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1.
J Virol Methods ; 311: 114640, 2023 Jan.
Artículo en Inglés | MEDLINE | ID: mdl-36332714

RESUMEN

HBV cure rates remain low despite prolonged nucleos(t)ide (NrtI) therapy, likely due to persistent residual viral replication and an inability to eliminate covalently closed circular DNA (cccDNA). Therapies with novel mechanisms of action against hepatitis B virus (HBV) are being explored with the goal of achieving sustained off-treatment response and a functional cure without requiring lifelong therapy. Recent studies have indicated that serum HBV DNA levels (a biomarker for viral replication) combined with serum pregenomic RNA (pgRNA) levels (a surrogate for intrahepatic cccDNA transcriptional activity), may provide a better prediction for the risk of liver-related complications. Current HBV DNA assays, such as the COBAS AmpliPrep/COBAS TaqMan HBV test v2.0, quantitate HBV DNA down to 20 IU/mL, but are not able to monitor loss of residual virus in patients on NrtI therapy. There are no commercially available assays approved to detect serum/plasma HBV pgRNA levels. We have developed a multi-assay panel of highly sensitive nucleic acid assays designed to monitor levels of HBV DNA, pgRNA and total nucleic acids (TNA, composite DNA + pgRNA) in clinical specimens and to monitor changes during treatment with new antiviral combination regimens.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/tratamiento farmacológico , ADN Viral/genética , Virus de la Hepatitis B/genética , ADN Circular/genética , ARN , Antivirales/uso terapéutico
2.
PLoS One ; 17(11): e0277186, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36331946

RESUMEN

This study aimed to assess the knowledge, practices, and beliefs among the Jordanian population regarding hepatitis B virus (HBV) infection. A cross-sectional questionnaire was designed and used to recruit participants from October 5th through December 12th. Statistical analysis was conducted using SPSS. Descriptive statistical analysis was used to analyse the sociodemographic data, the Shapiro-Wilk test was used to assess the normality, Cronbach's α was used to evaluate the reliability of the questionnaire and Point-biserial correlation was used to figure out whether there is an association between Score of knowledge and the dichotomous variables. A random sample of 432 participated in the study. The majority were females (n = 310, 71.8%), the mean age was 21 (42.0%) years,416 (96.3%) were urban inhabitants and most of them (n = 351, 81.3%) had bachelor's degree. School/university (n = 280, 64.8%) were reported as a major source of information followed by TV/internet/social media 276 (63.9%). The total mean (± SD) of knowledge score regarding HBV infection symptoms, transmission modes and treatment was found 12.28 ± 3.2. Participants' knowledge regarding symptoms including nausea, vomiting and loss of appetite was 73 (16.9%). More than 80% had good knowledge regarding the complications of HBV infection. Only 100 participant reported vaccination (23.1%) against the virus. Poor knowledge and low vaccination rate against HBV were found thus implementing comprehensive educational program for people highlighting the importance of vaccination against the virus is crucial.


Asunto(s)
Conocimientos, Actitudes y Práctica en Salud , Hepatitis B , Femenino , Humanos , Adulto Joven , Adulto , Masculino , Estudios Transversales , Jordania , Reproducibilidad de los Resultados , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Virus de la Hepatitis B , Vacunación , Encuestas y Cuestionarios , Vacunas contra Hepatitis B
3.
Pan Afr Med J ; 42: 252, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36338549

RESUMEN

Introduction: adequate knowledge on hepatitis B virus (HBV) infection is important among patients with the infection as this impacts their health-seeking behavior. This study therefore assessed the knowledge and attitude among patients infected with HBV in The Gambia. Methods: this cross-sectional study was conducted at the main liver clinic, Medical Research Council Gambia at London School of Hygiene and Tropical Medicine (MRCG@LSHTM). A questionnaire was administered on a one-on-one basis to assess the level of knowledge and attitude of people with chronic HBV. Results: a total of 152 HBV patients were recruited into the study. Majority of the participants were male 136 (89.5%), within the 30-39 years age group. Sixty-four (42.1%) of the patients attained secondary education and 72 (47.4%) were working as civil servants. The mean knowledge score was 11.09/20 (standard deviation = 4.89). HBV patients having tertiary level education (p-value =0.001) or HBV diagnosis greater than 1 year (p-value =0.031) were more likely to have adequate knowledge of HBV infection. No significant associations were found between the socio-demographic and clinical characteristic variables and attitude. However, majority of the participants (56.6%) reported been worried about having HBV infection ever since being diagnosed. Conclusion: this study has highlighted the need for more patient health education especially for those with lower levels of education and newly diagnosed patients. It also further confirms the need for cultural and appropriate language consideration in providing education and information for HBV patients in The Gambia at the point of diagnosis.


Asunto(s)
Hepatitis B , Humanos , Masculino , Femenino , Gambia , Estudios Transversales , Hepatitis B/epidemiología , Hepatitis B/diagnóstico , Virus de la Hepatitis B , Conocimientos, Actitudes y Práctica en Salud
4.
PLoS One ; 17(11): e0278029, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36413542

RESUMEN

Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9-12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32-9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58-9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03-2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12-2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48-4.64). The findings indicate that public policies-including vaccination, early diagnosis, harm reduction strategies, and adequate treatment-should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.


Asunto(s)
Hepatitis B , Prisioneros , Humanos , Masculino , Adulto , Virus de la Hepatitis B , Estudios Seroepidemiológicos , Brasil/epidemiología , Estudios Transversales , Anticuerpos contra la Hepatitis B , Hepatitis B/epidemiología , Hepatitis B/diagnóstico
5.
Clin Infect Dis ; 75(Supplement_4): S517-S524, 2022 Nov 21.
Artículo en Inglés | MEDLINE | ID: mdl-36410388

RESUMEN

There are an estimated 257 million persons living with chronic hepatitis B for whom there are multiple potential applications of long-acting antiviral compounds. Current efforts include both injection and implant approaches to formulating derivates of existing anti-HBV compounds such as tenofovir or entecavir. Substantial progress has already occurred especially as aligned with the development of long-acting tenofovir-based medications with dual activity against human immunodeficiency virus (HIV) and hepatitis B virus (HBV). Nonetheless, substantial challenges will need to be overcome before these agents are available.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Hepatitis B/tratamiento farmacológico , Hepatitis B Crónica/tratamiento farmacológico , Virus de la Hepatitis B , Tenofovir/uso terapéutico , Antivirales/uso terapéutico
6.
Ann Afr Med ; 21(4): 316-321, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36412329

RESUMEN

Introduction: Hepatitis B virus (HBV) is known as a metabolovirus due to its impact on lipid and glucose metabolism in the liver. Previous literature showed a trend of hypolipidemia and reduced risk of metabolic syndrome in hepatitis B surface antigen-positive patients. However, data from the Indian population are lacking. We evaluate the relation of lipid profile with HBV infection and severity of liver disease. Materials and Methods: This was an observational cross-sectional study in which 50 patients with chronic hepatitis B and 43 anthropometrically matched seronegative controls were enrolled. Demographical, clinical, and laboratory data including lipid profile (high-density lipoprotein [HDL], low-density lipoprotein [LDL], triglycerides, and total cholesterol [TC]) were collected. Seropositive patients were categorized based on prognostic models (model for end-stage liver disease [MELD] and Child-Pugh score) for further analysis. Results: Our study revealed significant low levels of serum TC, HDL, and LDL cholesterol in hepatitis B patients compared to seronegative controls (133.06 vs. 162.39, 35.56 vs. 43.65, and 76.62 vs. 99.95 mg/dl respectively, P < 0.05). The patients with high MELD and Child-Pugh score were associated with hypolipidemia. Significant low levels of LDL and TC were observed in Child-Pugh class C in comparison to class A (94.8 vs. 149.2 and 50.6 vs. 87.9 mg/dl respectively, P < 0.05). Conclusions: A significant reduction in various lipid parameters was seen with chronic hepatitis B. Furthermore, prognostic score (high MELD and Child-Pugh score) were associated with hypolipidemia.


Résumé Introduction: Le virus de l'hépatite B (VHB) est connu comme un métabolovirus en raison de son impact sur le métabolisme des lipides et du glucose dans le foie. Précédent la littérature a montré une tendance à l'hypolipidémie et à une réduction du risque de syndrome métabolique chez les patients positifs à l'antigène de surface de l'hépatite B. Cependant, les données de la population indienne font défaut. Nous évaluons la relation entre le profil lipidique et l'infection par le VHB et la gravité de la maladie hépatique. Matériels et méthodes: Il s'agissait d'une étude transversale observationnelle dans laquelle 50 patients atteints d'hépatite B chronique et 43 des témoins séronégatifs appariés ont été recrutés. Données démographiques, cliniques et de laboratoire, y compris le profil lipidique (lipoprotéines de haute densité [HDL], lipoprotéines de basse densité [LDL], triglycérides et cholestérol total [TC]) ont été collectés. Les patients séropositifs ont été classés en fonction de modèles pronostiques (modèle pour l'hépatopathie terminale [MELD] et score de Child-Pugh) pour une analyse plus approfondie. Résultats: Notre étude a révélé des taux sériques bas significatifs de cholestérol TC, HDL et LDL chez les patients atteints d'hépatite B par rapport aux témoins séronégatifs (133,06 contre 162,39, 35,56 vs 43,65 et 76,62 vs 99,95 mg/dl respectivement, P < 0,05). Les patients avec un MELD et un score de Child-Pugh élevés étaient associés à hypolipidémie. Des niveaux significativement faibles de LDL et de TC ont été observés dans la classe C de Child-Pugh par rapport à la classe A (94,8 vs. 149,2 et 50,6 vs 87,9 mg/dl respectivement, P < 0,05). Conclusions: Une réduction significative de divers paramètres lipidiques a été observée avec l'hépatite chronique B. De plus, le score pronostique (MELD élevé et score de Child-Pugh) était associé à une hypolipidémie. Mots-clés: Cholestérol, maladie hépatique chronique, hépatite B, hypolipidémie, métabolisme lipidique.


Asunto(s)
Enfermedad Hepática en Estado Terminal , Hepatitis B Crónica , Hepatitis B , Humanos , Hepatitis B Crónica/epidemiología , Estudios Transversales , Cirrosis Hepática , Centros de Atención Terciaria , Colesterol , Índice de Severidad de la Enfermedad , Lipoproteínas HDL , Virus de la Hepatitis B
7.
Ann Afr Med ; 21(4): 322-326, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36412330

RESUMEN

Background: Hepatitis B and C lead to chronic disease in hundreds of millions of people and together constitute the most common cause of liver cirrhosis and cancer with attendant mortality. Objective: The objective of this study was to estimate the prevalence of hepatitis B and C virus infection among different categories of health-care workers, looking at the exposure to patients' samples and the prevalence rate among these categories of health workers. This will help to ascertain the risk and the need to pay more attention to preventive measures. Materials and Methods: This was a cross-sectional study conducted over a 2-year period among 217 health-care workers at the department of Haematology of the Federal Teaching Hospital, Ido-Ekiti, Nigeria. Respondents were randomly selected, and blood samples were taken for the hepatitis B and C screening. Data were analyzed using SPSS 20; bivariate analyses were done, and the level of statistical significance was set at P < 0.05. Results: A total of 13 (6.0%) tested positive for HBsAg. Analysis of the marital status of those that tested positive to Hepatitis B, revealed that the highest number (77%) was found among the married, while the singles and the divorced constitute 15.3% and 7.7% respectively. The nurses and nonhealth professionals (admin staff) constitute the highest positive yield of hepatitis B virus (HBV), followed by medical doctors and laboratory staff. The age of the respondent was found to have a statistically significant association with HBV serology (P < 0.05). Conclusion: There is a comparatively lower prevalence of HBsAg among the health-care workers who are directly exposed to patients' samples. The age of the respondent has a significant association with hepatitis B infection.


Résumé Contexte: L'hépatite B et C conduisent à des maladies chroniques chez des centaines de millions de personnes et constituent ensemble la cause la plus courante de cirrhose du foie et de cancer avec la mortalité des participants. Objectif: L'objectif de cette étude était d'estimer la prévalence de l'infection par le virus de l'hépatite B et du C entre différentes catégories de travailleurs de la santé, en examinant l'exposition aux échantillons des patients et le taux de prévalence entre ces catégories d'agents de santé. Cela aidera à déterminer le risque et la nécessité de prêter plus d'attention aux mesures préventives. Matériel et méthodes: Il s'agissait d'une étude transversale menée sur une période de 2 ans parmi 217 travailleurs de la santé au Département d'hématologie de l'hôpital fédéral universitaire, Ido - Ekiti, au Nigéria. Les répondants ont été sélectionnés au hasard et des échantillons de sang ont été prélevés pour le dépistage de l'hépatite B et du C. Les données ont été analysées à l'aide de SPSS 20; Des analyses bivariées ont été effectuées et le niveau de signification statistique a été fixé à p <0,05. Résultats: Un total de 13 (6,0%) ont été testés positifs pour HBSAG. L'analyse de l'état matrimonial de ceux qui se sont testés positifs à l'hépatite B, ont révélé que le nombre le plus élevé (77%) a été trouvé chez les mariés, tandis que les célibataires et les divorcés constituent respectivement 15,3% et 7,7%. Les infirmières et les professionnels de la santé (personnel administratif) constituent le plus élevé Rendement positif du virus de l'hépatite B (HBV), suivi des médecins et du personnel de laboratoire. L'âge du répondant s'est avéré avoir une association statistiquement significative avec la sérologie du VHB (p <0,05). Conclusion: Il existe une prévalence relativement plus faible de HBSAG chez les travailleurs de la santé qui sont directement exposés aux échantillons des patients. L'âge du répondant a une association significative avec l'infection à l'hépatite B. Mots-clés: Exposition, hépatite B et C, prévalence.


Asunto(s)
Antígenos de Superficie de la Hepatitis B , Hepatitis B , Humanos , Nigeria/epidemiología , Prevalencia , Centros de Atención Terciaria , Estudios Transversales , Virus de la Hepatitis B
8.
Genes (Basel) ; 13(11)2022 10 25.
Artículo en Inglés | MEDLINE | ID: mdl-36360178

RESUMEN

Adenoviral vaccines have been at the front line in the fight against pandemics caused by viral infections such as Ebola and the coronavirus disease 2019. This has revived an interest in developing these vectors as vaccines and therapies against other viruses of health importance such as hepatitis B virus (HBV). Current hepatitis B therapies are not curative; hence, chronic hepatitis B remains the major risk factor for development of liver disease and death in HBV-infected individuals. The ability to induce a robust immune response and high liver transduction efficiency makes adenoviral vectors attractive tools for anti-HBV vaccine and therapy development, respectively. This review describes recent developments in designing adenoviral-vector-based therapeutics and vaccines against HBV infection.


Asunto(s)
COVID-19 , Hepatitis B Crónica , Hepatitis B , Vacunas Virales , Humanos , Vectores Genéticos/genética , Virus de la Hepatitis B/genética , Hepatitis B/genética , Hepatitis B/prevención & control
9.
J Glob Health ; 12: 04076, 2022 Nov 12.
Artículo en Inglés | MEDLINE | ID: mdl-36370422

RESUMEN

Background: To reduce mortality associated with hepatitis B virus (HBV) infection, timely detection of cirrhosis and early-stage hepatocellular carcinoma (HCC) is essential. In low-income countries, however, HBV-infected people have limited access to liver histopathology, a reference test. Recently, Asian studies have suggested the usefulness of an inexpensive serum biomarker called Mac-2 binding protein glycosylation isomer (M2BPGi) in staging liver fibrosis and predicting HCC in HBV-infected patients. Methods: We systematically searched PubMed for studies examining the performance of M2BPGi in staging liver fibrosis in HBV-infected people, published up to September 21, 2021, to elucidate the knowledge gap. We then conducted a cross-sectional study of 339 HBV-infected patients in The Gambia (cirrhosis = 65, HCC = 73, non-cirrhosis non-HCC = 201). We evaluated the association of M2BPGi with cirrhosis and HCC by computing odds ratios (ORs) derived from logistic regression. We also assessed the performance of M2BPGi to stage liver fibrosis in 49 patients who underwent liver biopsy (derivation set) and 217 patients with transient elastography (validation set). Using the derivation set we drew the receiver operating characteristics (ROC) curves to identify optimal M2BPGi thresholds to indicate significant fibrosis and cirrhosis using biopsy as a reference. We then applied these cut-offs to the validation set to obtain its sensitivity and specificity for indicating significant fibrosis and cirrhosis using transient elastography as a reference. Results: The systematic review identified 13 studies, all of which were conducted in East Asia and none in Africa. In The Gambia, positive M2BPGi was significantly associated with both cirrhosis (adjusted OR = 7.8, 95% CI = 3.1-19.7) and HCC (adjusted OR = 10.1, 2.6-40.2). The areas under the ROC curve (AUROC) in the derivation and validation set were 0.62 and 0.78, respectively, to diagnose significant fibrosis, and 0.80 and 0.89, respectively, to diagnose cirrhosis. By applying the optimal cut-offs, the sensitivity and specificity in the validation set were 61.5% and 93.4%, respectively, to diagnose significant fibrosis, and 72.5% and 92.2%, respectively, for cirrhosis. Conclusions: To the best of our knowledge, this is the first evaluation of M2BPGi in HBV-infected African population. The findings supported its accuracy in the diagnosis of cirrhosis in HBV-infected patients in West Africa.


Asunto(s)
Carcinoma Hepatocelular , Hepatitis B , Neoplasias Hepáticas , Humanos , Virus de la Hepatitis B , Glicosilación , Estudios Transversales , Cirrosis Hepática/diagnóstico , Cirrosis Hepática/complicaciones , Carcinoma Hepatocelular/diagnóstico , Carcinoma Hepatocelular/complicaciones , Carcinoma Hepatocelular/metabolismo , Hepatitis B/complicaciones , Hepatitis B/diagnóstico , Neoplasias Hepáticas/diagnóstico , Neoplasias Hepáticas/complicaciones , Neoplasias Hepáticas/metabolismo
10.
Adv Gerontol ; 35(4): 485-491, 2022.
Artículo en Ruso | MEDLINE | ID: mdl-36401856

RESUMEN

According to the Russian Society of Urologists, the frequency of infertility in marriage in the Russian Federation is 8-17,2%; half of the cases are associated with the male factor. Among the risk factors for the development of male infertility, there are mainly medical reasons, lifestyle factors and negative environmental factors. Despite the fact that the problem of infertility is addressed by men of different ages, from youth to the elderly, the correction of risk factors is usually carried out without taking into account the age of the patient, which makes it difficult to develop a personalized strategy for the treatment or prevention of infertility. The aim of the study was to study the structure of the leading risk factors for the development of infertility in men from infertile couples, to identify and characterize their age-associated features. The analysis of the medical histories of 1 198 men from infertile couples and the collection of information on all available risk factors for infertility were carried out. The analysis of age features was performed by dividing the sample into 5 age groups: 1st (n=271) - men ≤29,9 years; 2nd (n=415) - 30-34,9 years; 3rd (n=291) - 35-39,9 years; 4th (n=141) - 40-44,9 years; 5th (n=80) - ≥45 years. It was shown that in the general sample of medical causes, factors associated with chronic inflammation predominate: sexually transmitted infections (STIs) - 54%; prostatitis - 32%; obesity - 27%; from non-medical: alcohol - 73%; stress - 47%; smoking - 41%. With increasing age, the frequency of obesity, STIs, prostatitis, hepatitis B/C, mumps increases statistically significantly, while the most unfavorable group of men is 40-45 years old for factors such as STIs, hepatitis B/C and mumps, and the group of men over 45 years old for factors such as obesity and prostatitis.


Asunto(s)
Hepatitis B , Infertilidad Masculina , Paperas , Prostatitis , Enfermedades de Transmisión Sexual , Humanos , Masculino , Anciano , Adolescente , Prostatitis/complicaciones , Paperas/complicaciones , Infertilidad Masculina/epidemiología , Infertilidad Masculina/etiología , Factores de Riesgo , Enfermedades de Transmisión Sexual/complicaciones , Obesidad/complicaciones , Hepatitis B/complicaciones
13.
World J Gastroenterol ; 28(40): 5784-5800, 2022 Oct 28.
Artículo en Inglés | MEDLINE | ID: mdl-36353205

RESUMEN

Hepatitis B virus (HBV) infection is a global public health issue. Interferon-α (IFN-α) treatment has been used to treat hepatitis B for over 20 years, but fewer than 5% of Asians receiving IFN-α treatment achieve functional cure. Thus, IFN-α retreatment has been introduced to enhance antiviral function. In recent years, immune-related studies have found that the complex interactions between immune cells and cytokines could modulate immune response networks, in-cluding both innate and adaptive immunity, triggering immune responses that control HBV replication. However, heterogeneity of the immune system to control HBV infection, particularly HBV-specific CD8+ T cell heterogeneity, has consequ-ential effects on T cell-based immunotherapy for treating HBV infection. Altogether, the host's genetic variants, negative-feedback regulators and HBV components affecting the immune system's ability to control HBV. In this study, we reviewed the literature on potential immune mechanisms affecting the immune control of HBV and the clinical effects of IFN-α treatment and retreatment.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Interferón-alfa/uso terapéutico , Interferón-alfa/farmacología , Virus de la Hepatitis B , Antígenos de Superficie de la Hepatitis B , Hepatitis B/tratamiento farmacológico , Antivirales/farmacología , Retratamiento , Replicación Viral
14.
PLoS One ; 17(11): e0272474, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36383523

RESUMEN

Hepatitis B virus (HBV) morphogenesis is characterized by a large over-production of subviral particles and recently described new forms in parallel of complete viral particles (VP). This study was designed to depict circulating viral forms in HBV infected patient plasmas, using velocity gradients and most sensitive viral markers. Plasmas from chronic hepatitis B (CHB) patients, HBeAg positive or negative, genotype D or E, were fractionated on velocity and equilibrium gradients with or without detergent treatment. Antigenic and molecular markers were measured in plasma and in each collected fraction. Fast Nycodenz velocity gradients revealed good reproducibility and provided additional information to standard equilibrium sucrose gradients. HBV-RNAs circulated as enveloped particles in all plasmas, except one, and at lesser concentrations than VP. Calculations based on standardized measurements and relative virion and subviral particle molecular stoichiometry allowed to refine the experimental approach. For the HBeAg-positive plasma, VP were accompanied by an overproduction of enveloped capsids, either containing HBs, likely corresponding to empty virions, or for the main part, devoid of this viral envelope protein. Similarly, in the HBeAg-negative sample, HBs enveloped capsids, likely corresponding to empty virions, were detected and the presence of enveloped capsids devoid of HBs protein was suspected but not clearly evidenced due to the presence of contaminating high-density subviral particles. While HBeAg largely influences HBcrAg measurement and accounts for two-thirds of HBcrAg reactivity in HBeAg-positive patients, it remains a 10 times more sensitive marker than HBsAg to characterize VP containing fractions. Using Nycodenz velocity gradients and standardized biomarkers, our study proposes a detailed characterization of circulating viral forms in chronically HBV infected patients. We provide evidence for an excess of capsids in fractions enriched in Dane particles, likely due to the presence of empty virions but also by capsids enveloped by an HBs free lipid layer. Identification of this new circulating viral particle sets the basis for studies around the potential role of these entities in hepatitis B pathogeny and their physiological regulation.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Virus de la Hepatitis B/genética , Cápside/metabolismo , Antígenos e de la Hepatitis B/metabolismo , Yohexol/metabolismo , Reproducibilidad de los Resultados , Antígenos de Superficie de la Hepatitis B , ADN Viral/metabolismo
15.
Front Public Health ; 10: 1037508, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36388269

RESUMEN

Background and aim: Chronic hepatitis B (CHB) can be divided into immune tolerance (IT), immune clearance (IC), hepatitis B e antigen (HBeAg)-negative inactive/quiescent carrier (ENQ), and HBeAg-negative hepatitis (ENH) phases. The conventional biomarkers used to distinguish these phases have limitations. We examined the clinical significance of hepatitis B virus (HBV) RNA and hepatitis B core-related antigen (HBcrAg) as novel biomarkers. Methods: One hundred eighty-nine patients without treatment currently were categorized by CHB phase (IT = 46, IC = 45, ENQ = 49, ENH = 49). The associations of HBV RNA and HBcrAg with HBV DNA and alanine transaminase (ALT) were analyzed. The decision tree model was used to distinguish the four phases in the natural course of CHB. Results: The concentrations of HBV RNA and HBcrAg were highest in the IT and IC phases (P < 0.01). Serum HBV RNA was similar to HBcrAg in treatment-naïve patients. HBV RNA and HBcrAg correlated with HBV DNA in the HBeAg+ and HBeAg- status (HBV RNA: e+ r = 0.51, e- r = 0.62; HBcrAg: e+ r = 0.51, e- r = 0.71), but their association with HBV DNA differed among phases. The accuracy, sensitivity, and specificity of HBcrAg with ALT in distinguishing the CHB phases were 95.65%, 95.83%, and 95.55%, respectively. Conclusion: Serum HBV RNA and HBcrAg may be useful to monitor CHB progression.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Antígenos e de la Hepatitis B/uso terapéutico , Hepatitis B Crónica/diagnóstico , Hepatitis B Crónica/tratamiento farmacológico , ADN Viral/uso terapéutico , Antígenos del Núcleo de la Hepatitis B/uso terapéutico , Biomarcadores , ARN/uso terapéutico
16.
Medicine (Baltimore) ; 101(45): e31385, 2022 Nov 11.
Artículo en Inglés | MEDLINE | ID: mdl-36397400

RESUMEN

At its onset, the coronavirus disease 2019 (COVID-19) pandemic brought significant challenges to healthcare systems, changing the focus of medical care on acute illness. Disruptions in medical service provision have impacted the field of viral hepatitis, with screening programs paused throughout much of 2020 and 2021. We performed a retrospective study on consecutive outpatients with COVID-19 during the second and third wave of COVID-19 in Romania, from November 2020 to April 2021, aiming to characterize the prevalence of undiagnosed hepatitis B virus (HBV) infection among patients presenting with acute illness. Overall, 522 patients had available records during the study timespan. Their mean ±â€…standard deviation age was 51 ±â€…13 years; 274 (52.5%) were male. We identified 16 (3.1%) cases of active HBV infection; only six of these patients were aware of their HBV status, and 3 of the newly diagnosed cases were identified as candidates for HBV treatment. A total of 96 patients (18.4%) had serological markers suggestive for prior HBV vaccination. A large proportion of patients (n = 120, 23.0%) had positive HBV core antibodies; among these, 90 (17.2%) had cleared a previous HBV infection (being positive for HBV surface antibodies and HBV core antibodies). We identified the following parameters that were significantly more frequent in patients with a history of HBV infection: older age (P < .001), hypoalbuminemia (P = .015), thrombocytopenia (P < .001), thrombocytopenia followed by thrombocytosis (P = .041), increased blood urea nitrogen (P < .001) and increased creatinine (P = .011). In conclusion, the COVID-19 pandemic has taught us essential lessons about the importance of maintaining access to screening programs and of ensuring active monitoring of patients with chronic infections such as hepatitis B, even during a medical crisis.


Asunto(s)
COVID-19 , Hepatitis B , Trombocitopenia , Humanos , Masculino , Adulto , Persona de Mediana Edad , Femenino , Virus de la Hepatitis B , Estudios Retrospectivos , Prevalencia , COVID-19/diagnóstico , COVID-19/epidemiología , Pandemias , Enfermedad Aguda , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Hepatitis B/prevención & control , Anticuerpos contra la Hepatitis B , Trombocitopenia/epidemiología
17.
Front Immunol ; 13: 1036612, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-36353632

RESUMEN

Objective: We explore the expression of functional molecules on CD8+ T lymphocytes, cytokines concentration, and their correlation to occurrence of hepatitis B and hepatitis B virus (HBV) desoxyribose nucleic acid (DNA), hepatitis B surface antigen (HBsAg), hepatitis B envelope antigen (HBeAg), and alanine aminotransferase (ALT) in patients infected with HBV. Methods: This is a single center study. 32 patients with acute hepatitis B (AHB), 30 patients with immune tolerant (IT) phase chronic HBV infected, and 50 patients with chronic hepatitis B (CHB) were enrolled. The activation molecules (CD69) and the apoptosis-inducing molecules (CD178) on surface of CD8+ T lymphocytes were tested by the flow cytometry. Fms-like tyrosine kinase 3 ligand (Flt-3L), interleukin 17A (IL-17A), interferon γ (IFN-γ), and Interferon α2 (IFN-α2) were quantitated by Luminex assay. We use linear regression analysis to analyze their correlations to ALT, HBV DNA, HBsAg, and HBeAg. Results: The frequency of CD69+CD8+ T lymphocytes in CHB and AHB groups were increased significantly compared with IT group (4.19[3.01, 6.18]% and 4.45[2.93, 6.71]% vs. 3.02[2.17, 3.44]%; H=26.207, P=0.001; H=28.585, P=0.002), and the mean fluorescence intensity (MFI) of CD69 in AHB group was significantly higher than IT and CHB groups (27.35[24.88, 32.25] vs. 20.45[19.05, 27.75] and 23.40[16.78, 28.13]; H=25.832, P=0.005 and H=22.056, P=0.008). In IT group, HBsAg levels and HBV DNA loads were negatively correlated with CD69MFI (ß=-0.025, t=-2.613, P=0.014; ß=-0.021, t=-2.286, P=0.030), meanwhile, HBeAg was negatively related to the frequency of CD69+CD8+ T lymphocytes (ß=-61.306, t=-2.116, P=0.043). In AHB group, IFN-α2 was positively related to the frequency of CD8+ T lymphocytes (ß=6.798, t=2.629, P=0.016); however, in CHB group, IFN-α2 was negatively associated with frequency of CD8+ T lymphocytes (ß=-14.534, t=-2.085, P=0.043). In CHB group, HBeAg was positively associated with frequency of CD69+CD8+ T lymphocytes (ß=43.912, t=2.027, P=0.048). In AHB group, ALT was positively related to CD69MFI (ß=35.042, t=2.896, P=0.007), but HBsAg was negatively related to CD178MFI (ß=-0.137, t=-3.273, P=0.003). Conclusions: The activation of CD8+ T lymphocytes was associated with the occurrence of AHB and CHB. However, due to the insufficient expression of functional molecules of CD8+ T lymphocytes and the depletion of CD8+ T lymphocytes, CHB patients were difficult to recover from HBV infection.


Asunto(s)
Hepatitis B Crónica , Hepatitis B , Humanos , Antígenos de Superficie de la Hepatitis B/metabolismo , Antígenos e de la Hepatitis B , ADN Viral/metabolismo , Virus de la Hepatitis B , Linfocitos T CD8-positivos/metabolismo , Citocinas/metabolismo
18.
Sci Rep ; 12(1): 19257, 2022 Nov 10.
Artículo en Inglés | MEDLINE | ID: mdl-36357472

RESUMEN

Innovative testing approaches and care pathways are required to meet HIV, hepatitis B (HBV) and hepatitis C (HCV) elimination goals. Routine testing for blood-borne viruses (BBVs) within emergency departments (EDs) is suggested by the European Centre for Disease Prevention and Control but there is a paucity of supporting evidence. We evaluated the introduction of routine BBV testing in EDs at a large teaching hospital in northern England. In October 2018, we modified the electronic laboratory ordering system to reflex opt-out HIV, HBV and HCV testing for all ED attendees aged 16-65 years who had a routine blood test for urea and electrolytes (U&Es). Linkage to care (LTC) was attempted for newly diagnosed patients, those never referred and those who had previously disengaged from care. The project operated for 18 months, here we present evaluation of the initial nine months (2 October 2018-1 July 2019). We analysed testing uptake, BBV seropositivity, LTC and treatment initiation within six months post-diagnosis. Over 9 months, 17,026/28,178 (60.4%) ED attendees who had U&Es performed were tested for ≥ 1 BBV. 299 active BBV infections were identified: 70 HIV Ab/Ag-positive (0.4% seroprevalence), 73 HBsAg-positive (0.4%) and 156 HCV RNA-positive (1.0%). Only 24.3% (17/70) HIV Ab/Ag-positive individuals required LTC, compared to 94.9% (148/156) HCV RNA-positive and 53.4% (39/73) HBsAg-positive individuals. LTC was successful in 94.1% (16/17) HIV Ab/Ag-positive and 69.3% (27/39) HBsAg-positive individuals. However, at 6 months LTC was just 39.2% (58/148) for HCV RNA-positive individuals, with 64% (37/58) of these commencing treatment. Universal opt-out ED BBV testing proved feasible and effective in identifying active BBV infections, especially among marginalised populations with reduced healthcare access. Our integrated approach achieved good LTC rates although further service development is necessary, particularly for HCV RNA-positive people who inject drugs.


Asunto(s)
Infecciones por VIH , Hepatitis B , Hepatitis C , Humanos , Antígenos de Superficie de la Hepatitis B , Estudios Seroepidemiológicos , Infecciones por VIH/diagnóstico , Infecciones por VIH/epidemiología , Hepatitis C/diagnóstico , Hepatitis C/epidemiología , Hepatitis B/diagnóstico , Hepatitis B/epidemiología , Hepacivirus , Servicio de Urgencia en Hospital , Resultado del Tratamiento , Reino Unido , ARN
19.
BMC Infect Dis ; 22(1): 819, 2022 Nov 07.
Artículo en Inglés | MEDLINE | ID: mdl-36344923

RESUMEN

BACKGROUND: Hepatitis B virus (HBV) infection is a global public-health problem. Since the introduction of an effective vaccine, the epidemiology of HBV infection is changing. We aimed to estimate the prevalence of HBV infection in the Gulf Cooperation Council (GCC) region and delineate any variation in member-countries, special sub-groups, and over time. METHODS: This is a systematic review and meta-analysis to review studies of HBV prevalence in the GCC region. Databases were searched and all studies from inception to July 31st, 2021, were considered for inclusion. The pooled HBV prevalence was analyzed using the random-effect model after assessment for heterogeneity. True prevalence was adjusted using the Rogan-Gladen estimator. Pre-defined subgroup analysis was performed, and publication bias was assessed. RESULTS: Overall, 99 studies (n = 1,944,200 participants) met the inclusion criteria. The overall HBV apparent prevalence was 3.05% (95% CI 2.60, 3.52) and the true prevalence was 1.67% (95% CI 1.66, 1.68). The apparent prevalence varied between subgroups. Over time, the apparent prevalence of HBV infection has declined from 9.38% (95% CI 7.26, 11.74) before 1990 to 1.56% (95% CI 1.07, 2.12) during the period 2010 to 2020. CONCLUSION: Over the last four decades the overall prevalence of HBV infection in the GCC region has decreased from high- to low-endemicity level. However, due to poor methodology of the included studies, further high-quality community-based studies are needed to obtain more precise estimate of HBV infection in this region.


Asunto(s)
Virus de la Hepatitis B , Hepatitis B , Humanos , Prevalencia , Hepatitis B/epidemiología , Antígenos de Superficie de la Hepatitis B
20.
J Int Med Res ; 50(11): 3000605221131136, 2022 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-36345172

RESUMEN

Cryoglobulinaemia can manifest as fatigue, purpura, and joint pain, and can involve the kidneys and peripheral nervous system. Type II and mixed cryoglobulinemia cases are usually associated with hepatitis C virus infection and autoimmune diseases, and most cases reported outside China have been related to hepatitis C virus. The pathological manifestation of cryoglobulinaemia glomerulonephritis is always membranous proliferative glomerulonephritis or membranous nephropathy; other pathological types are rare. This current case report describes a female patient with hepatitis B virus (HBV)-associated cryoglobulinaemic glomerulonephritis. The patient had hepatitis B complicated with purpura, abnormal urinalysis and renal function. She was positive for rheumatoid factor and had decreased complement, and her blood cryoglobulin level was positive. The pathological findings were consistent with late-stage capillary proliferative glomerulonephritis, which improved after steroid, immunosuppressant and anti-HBV treatment.


Asunto(s)
Crioglobulinemia , Glomerulonefritis Membranosa , Glomerulonefritis , Hepatitis B , Hepatitis C , Humanos , Femenino , Crioglobulinemia/complicaciones , Virus de la Hepatitis B , Hepacivirus , Glomerulonefritis/complicaciones , Glomerulonefritis/tratamiento farmacológico , Hepatitis B/complicaciones
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