 ml, and postoperative biliary fistula were risk factors for postoperative infection (all P<0.05). Based on the above risk factors, a postoperative infection nomogram of hepatitis B-associated HCC after hepatectomy was established. The C-index was 0.839 (95% CI: 0.768-0.910), and the area under ROC curve was 0.853 (95% CI: 0.795-0.912), indicating that the model had a good predictive ability. The calibration curve was basically consistent with the ideal curve. The DCA showed that the model had a good clinical applicability. Internal validation C-index was 0.829 (95% CI: 0.766-0.892). Conclusion:The nomogram based on BMI, surgical resection fashion, intraoperative blood loss >500 ml, and postoperative biliary fistula has a high predictive accuracy and can be used to predict postoperative infections after hepatectomy for HCC.
摘要
Guidelines for the prevention and treatment of chronic hepatitis B （2022 edition） expanded the indications for antiviral therapy in patients with chronic hepatitis B. The guidelines recommend to initiate antiviral therapy for patients with chronic HBV infection who have a normal alanine aminotransferase （ALT） level， positive HBV DNA， and an age of >30 years. However， for pregnant women aged >30 years， no consensus has been reached on whether to start antiviral therapy immediately. Some experts believe that pregnant women with a normal ALT level are mostly in the immune-tolerant phase， and antiviral therapy tends to have an unsatisfactory therapeutic effect； in addition， medication during pregnancy may affect the safety of mothers and fetuses. Therefore， it is not recommended to start antiviral therapy immediately in early pregnancy even if the pregnant women are aged >30 years. Other experts believe that immune changes of the body during pregnancy may be a special period for HBV immune clearance， and if the patients are aged >30 years， antiviral therapy should be initiated immediately even if the patient has a normal ALT level； pregnant women may get better virologic and even serological response. With a focus on the above issues， this article elaborates on the purpose， treatment timing， and drug withdrawal timing of antiviral therapy during pregnancy.
摘要
Chronic hepatitis B （CHB） is a major public health issue around the world， and there are currently about 2 million children with hepatitis B virus （HBV） infection in China. HBV infection in children tends to become chronic， leading to high risks of liver cirrhosis and liver cancer in adulthood. Traditionally， it is believed that children with HBV infection are mainly in the immune-tolerant phase and do not require antiviral therapy， and antiviral therapy is only initiated for CHB children who are in the immune-active phase or suffer from compensated or decompensated liver cirrhosis. More and more clinical studies on CHB in children have shown that CHB children tend to have a high response rate to antiviral therapy， especially interferon-based regimens， and young children are at the advantage of clinical cure； however， there are still controversies over whether antiviral therapy should be initiated for children with HBV infection who have a normal alanine aminotransferase （ALT） level and are in the immune-tolerant phase. This article reviews the features of children with HBV infection and the necessity of antiviral therapy for children with a normal ALT level， with a special focus on treatment timing.
摘要
To achieve the goal of “eliminating viral hepatitis as a public health hazard by 2030”， extensive screening， active prevention， and antiviral therapy are currently recommended for chronic hepatitis B virus （HBV） infection； however， no consensus has been reached on whether to initiate antiviral therapy for patients in the immune-tolerant phase of chronic HBV infection. Some experts believe that patients in the immune-tolerant phase tend to have a stable liver immune microenvironment， with a low risk of disease progression and poor response to treatment， and thus it is not recommended to initiate antiviral therapy. However， various other studies have shown that patients in the immune-tolerant phase still have inflammatory damage in the liver， with a risk of disease progression and a high level of cost effectiveness， and therefore， some experts suggest that antiviral therapy should be actively initiated for patients in the immune-tolerant phase. This article performs a literature review of the definition of patients in the immune-tolerant phase of chronic HBV infection and the advantages and disadvantages of antiviral therapy and conducts a preliminary analysis based on previous studies， in order to accumulate the evidence for whether to initiate antiviral therapy in the immune-tolerant phase of chronic HBV infection and lay a foundation for standardized clinical diagnosis and treatment of patients in the immune-tolerant phase.
摘要
ObjectiveTo investigate the value of magnetic resonance imaging-proton density fat fraction （MRI-PDFF） in evaluating hepatic steatosis in patients with chronic hepatitis B virus （HBV） infection. MethodsThe patients， aged >16 years， who visited the outpatient service or were hospitalized in Beijing Tsinghua Changgung Hospital from January 2018 to December 2022 and were diagnosed with chronic HBV infection were enrolled， and all patients underwent MRI examination of the liver in our hospital. The patients were divided into groups based on the presence or absence of liver cirrhosis， and the consistency in PDFF between different hepatic segments was compared between groups. The Kappa consistency test and intraclass correlation coefficient （ICC） were used for consistency analysis. ResultsA total of 76 patients treated with nucleoside analogues were enrolled， among whom 23 （30.26%） had liver cirrhosis. For all patients， the simple arithmetic average of PDFF fluctuated between 1.49% and 30.93%. According to MRI-PDFF ≥5% as the diagnostic criterion for fatty liver disease， there were 29 patients （38.16%） with fatty liver disease among all patients. For all 76 patients， the simple arithmetic average of PDFF was lower than the weighted average of PDFF for the whole liver， and there was no significant difference between the simple arithmetic average of PDFF， the weighted average of PDFF， and the PDFF values of the left and right lobes of the liver （F=0.39， P=0.76）. The consistency test showed that the PDFF values of each hepatic segment and the left and right lobes of the liver had strong consistency with the weighted average and simple arithmetic average of PDFF， with an ICC of >0.75， but the consistency between the PDFF value of the right lobe and the weighted average of PDFF was higher than that between the PDFF value of the left lobe and the weighted average of PDFF. In the consistency test of differentiating fatty liver disease in patients with liver cirrhosis， there was poor consistency between the PDFF value of segment Ⅶ and the weighted average of PDFF （Kappa=0.39）， with moderate consistency for the left lobe and the Ⅰ， Ⅱ， Ⅲ， Ⅴ， Ⅵ， and Ⅷ segments. For the patients with liver cirrhosis， the lowest consistency was observed between the PDFF value of Ⅶ segment and the weighted average of PDFF for the whole liver， and the highest consistency was observed between the PDFF value of Ⅵ segment and the weighted average of PDFF for the whole liver. For the patients without liver cirrhosis， the lowest consistency was observed between the PDFF value of Ⅱ segment and the weighted average of PDFF for the whole liver， and the highest consistency was observed between the PDFF value of Ⅴ segment and the weighted average of PDFF for the whole liver. ConclusionMRI-PDFF is more comprehensive in evaluating hepatic steatosis in patients with chronic HBV infection， and for the patients with liver cirrhosis， there is poor consistency between the PDFF value of each segment and the weighted average of PDFF.
摘要
ObjectiveTo investigate the liver histopathological features of chronic hepatitis B （CHB） patients with normal alanine aminotransferase （ALT） and their correlation with serological markers. MethodsClinical data were collected from 137 patients with normal ALT who were treated in Wuxi Fifth People’s Hospital from April 2018 to June 2021， and the differences in liver histopathology and serological markers were analyzed， as well as the correlation between liver histopathology and serological markers. The chi-square test was used for comparison of categorical data between groups， and the Kruskal-Wallis H test was used for comparison of data between multiple groups. A Spearman rank correlation test was performed， and logistic regression was used to perform the multivariate analysis. ResultsIn the ALT ≤20 U/L， 20 — 29 U/L， and 30 — 40 U/L groups， the patients with significant inflammatory necrosis （≥G2） accounted for 57.4%， 53.4%， and 75%， respectively， and the patients with significant fibrosis （≥S2） accounted for 63.8%， 62.1%， and 75%， respectively. There was a significant difference in the degree of inflammatory necrosis between the patients with positive or negative HBeAg， the patients with different levels of serum HBV DNA， and the patients with different levels of serum HBV RNA （χ2=10.008， 6.911， and 7.946， all P<0.05）， and there was a significant difference in fibrosis stage between the patients with positive or negative HBeAg and the patients with different levels of serum HBV RNA （χ2=7.996 and 10.874， both P<0.05）. The degree of liver inflammation and fibrosis stage were not significantly correlated with serum HBV DNA （rs=0.024， P=0.785； rs=0.039， P=0.652）， while they were significantly correlated with serum HBV RNA （rs=0.222， P=0.009； rs=0.187， P=0.029）. The multivariate analysis showed that in CHB patients， positive HBeAg was an independent risk factor for inflammatory necrosis （odds ratio ［OR］=-0.302， 95% confidence interval ［CI］： -1.160 to 0.386， P=0.002） and fibrosis （OR=-0.387， 95%CI： -1.160 to 0.386， P=0.011）. ConclusionThere are varying degrees of inflammatory necrosis and fibrosis in the liver of CHB patients with normal ALT， and positive HBeAg is independent risk factor for significant inflammatory necrosis and fibrosis in liver tissue of these patients.
摘要
ObjectiveTo investigate the correlation of serum angiopoietin-1 （Ang-1）， angiopoietin-2 （Ang-2）， and Ang-1/Ang-2 ratio with HBA DNA and alanine aminotransferase （ALT） in patients with chronic hepatitis B （CHB） or liver cirrhosis. MethodsClinical data and serum specimens were collected from 99 patients with CHB and 59 patients with liver cirrhosis who were admitted to Beijing YouAn Hospital， Capital Medical University， from March 2018 to October 2019， and 46 individuals who underwent physical examination were enrolled as control group. PCR was used to measure serum HBV DNA level， and ELISA was used to measure the serum levels of Ang-1 and Ang-2. The serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio were compared between groups. The Kruskal-Wallis H test was used for comparison of non-normally distributed continuous data between multiple groups， and the Bonferroni method was used for further comparison between two groups； the Spearman correlation analysis was used to investigate the correlation of Ang-1， Ang-2， and Ang-1/Ang-2 ratio with HBV DNA and ALT. ResultsCompared with the control group， the CHB group and the liver cirrhosis group had a significant reduction in the level of Ang-1 （479.0 pg/mL and 208.4 pg/mL vs 671.0 pg/mL， both P<0.05）， and compared with the CHB group， the liver cirrhosis group had a significant reduction in the level of Ang-1 （P<0.001）. Compared with the control group， the CHB group and the liver cirrhosis group had a significant increase in the level of Ang-2 （286.1 pg/mL and 438.4 pg/mL vs 198.0 pg/mL， both P<0.001）， and compared with the CHB group， the liver cirrhosis group had a significant increase in the level of Ang-2 （P<0.001）. Compared with the control group， the CHB group and the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio （1.6 and 0.5 vs 3.4， both P<0.001）， and compared with the CHB group， the liver cirrhosis group had a significant reduction in Ang-1/Ang-2 ratio （P<0.001）. The Spearman correlation analysis showed that in the CHB group， Ang-1 was negatively correlated with HBV DNA and ALT （r=-0.400 and -0.394， both P˂0.001）， Ang-2 was positively correlated with HBV DNA and ALT （r=0.365 and 0.351， both P<0.001）， and Ang-1/Ang-2 ratio was negatively correlated with HBV DNA and ALT （r=-0.463 and -0.473， both P<0.001）； in the liver cirrhosis group， Ang-1， Ang-2， and Ang-1/Ang-2 ratio had no correlation with HBV DNA or ALT （all P>0.05）. ConclusionThere are significant changes in the serum levels of Ang-1 and Ang-2 and Ang-1/Ang-2 ratio in patients with CHB or liver cirrhosis， and Ang-1， Ang-2， and Ang-1/Ang-2 ratio reflects the degree of liver injury in patients with CHB to a certain extent.
摘要
ObjectiveTo explore the importance of post-vaccination serological testing （PVST） for children exposed to hepatitis B virus （HBV）， and analyze the factors affecting the progress of PVST. MethodsThe study focused on hepatitis B surface antigen （HBsAg）-positive pregnant women and their newborns residing in Tongzhou District， Beijing， who delivered at various obstetric institutions from January 1， 2020 to March 31， 2022. The obstetric institutions and community health service centers conducted follow-up visits 1 to 2 months after the children had received three doses of the hepatitis B vaccine （HepB）. ResultsThe vaccination rate of hepatitis B immunoglobulin （HBIg） was 100.00% （800/800）， with a successful PVST follow-up rate of 85.88% （687/800） in Tongzhou District. The initial non-response rate to immunization was 0.29% （2/687）， but successful immunization was achieved after re-immunization. The mother-to-infant transmission rate of hepatitis B was 0. Children who did not undergo PVST accounted for 14.13% （113/800）， with the main reasons being delays due to the COVID-19 pandemic， parents’ reluctance to allow venous blood collection due to the young age of the children， and loss to follow-up because children moved back to their parents’ place of origin. Logistic regression analysis showed that the proportion of PVST was higher among high-risk children （OR=30.009，P=0.001）， children with family residing in Beijing （OR=2.218，P=0.002）， and children whose mothers were <35 years old （OR=1.687，P=0.020）. ConclusionPVST is necessary for assessing the status of HBV immune response in newborns after vaccination with HepB. The COVID-19 pandemic impacted the implementation of PVST for children exposed to HBV. Strengthening the management of non-high-risk children， those living outside Beijing， and children with mothers aged ≥ 35 years old may increase the rate of PVST in Tongzhou District.
摘要
Objective@#To investigate the prevalence of hepatitis B virus (HBV) carriage among pregnant and lying-in women in Cangnan County, Zhejiang Province from 2011 to 2022 and identify the influencing factors, so as to provide insights into the guidance of healthcare among HBV carriers during pregnancy.@*Methods@#A total of 34 403 women delivered in The Third People's Hospital of Cangnan County from January 2011 to July 2022 were enrolled, and their demographics, HBV carriage and pregnant outcomes were collected. The prevalence of HBV carriage was analyzed among pregnant and lying-in women, and factors affecting HBV carriage were identified using a multivariable logistic regression model.@*Results@#A total of 34 403 pregnant and lying-in women were enrolled, with a median age of 27.00 (interquartile range, 7.00) years, and including 8 118 floating populations (23.60%). The overall prevalence of HBV carriage was 3.44%, and the prevalence of HBV carriage was 1.59% from 2011 to 2014, 4.08% from 2015 to 2018 and 6.86% from 2019 to 2022, appearing a tendency towards a rise (P<0.05). Multivariable logistic regression analysis identified estimated age of delivery (20-24 years, OR=1.832, 95%CI: 1.037-3.235; 25-29 years, OR=2.404, 95%CI: 1.372-4.214; 30-34 years, OR=2.914, 95%CI: 1.656-5.129; 35-39 years, OR=3.116, 95%CI: 1.741-5.576; 40 years and older, OR=2.358, 95%CI: 1.145-4.858), floating population (OR=0.670, 95%CI: 0.574-0.782), scarred uterus after cesarean section (OR=1.228, 95%CI: 1.076-1.521) and year of delivery (from 2015 to 2018, OR=2.504, 95%CI: 2.143-2.926; from 2019 to 2022, OR=4.425, 95%CI: 3.779-5.182) as factors affecting HBV carriage among pregnant and lying-in women.@*Conclusions@#The prevalence of HBV carriage rate appeared a tendency towards a rise among pregnant and lying-in women in Cangnan County from 2011 to 2022. Estimated age of delivery, floating population, year of delivery and scarred uterus after cesarean section are factors affecting HBV carriage.
摘要
ObjectiveTo predict whether antiviral therapy is required in patients with chronic hepatitis B virus （HBV） infection and an age of ≤30 years by establishing a noninvasive model， and to investigate the diagnostic value of this model. MethodsA retrospective analysis was performed for the clinical data of 175 patients with chronic HBV infection who were admitted to Shenzhen Third People’s Hospital from January 2017 to January 2023 and met the inclusion criteria， and according to the results of liver biopsy， they were divided into treatment group with 41 patients （with indications for antiviral therapy） and observation group with 134 patients （without indications for antiviral therapy）. The two groups were analyzed in terms of the indicators including clinical data， imaging examinations， and serum biochemical parameters. The univariate and multivariate Logistic regression analyses were used to investigate the parameters affecting the indication for antiviral therapy， and different models for predicting the need for antiviral therapy were constructed based on related parameters. The receiver operating characteristic （ROC） curve was used to compare the diagnostic value of different models. The independent-samples t test was used for comparison of normally distributed continuous variables between groups， and the Mann-Whitney U rank sum test was used for comparison of non-normally distributed continuous variables between groups； the chi-square test or the Fisher’s exact test was used for comparison of categorical data between groups. ResultsThere were significant differences between the treatment group and the observation group in alanine aminotransferase， ferritin， total cholesterol （CHOL）， triglyceride， platelet count， liver stiffness measured by sound touch elastography （STE）， and procollagen III N-terminal propeptide （PIIIP） （all P<0.05）. The multivariate Logistic regression analysis showed that CHOL （odds ratio ［OR］=0.4， 95% confidence interval ［CI］： 0.2 — 1.0）， STE （OR=1.5， 95%CI： 1.0 — 2.1）， and PIIIP （OR=1.1， 95%CI： 1.0 — 1.1） were independent predictive factors for the indications for antiviral therapy. Model 1 （STE+PIIIP+CHOL）， model 2 （STE+PIIIP）， model 3 （STE+CHOL）， model 4 （PIIIP+CHOL） had an area under the ROC curve of 0.908， 0.848， 0.725， and 0.725， respectively， while STE， PIIIP， and CHOL used alone had an AUC of 0.836， 0.725， and 0.634， respectively， suggesting that model 1 had the largest AUC， with a specificity of 77.34% and a sensitivity of 96.36%， and had a significant difference compared with STE， PIIIP， CHOL， and the models 2， 3， and 4 （Z=0.21， 3.08， 3.06， 3.23， 0.89， and 0.88， all P<0.05）. ConclusionThe noninvasive model established based on CHOL， STE， and PIIIP has a good value in predicting the need for antiviral therapy in patients with chronic HBV infection and an age of ≤30 years.
摘要
About 1% of the patients with acute hepatitis B can progress to acute liver failure， and 75% of the patients with hepatitis B virus （HBV）-related acute liver failure need to undergo liver transplantation or face death. This article reports a patient with HBV infection-related acute liver failure who achieved clinical cure and HBsAg seroconversion after antiviral therapy and symptomatic/supportive treatment， and dynamic monitoring was performed for immunological markers in peripheral blood.