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1.
BMC Infect Dis ; 20(1): 806, 2020 Oct 31.
Artigo em Inglês | MEDLINE | ID: mdl-33129259

RESUMO

BACKGROUND: This study aimed at determining the prevalence of and risk factors for hepatitis B virus (HBV) and hepatitis C virus (HCV) among incarcerated people who inject drugs (PWID) in Iran in 2015-16. METHODS: The required data was collected from a database provided by Iranian national bio-behavioral surveillance surveys (BBSSs) on 11,988 prisoners selected from among 55 prisons in 19 provinces in 2015-16. The data on demographics and behavioral variables were collected through interviews and the status of exposure to HBV and HCV were determined using ELISA blood test. A total of 1387 individuals with a history of drug injection in their lifetime were enrolled into the study. Data were analyzed using the survey package in Stata/SE software, Version 14.0. Univariate and multivariate logistic regression tests were used to investigate the relationships between risk factors and outcomes. RESULTS: The mean age of the incarcerated PWID was 36.83 ± 8.13 years. Of all the studied subjects, 98.46% were male and 50.97% were married. The prevalence of HCV and HBV among the subjects were 40.52 and 2.46%, respectively. The prevalence of HCV was associated with age ≥ 30 years, being single, illiteracy and low level of education, prison term> 5 years, history of piercing, and extramarital sex in lifetime (P < 0.05). CONCLUSIONS: The prevalence of HCV is alarmingly high. In general, it is recommended to adopt measures to screen and treat patients with HCV and vaccinat incarcerated PWID without a history of vaccination against HBV.


Assuntos
Hepatite B/epidemiologia , Hepatite C/epidemiologia , Prisioneiros , Abuso de Substâncias por Via Intravenosa/complicações , Adulto , Estudos Transversais , Feminino , Hepacivirus , Hepatite B/complicações , Hepatite B/prevenção & controle , Vírus da Hepatite B , Hepatite C/complicações , Hepatite C/prevenção & controle , Humanos , Irã (Geográfico)/epidemiologia , Modelos Logísticos , Masculino , Prevalência , Prisioneiros/estatística & dados numéricos , Prisões , Fatores de Risco , Vacinas contra Hepatite Viral/administração & dosagem
2.
Acta Gastroenterol Belg ; 83(3): 426-431, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33094590

RESUMO

PURPOSE: The prevalence of hepatitis B virus (HBV) reacti- vation in HBsAg-negative/anti-HBc-positive patients receiving chemotherapy for solid tumors is not fully known. The aim of this study was to investigate the incidence and outcomes of HBV reactivation in these patients. METHODS: Data among 645 HBsAg-negative/ anti-HBc-positive patients who underwent intravenous chemotherapy were retrospectively analyzed. Patients were categorized into two groups, based on received antiviral prophylaxis (n = 43) or not (n = 602). HBV reactivation was defined as the presence of detectable serum HBV DNA or HBsAg seroconversion from negative to positive, with or without increased liver enzymes. RESULTS: HBV reactivation was detected in 3 patients (0.49%) among non-antiviral prophylaxis group and in none of those with antiviral prophylaxis. Two of the HBV reactivation detected patients were successfully treated with rescue therapy, while the third died due to liver failure. CONCLUSIONS: HBV reactivation is rare in HBsAg-negative and anti-HBc-positive patients receiving chemotherapy for solid tumors. However, considering the fatal outcomes patients must be closely monitored in terms of HBV-DNA positivity and/or HBsAg seroreversion and pre-emptive antiviral therapy must be initiated as soon as HBV reactivation occurs.


Assuntos
Hepatite B , Neoplasias , Ativação Viral , Antineoplásicos/uso terapêutico , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B/imunologia , Humanos , Neoplasias/tratamento farmacológico , Neoplasias/virologia , Estudos Retrospectivos
3.
BMC Infect Dis ; 20(1): 725, 2020 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-33008316

RESUMO

BACKGROUND: Commencing lifelong antiretroviral therapy (ART) immediately following HIV diagnosis (Option B+), has greatly improved maternal-infant health. Thus, large and increasing numbers of HIV-infected women are on ART during pregnancy, a situation concurrently increasing numbers of HIV-exposed-uninfected (HEU) infants. Compared to their HIV-unexposed-uninfected (HUU) counterparts, HEU infants show higher rates of adverse birth outcomes, mortality, infectious/non-communicable diseases including impaired growth and neurocognitive development. There is an urgent need to understand the impact of HIV and early life ART exposures, immune-metabolic dysregulation, comorbidities and environmental confounders on adverse paediatric outcomes. METHODS: Six hundred (600) HIV-infected and 600 HIV-uninfected pregnant women ≥20 weeks of gestation will be enrolled from four primary health centres in high density residential areas of Harare. Participants will be followed up as mother-infant-pairs at delivery, week(s) 1, 6, 10, 14, 24, 36, 48, 72 and 96 after birth. Clinical, socio-economic, nutritional and environmental data will be assessed for adverse birth outcomes, impaired growth, immune/neurodevelopment, vertical transmission of HIV, hepatitis-B/C viruses, cytomegalovirus and syphilis. Maternal urine, stool, plasma, cord blood, amniotic fluid, placenta and milk including infant plasma, dried blood spot and stool will be collected at enrolment and follow-up visits. The composite primary endpoint is stillbirth and infant mortality within the first two years of life in HEU versus HUU infants. Maternal mortality in HIV-infected versus -uninfected women is another primary outcome. Secondary endpoints include a range of maternal and infant outcomes. Sub-studies will address maternal stress and malnutrition, maternal-infant latent tuberculosis, Helicobacter pylori infections, immune-metabolomic dysregulation including gut, breast milk and amniotic fluid dysbiosis. DISCUSSION: The University of Zimbabwe-College of Health-Sciences-Birth-Cohort study will provide a comprehensive assessment of risk factors and biomarkers for HEU infants' adverse outcomes. This will ultimately help developing strategies to mitigate effects of maternal HIV, early-life ART exposures and comorbidities on infants' mortality and morbidity. TRIAL REGISTRATION: ClinicalTrial.gov Identifier: NCT04087239 . Registered 12 September 2019.


Assuntos
Transmissão Vertical de Doença Infecciosa , Estudos de Coortes , Feminino , Infecções por HIV/tratamento farmacológico , Infecções por Helicobacter/complicações , Helicobacter pylori , Hepatite B/complicações , Humanos , Lactente , Mortalidade Infantil , Leite Humano , Morbidade , Parto , Gravidez , Complicações Infecciosas na Gravidez/virologia , Fatores de Risco , Natimorto , Sífilis/complicações , Universidades , Zimbábue
4.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 45(9): 1109-1114, 2020.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33051426

RESUMO

OBJECTIVES: To investigate volume changes of subcortical structures in patients with post-hepatitis B cirrhosis. METHODS: Thirty patients with post-hepatitis B cirrhosis (the cirrhosis group) and 24 age- and sex-matched healthy controls (the control group) were enrolled in this prospective study. All subjects underwent neuropsychological tests, blood biochemical determinations, and cerebral MRI. Volumes of 18 selected subcortical structures were automatically segmented and analyzed by the FreeSurfer. In the cirrhosis group, the relationships between abnormal subcortical volumes and clinical index or neurocognitive performance were investigated. The relationships between globus pallidus volumes and pallidal hyperintensity were also examined. RESULTS: Compared with the healthy controls, patients with post-hepatitis B cirrhosis displayed smaller bilateral putamen, amygdala, and nucleus accumbens volumes and larger bilateral globus pallidus volumes (P<0.001 or P=0.001). In the cirrhosis group, the volumes of left putamen and amygdala were negatively correlated with the number connection test-A (NCT-A)(left putamen r=-0.410, P=0.034; left amygdala r=-0.439, P=0.022), and the volumes of bilateral globus pallidus were positively correlated with pallidal index (PI) (left globus pallidus r=0.889, P<0.001; right globus pallidus r=0.900, P<0.001). CONCLUSIONS: Abnormalities of subcortical volumes appear bilaterally symmetrical in patients with post-hepatitis B cirrhosis. Atrophy of left putamen and amygdala might contribute to poor neurocognitive performance, and the manganese deposition might contribute to the increased globus pallidus volumes in patients with post-hepatitis B cirrhosis.


Assuntos
Hepatite B , Imagem por Ressonância Magnética , Hepatite B/complicações , Hepatite B/diagnóstico por imagem , Humanos , Cirrose Hepática/diagnóstico por imagem , Testes Neuropsicológicos , Estudos Prospectivos
5.
PLoS Pathog ; 16(9): e1008744, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32898182

RESUMO

In HIV-hepatitis B virus (HBV) co-infection, adverse liver outcomes including liver fibrosis occur at higher frequency than in HBV-mono-infection, even following antiretroviral therapy (ART) that suppresses both HIV and HBV replication. To determine whether liver disease was associated with intrahepatic or circulating markers of inflammation or burden of HIV or HBV, liver biopsies and blood were collected from HIV-HBV co-infected individuals (n = 39) living in Bangkok, Thailand and naïve to ART. Transient elastography (TE) was performed. Intrahepatic and circulating markers of inflammation and microbial translocation were quantified by ELISA and bead arrays and HIV and HBV infection quantified by PCR. Liver fibrosis (measured by both transient elastography and liver biopsy) was statistically significantly associated with intrahepatic mRNA for CXCL10 and CXCR3 using linear and logistic regression analyses adjusted for CD4 T-cell count. There was no evidence of a relationship between liver fibrosis and circulating HBV DNA, qHBsAg, plasma HIV RNA or circulating cell-associated HIV RNA or DNA. Using immunohistochemistry of liver biopsies from this cohort, intrahepatic CXCL10 was detected in hepatocytes associated with inflammatory liver infiltrates in the portal tracts. In an in vitro model, we infected an HBV-infected hepatocyte cell line with HIV, followed by interferon-γ stimulation. HBV-infected cells lines produced significantly more CXCL10 than uninfected cells lines and this significantly increased in the presence of an increasing multiplicity of HIV infection. Conclusion: Enhanced production of CXCL10 following co-infection of hepatocytes with both HIV and HBV may contribute to accelerated liver disease in the setting of HIV-HBV co-infection.


Assuntos
Quimiocina CXCL10/metabolismo , Coinfecção/complicações , Infecções por HIV/complicações , HIV/isolamento & purificação , Vírus da Hepatite B/isolamento & purificação , Hepatite B/complicações , Cirrose Hepática/epidemiologia , Adulto , Austrália/epidemiologia , Estudos de Coortes , Coinfecção/virologia , Feminino , Infecções por HIV/virologia , Hepatite B/virologia , Humanos , Incidência , Cirrose Hepática/metabolismo , Cirrose Hepática/virologia , Masculino , Países Baixos/epidemiologia , Prognóstico , Tailândia/epidemiologia
6.
Ann Epidemiol ; 49: 13-19, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32951803

RESUMO

PURPOSE: China has the world's largest burden of hepatitis B virus (HBV) infection. However, there are few studies reported on the latest prevalence of hepatitis B surface antigen (HBsAg) among pregnant women in China. We aimed to assess the prevalence of HBV infection and its associated risk factors among pregnant women in Yunnan, which is a province with relatively high prevalence of blood-borne viruses. METHODS: We conducted a cross-sectional study of 15,641 pregnant women who underwent routine antenatal screening for HBsAg in Yunnan between 2013 and 2016. Logistic regression analyses were used to examine the associations between HBV infection and risk factors. RESULTS: Overall, 7.89% (95% confidence interval (CI), 7.47%-8.31%) of the 15,641 pregnant women tested positive for HBsAg. Multivariable logistic regression analysis showed that advanced age (≥35 years old; adjusted odds ratio [aOR], 2.43-2.59), Hani ethnicity (aOR, 1.97; 95% CI, 1.22-3.17), unemployed women (aOR, 1.88; 95% CI, 1.30-2.72), multigravidas (aOR, 1.21; 95% CI, 1.05-1.40), and multiparas (aOR, 1.28; 95% CI, 1.10-1.49) were more likely to be infected with HBV. HBV infection was associated with cesarean section and preterm birth, with aORs of 1.31 (1.17-1.48) and 1.23 (1.00-1.51), respectively. In the subgroup analysis, the association between Hani ethnicity and HBV infection was significantly higher in women aged 35 years or older (aOR = 5.15; 95% CI, 1.51-17.55) than in women younger than 35 years of age (aOR = 1.69; 95% CI, 1.00-2.86). CONCLUSIONS: HBV infection among 15,641 pregnant women was of high-intermediate endemicity in Yunnan, China. Advanced age, Hani ethnicity, unemployment, and multigravid and multiparous statuses were associated with an increased prevalence of HBV infection. High-risk pregnant women should be paid more attention during routine antenatal examination.


Assuntos
Vírus da Hepatite B/isolamento & purificação , Hepatite B/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Adulto , China/epidemiologia , Estudos Transversais , Feminino , Hepatite B/complicações , Antígenos de Superfície da Hepatite B , Humanos , Gravidez , Complicações Infecciosas na Gravidez/virologia , Gestantes , Cuidado Pré-Natal , Diagnóstico Pré-Natal , Prevalência , Fatores de Risco , Adulto Jovem
7.
Nan Fang Yi Ke Da Xue Xue Bao ; 40(9): 1265-1272, 2020 Sep 30.
Artigo em Chinês | MEDLINE | ID: mdl-32990234

RESUMO

OBJECTIVE: To construct and validate an individualized nomogram to predict the probability of occurrence of portal vein thrombosis (PVT) after splenectomy in patients with hepatitis B cirrhosis. METHODS: We retrospectively collected the clinical data from 180 patients with hepatitis B cirrhosis undergoing splenectomy with postoperative anticoagulation therapy during the period from January, 2014 to January, 2020 in our hospital. The patients were randomized into modeling group (n= 120) and validation group (n=60), and the former group was further divided into PVT group (n=49) and non-PVT group (n=71) according to the occurrence of PVT occurred within 1 month after splenectomy. The independent risk factors of PVT after splenectomy were screened in the modeling group using univariate and multivariate binary logistic regression analyses and were used for construction of the nomogram prediction model. The area under the receiver-operating characteristic (AUROC) curve (C-index), GiViTI calibration belt and Hosmer-Lemeshow test, and the DCA curve were used to estimate the discrimination power, calibration and clinical efficiency of the prediction model in both the model construction group and validation group. RESULTS: Univariate and multivariate logistic regression analyses showed that a history of hemorrhage, portal vein diameter, spleen vein diameter, spleen volume, varicose, postoperative platelet change, and postoperative D-dimer differed significantly between PVT group and non-PVT group (P < 0.05), and portal vein diameter, spleen vein diameter, and postoperative platelet change were independent risk factors of PVT after splenectomy (P < 0.05). The prediction model had a good discrimination power with AUROC (C-index) of 0.880 (95% CI: 0.818-0.942) in the modeling group and 0.873 (95% CI: 0.785-0.960) in the validation group. The 80% and 95%CI region of GiViTI calibration belt did not cover the 45-degree diagonal bisector line (P=0.965 and 0.632, respectively), and the P-values of the Hosmer-Lemeshow test were 0.624 and 0.911, respectively, suggesting a high reliability of the predicted probability by the model. DCA curve analysis showed a threshold probability of 30.5%, with a net benefit of 30% in the modeling group and 34% in the validation group, indicating a good clinical efficiency of the model. CONCLUSIONS: The model for predicting the risk of PVT after splenectomy in patients with hepatitis B cirrhosis can help in early identification of patients having high risks of PVT.


Assuntos
Hepatite B , Cirrose Hepática , Esplenectomia , Trombose Venosa/etiologia , Adulto , Feminino , Hepatite B/complicações , Humanos , Cirrose Hepática/complicações , Cirrose Hepática/etiologia , Masculino , Pessoa de Meia-Idade , Nomogramas , Veia Porta/patologia , Reprodutibilidade dos Testes , Estudos Retrospectivos , Esplenectomia/efeitos adversos
8.
Medicine (Baltimore) ; 99(33): e20877, 2020 Aug 14.
Artigo em Inglês | MEDLINE | ID: mdl-32871973

RESUMO

OBJECTIVE: The purpose of this study was to evaluate the efficacy of different nucleos(t)ide analogues in the prognosis of HBV-related hepatocellular carcinoma (HCC) patients after curative treatment by network meta-analysis. METHODS: Literature retrieval was conducted in globally recognized databases, namely, PubMed, EMBASE, Cochrane Library databases, and Science Citation Index Expanded, to address relative studies investigating nucleot(s)ide analogues for HBV-related HCC patients after curative resection. Relative parametric data, including 1-, 3-, and 5-year overall survival rate and 1-, 3-, and 5-year recurrence-free survival rate were quantitatively pooled and estimated. The inconsistency factor, the cumulative ranking curve, and the publication bias were evaluated. RESULTS: Fourteen observational studies of 2481 adults performed between 2000 and 2019 were eligible. In terms of overall survival, ADV (Adefovir dipivoxil) (Odds ratio (OR): 2.35, 95% confidence interval (CI): 1.17-4.73), Lamivudine (OR: 2.08, 95% CI: 1.78-5.58), and Entecavir (OR: 2.14, 95% CI: 1.59-2.88) were found to be more beneficial than control group while ADV has the highest probability of having the most efficacious treatment (SCURA values 66.3) for 5-year overall survival. In late recurrence-free survival, ADV (OR = 1.88, 95% CI: 1.77-4.60), Entecavir (OR = 1.96, 95% CI: 1.36-2.55), and Lamivudine (OR = 1.73, 95% CI: 1.06-2.82) all had better significant prognosis than patients without antiviral therapy postoperatively and patients with ADV as postoperative antiviral therapy has significantly recurrence-free survival benefit at 5-year follow-up compared to those undertaking Entecavir (OR = 1.96, 95% CI: 1.52-7.38) and Lamivudine (OR = 1.39, 95% CI: 1.09-3.01). Moreover, the application of ADV possessed the highest possibility of having the best clinical effects on 1- (surface under the cumulative ranking probabilities (SUCRA), 64.7), 3- (SUCRA, 64.7), and 5-year (SUCRA, 70.4) recurrence survival rate for HBV-related HCC patients. CONCLUSIONS: Patients with postoperative nucleos(t)ide analogues antiviral therapy had better survival benefit than those without antiviral therapy for HBV-related HCC patients after curative treatment. Additionally, nucleotide analogues like ADV and Tenofovir disoproxil fumarate has better impact on early and late recurrence-free survival of patients after curative treatment than those undertaking nucleoside analogues.


Assuntos
Antivirais/uso terapêutico , Carcinoma Hepatocelular/terapia , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Neoplasias Hepáticas/terapia , Carcinoma Hepatocelular/complicações , Carcinoma Hepatocelular/epidemiologia , Hepatite B/epidemiologia , Vírus da Hepatite B , Humanos , Neoplasias Hepáticas/complicações , Neoplasias Hepáticas/epidemiologia , Metanálise em Rede
9.
Medicine (Baltimore) ; 99(37): e22065, 2020 Sep 11.
Artigo em Inglês | MEDLINE | ID: mdl-32925741

RESUMO

BACKGROUND: Liuweiwuling (LWWL) tablet, a kind of plant-derived traditional Chinese medicine preparation, has been widely applied as a promising adjunctive drug for hepatitis B virus-related cirrhosis (HBVC). However, its exact clinical efficacy and safety is still not well investigated. In this study, we aimed to summarize the efficacy of LWWL tablet on biochemical and virological parameters, and quality of life (QoL) in patients with HBVC through the meta-analysis. METHODS: All available randomized controlled trials and high-quality prospective cohort studies that investigated the efficacy and safety of LWWL for patients with HBVC were searched from the following electronic databases: PubMed, Medline, Cochrane Library, Google Scholar, Web of Science, Excerpt Medica Database, China National Knowledge Infrastructure, Chinese Biomedical Literature Database, China Scientific Journal Database, and Wanfang Database. Papers in Chinese or English published from January 2000 to August 2020 will be included without any restrictions.Study selection and data extraction will be performed independently by 2 authors. The clinical outcomes including biochemical (liver function and fibrosis indexes) and virological parameters, QoL, immune function and adverse events, were systematically evaluated. Review Manager 5.3 and Stata 14.0 were used for data synthesis, sensitivity analysis, meta regression, subgroup analysis, and risk of bias assessment. RESULTS: The results of this study will be published in a peer-reviewed journal, and provide a helpful evidence for clinicians to formulate the best postoperative adjuvant treatment strategy for HBVC patients. CONCLUSION: Our study will draw an objective conclusion of the efficacy of LWWL on biochemical and virological parameters, and QoL in patients with HBVC. INPLASY REGISTRATION NUMBER: INPLASY202080010.


Assuntos
Medicamentos de Ervas Chinesas/uso terapêutico , Hepatite B/complicações , Cirrose Hepática/tratamento farmacológico , Cirrose Hepática/virologia , Metanálise como Assunto , Qualidade de Vida , Revisões Sistemáticas como Assunto , Medicamentos de Ervas Chinesas/efeitos adversos , Hepatite B/virologia , Humanos , Comprimidos , Resultado do Tratamento
10.
PLoS One ; 15(9): e0236456, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32941424

RESUMO

INTRODUCTION: Sub-Saharan Africa houses over two-thirds of the 37 million people living with human immunodeficiency virus (HIV) globally and of this, 5-20% are co-infected with Hepatitis B virus (HBV). This is double jeopardy, especially for women of reproductive age in these settings, who can transmit both viruses vertically as well as horizontally to their children. The objectives of this study were to investigate the prevalence and determinants of HBV among women of reproductive age living with HIV. METHODS: This was a cross-sectional study of HIV-infected women of reproductive age in Benue State, Nigeria. Participants were eligible for the study if they were HIV-infected women (ages 18-45 years) receiving care from any of the selected study sites. A global rapid hepatitis B surface antigen (HBsAg) antibody test strip was used to test for HBsAg in plasma. A pretested questionnaire was used to collect data on sociodemographic, clinical and lifestyle characteristics of participants. We estimated prevalence of HBV infection and used multivariable logistic regression to determine factors associated with the infection at a significance level of <0.05. RESULTS: A total of 6577 women were screened for HBsAg. The prevalence of HBV was 10.3% (95% CI: 9.5-10.9%). Age, parity and male partner's HIV status were found to be associated with having HBV infection. Compared to women older than 40 years, the odds of HBV infection increased significantly with increasing age until age 35 years and decreased significantly with increasing parity (versus no parity). Women with HIV-infected partners and those without a partner had higher odds of HBV infection compared to women with HIV-negative partners. CONCLUSION: HBV is hyperendemic among HIV-infected women of reproductive age in North Central Nigeria. Specific programs targeting HBV testing, vaccination and treatment of all women of reproductive age need to be developed in this resource-limited, high-need setting.


Assuntos
Infecções por HIV/complicações , Hepatite B/epidemiologia , Adolescente , Adulto , Feminino , Infecções por HIV/epidemiologia , Infecções por HIV/transmissão , Hepatite B/sangue , Hepatite B/complicações , Anticorpos Anti-Hepatite B/sangue , Humanos , Estilo de Vida , Nigéria , Prevalência , Testes Sorológicos/estatística & dados numéricos , Fatores Socioeconômicos
11.
PLoS One ; 15(9): e0238839, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32915862

RESUMO

In patients who are HIV infected, hepatitis B virus (HBV) infection is an important co-morbidity. However, antiretroviral options for HIV/HBV co-infected children are limited and, at the time of this study, only included lamivudine. These children may remain on this regimen for many years until late adolescence. They are at high risk of developing HBV drug resistance and uncontrolled HBV disease. The aim of this study was to characterize HBV infection in HIV/HBV co-infected children. Known HIV-infected/HBsAg-positive children, previously exposed to lamivudine monotherapy against HBV, and their mothers were recruited at the Katutura Hospital paediatric HIV clinic in Windhoek, Namibia. Dried blood spot and serum samples were collected for HBV characterization and serological testing, respectively. Fifteen children and six mothers participated in the study. Eight of the 15 children (53.3%) tested HBV DNA positive; all eight children were on lamivudine-based ART. Lamivudine-associated resistance variants, together with immune escape mutants in the surface gene, were identified in all eight children. Resistance mutations included rtL80I, rtV173L, rtL180M, rtM204I/V and the overlapping sE164D, sW182*, sI195M and sW196LS variants. HBV strains belonged to genotypes E (6/8, 75%) and D3 (2/8, 25%). Further analysis of the HBV core promoter region revealed mutations associated with reduced expression of HBeAg protein and hepatocarcinogenesis. All six mothers, on HBV-active ART containing tenofovir and lamivudine, tested HBV DNA negative. This study confirms the importance of screening HIV-infected children for HBV and ensuring equity of drug access to effective HBV treatment if co-infected.


Assuntos
Coinfecção/epidemiologia , Farmacorresistência Viral/genética , Infecções por HIV/epidemiologia , Hepatite B/epidemiologia , Mutação , Proteínas do Core Viral/genética , Carga Viral , Adolescente , Adulto , Antirretrovirais/uso terapêutico , Criança , Estudos de Coortes , Coinfecção/genética , Coinfecção/virologia , Estudos Transversais , DNA Viral/análise , Feminino , HIV/efeitos dos fármacos , HIV/isolamento & purificação , Infecções por HIV/complicações , Infecções por HIV/genética , Infecções por HIV/virologia , Hepatite B/complicações , Hepatite B/genética , Hepatite B/virologia , Vírus da Hepatite B/efeitos dos fármacos , Vírus da Hepatite B/isolamento & purificação , Humanos , Masculino , Namíbia/epidemiologia , Adulto Jovem
13.
Medicine (Baltimore) ; 99(31): e21416, 2020 Jul 31.
Artigo em Inglês | MEDLINE | ID: mdl-32756142

RESUMO

BACKGROUND: Viral hepatitis type B is caused by hepatitis B virus (HBV) infection. Several studies have linked HBV infection to a higher risk of developing intrahepatic cholestasis of pregnancy (ICP), although some give contradictory results. To investigate the association and estimated risk of ICP in patients with HBV infection, we conducted this meta-analysis to summarize all available evidence. METHODS: This study consists of 2 meta-analyses. A literature search was performed using MEDLINE and EMBASE from inception to July 2019. The first study included studies that reported associations between HBV infection and the risk of ICP. The second analysis included studies comparing the risk of HBV infection in ICP patients with those without ICP. Odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effect, inverse variance method. RESULTS: Four studies were included in both analyses. The OR of ICP in HBV-infected pregnant women compared with non-HBV pregnant women was 1.68 (95% CI 1.43-1.97; I = 0%). The OR of HBV infection among ICP patients compared with non-ICP patients was 1.70 (95% CI 1.44-2.01; I = 0%). CONCLUSIONS: Our meta-analysis demonstrates not only a higher risk of ICP among HBV-infected pregnant women but also an increased risk of HBV infection among ICP patients. These findings suggest that HBV is a high-risk factor for ICP and screening for hepatitis B in women with ICP symptoms may be beneficial.


Assuntos
Colestase Intra-Hepática/diagnóstico , Vírus da Hepatite B , Hepatite B/diagnóstico , Complicações Infecciosas na Gravidez/diagnóstico , Complicações na Gravidez/diagnóstico , Colestase Intra-Hepática/complicações , Feminino , Hepatite B/complicações , Humanos , Gravidez , Diagnóstico Pré-Natal , Fatores de Risco
14.
Am J Med Sci ; 360(4): 372-377, 2020 10.
Artigo em Inglês | MEDLINE | ID: mdl-32723514

RESUMO

BACKGROUND: Infection is postulated as a possible risk factor for ischemic heart disease with a spiralling body of evidence. Hepatitis B is one of the most comprehensively investigated infection for its association with ischemic heart disease. This study aims at establishing an association between Hepatitis B core antibody status and ischemic heart disease using National Health and Nutrition Examination Survey (NHANES) database. METHODS: NHANES data from 2007 to 2016 were used for the present analysis. To identify patients with self-reported coronary heart disease, angina/angina pectoris, myocardial infarction, we examined the answers to questions MCQ160c, MCQ160d, MCQ160e delineated in NHANES data. These questions as described in the NHANES dataset are as follows: MCQ160c-Has a doctor or other health professional ever told you that you had coronary heart disease?, MCQ160d-Has a doctor or other health professional ever told you that you had angina, also called angina pectoris?, MCQ160e- Has a doctor or other health professional ever told you that you had a heart attack also called myocardial infarction?. Next, to identify patients with positive Hepatitis B core antibody, we examined the variable LBXHBC of the NHANES dataset. Baseline characteristics, along with unadjusted and adjusted odds ratio using multivariable logistic regression analysis, of included patients were analyzed for Hepatitis B core antibody and its association with ischemic heart disease. RESULTS: A total of 3,248 individuals with ischemic heart disease and 42,345 individuals with no ischemic heart disease were included in the final analysis. Hepatitis B core antibody positive status was associated with lower incidence of ischemic heart disease, adjusted odds ratio of 0.61 (95% confidence interval: 0.41-0.92, P value < 0.02). CONCLUSIONS: In conclusion, the present analysis points toward a possible association between past Hepatitis B infection and ischemic heart disease. Hepatitis B infection was associated with a decreased incidence of ischemic heart disease. Further research with better design and possible molecular mechanism is warranted.


Assuntos
Antígenos do Núcleo do Vírus da Hepatite B/sangue , Hepatite B/epidemiologia , Isquemia Miocárdica/epidemiologia , Idoso , Feminino , Hepatite B/sangue , Hepatite B/complicações , Humanos , Incidência , Modelos Logísticos , Masculino , Análise Multivariada , Isquemia Miocárdica/sangue , Isquemia Miocárdica/etiologia , Inquéritos Nutricionais , Razão de Chances , Fatores de Risco , Estados Unidos/epidemiologia
15.
J Immunother Cancer ; 8(2)2020 07.
Artigo em Inglês | MEDLINE | ID: mdl-32611687

RESUMO

The present review summarizes up-to-date evidence addressing the frequently discussed clinical controversies regarding the use of immune checkpoint inhibitors (ICIs) in cancer patients with viral infections, including AIDS, hepatitis B and C, progressive multifocal leukoencephalopathy, influenza, and COVID-19. In detail, we provide available information on (1) safety regarding the risk of new infections, (2) effects on the outcome of pre-existing infections, (3) whether immunosuppressive drugs used to treat ICI-related adverse events affect the risk of infection or virulence of pre-existing infections, (4) whether the use of vaccines in ICI-treated patients is considered safe, and (5) whether there are beneficial effects of ICIs that even qualify them as a therapeutic approach for these viral infections.


Assuntos
Imunossupressores/uso terapêutico , Neoplasias/complicações , Viroses/terapia , Betacoronavirus , Infecções por Coronavirus/complicações , Infecções por Coronavirus/tratamento farmacológico , Infecções por Coronavirus/imunologia , Infecções por Coronavirus/terapia , Hepatite B/complicações , Hepatite B/tratamento farmacológico , Hepatite B/imunologia , Hepatite B/terapia , Hepatite C/complicações , Hepatite C/tratamento farmacológico , Hepatite C/imunologia , Hepatite C/terapia , Humanos , Influenza Humana/complicações , Influenza Humana/tratamento farmacológico , Influenza Humana/imunologia , Influenza Humana/terapia , Pandemias , Pneumonia Viral/complicações , Pneumonia Viral/tratamento farmacológico , Pneumonia Viral/imunologia , Pneumonia Viral/terapia , Viroses/complicações , Viroses/tratamento farmacológico , Viroses/imunologia
16.
Medicine (Baltimore) ; 99(29): e21271, 2020 Jul 17.
Artigo em Inglês | MEDLINE | ID: mdl-32702915

RESUMO

Owing to similar routes of transmission, hepatitis B virus (HBV) and human immunodeficiency virus (HIV) coinfection commonly occurs. Compared with patients infected with only HBV, coinfected patients develop persistent HBV infection followed by advanced liver diseases. However, the characteristics of HIV-infected patients who can achieve the clearance of HBV surface antigen (HBsAg) have not been clarified. In this study, we retrospectively examined patients coinfected with HBV and HIV and determined the host factors associated with HBsAg clearance.Among HIV-infected patients who visited our hospital between 1994 and 2017, we examined medical records of those who were seropositive for HBsAg at least once. Among them, patients who cleared HBsAg afterward were regarded as "cured," while those who remained HBsAg-seropositive until 2017 were "chronic."HBsAg seropositivity was found in 57 patients, and among them, 27 male patients were cured whereas 18 were chronic. The cured patients were significantly younger and had higher CD4 cell and platelet counts than the chronic patients. In addition, the cured patients had higher levels of transaminases after the detection of HBsAg. Multivariate analysis revealed age as an independent factor. Analyses of the patients infected with genotype A also showed that the cured patients had significantly higher CD4 cell counts.Considering that the CD4 cell and platelet counts were higher in the cured patients, immunological and liver functions were closely associated with HBsAg clearance. Higher levels of transaminases in the cured patients may also reflect the immunological function leading to HBsAg clearance.


Assuntos
Coinfecção/virologia , Infecções por HIV/complicações , Antígenos de Superfície da Hepatite B/metabolismo , Hepatite B/complicações , Adulto , Feminino , Infecções por HIV/virologia , Hepatite B/virologia , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Adulto Jovem
17.
Arch Gynecol Obstet ; 302(3): 595-602, 2020 09.
Artigo em Inglês | MEDLINE | ID: mdl-32705338

RESUMO

PURPOSE: To investigate the association between maternal HBsAg-positive status and pregnancy outcomes. METHODS: The study enrolled women with singleton pregnancies who delivered during January-December 2018. Data of maternal demographics and main adverse pregnancy outcomes were collected from the institutional medical records and analyzed by univariate and multivariate logistic regression models to determine the association between maternal HBV markers (HBsAg/HBeAg/HBV-DNA loads status) and adverse pregnancy outcomes. RESULTS: Total 1146 HBsAg-positive and 18,354 HBsAg-negative pregnant women were included. After adjusting for potential confounding variables, maternal HBsAg-positive status was associated with a high risk of gestational diabetes mellitus (GDM) [adjusted odds ratio (aOR) = 1.24; 95% confidence interval (CI) 1.07-1.43], intrahepatic cholestasis of pregnancy (ICP) (aOR = 3.83; 95% CI 3.14-4.68), preterm birth (aOR = 1.42; 95% CI 1.17-1.72), and neonatal asphyxia (aOR = 2.20; 95% CI 1.34-3.63). Further, higher risks of ICP and neonatal asphyxia remained with either HBeAg-positive status (aOR = 1.64; 95% CI 1.10-2.44; aOR = 3.08; 95% CI 1.17-8.00) or high HBV-DNA load during the second trimester (aOR = 1.52; 95% CI 1.06-2.35; aOR = 4.20; 95% CI 4.20-15.83) among HBsAg-positive pregnant women. CONCLUSION: Women with maternal HBsAg-positive status may have increased risks of GDM, ICP, preterm birth, and neonatal asphyxia; furthermore, the risks of ICP and neonatal asphyxia were higher in women with HBeAg-positive status and a high HBV-DNA load during the second trimester among the HBsAg-positive pregnant women, implying that careful surveillance for chronic HBV infection during pregnancy is warranted.


Assuntos
Colestase Intra-Hepática/virologia , Antígenos de Superfície da Hepatite B/sangue , Hepatite B/complicações , Complicações Infecciosas na Gravidez/virologia , Complicações na Gravidez/virologia , Nascimento Prematuro/virologia , Adulto , Colestase Intra-Hepática/epidemiologia , Diabetes Gestacional/epidemiologia , Diabetes Gestacional/virologia , Feminino , Hepatite B/virologia , Antígenos E da Hepatite B/sangue , Vírus da Hepatite B/imunologia , Humanos , Recém-Nascido , Gravidez , Complicações na Gravidez/epidemiologia , Complicações Infecciosas na Gravidez/epidemiologia , Resultado da Gravidez , Gestantes , Nascimento Prematuro/epidemiologia , Nascimento Prematuro/etiologia , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
18.
Intern Med ; 59(12): 1519-1524, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32536678

RESUMO

A 53-year-old man presented with fulminant hepatitis due to de novo hepatitis B. He had been diagnosed previously with adult T-cell leukemia (ATL) and previously resolved hepatitis B virus infection. The ATL had been treated with cord blood transplantation (CBT). He developed fulminant hepatitis 18 months after CBT, 15 months after the withdrawal of immunosuppressants, and 10 months after vitreous injections of methotrexate for ATL-related retinal infiltration. The aggressive medical protocol included entecavir, prednisolone, plasma exchange, hemodialysis, and bilirubin adsorption. We herein report successful medical treatment for fulminant de novo hepatitis B in a patient considered unsuitable for liver transplantation.


Assuntos
Transplante de Células-Tronco de Sangue do Cordão Umbilical , Hepatite B/complicações , Leucemia de Células T/terapia , Necrose Hepática Massiva/etiologia , Necrose Hepática Massiva/terapia , Hepatite B/terapia , Hepatite B/virologia , Humanos , Leucemia de Células T/complicações , Masculino , Necrose Hepática Massiva/diagnóstico , Pessoa de Meia-Idade
19.
Zhongguo Shi Yan Xue Ye Xue Za Zhi ; 28(3): 855-860, 2020 Jun.
Artigo em Chinês | MEDLINE | ID: mdl-32552947

RESUMO

OBJECTIVE: To explore the expression and clinical significance of EZH2 in DLBCL patients accompanied by HBV infection. METHODS: The clinicopathological data of 59 patients with DLBCL accompanied by HBV infection in our hospital from February 2015 to October 2017 were analyzed retrospectively. The patients were divided into HBV negative and HBV positive groups by serological testing before surgery. The expression of EZH2 was detected by immumohistochemical staining, and the clinicopathological characteristics and survival were analyzed and compared between these two groups. RESULTS: There were 30 patients (50.8%) in the HBV negative group and 29 patients (49.2%)in the HBV positive group. The differences of age, LDH level and IPI score between two groups were statistically significant (P<0.05). The expression of EZH2 in HBV- positive group was significantly higher than that in the HBV- negative group (P<0.05), where the expression of EZH2 correlated with the expression of the BCL-6 (r=0.282, P<0.05), especially in the GCB-DLBCL (r=0.549, P<0.05). PFS was not significantly different between two groups of HBV (P>0.05), while the PFS in the R-CHOP regimen group was higher than that in the CHOP regimen group (P<0.05). COX multivariate analysis showed that both the chemotherapy regimen without R and the increased level of LDH were the risk factors affecting the prognosis of DLBCL patients (P<0.05). CONCLUSION: EZH2 highly expresses in HBV positive group, suggesting that the significance of EZH2 in DLBCL with HBV infection is worth further explore.


Assuntos
Proteína Potenciadora do Homólogo 2 de Zeste/genética , Vírus da Hepatite B , Hepatite B/complicações , Linfoma Difuso de Grandes Células B , Protocolos de Quimioterapia Combinada Antineoplásica , Ciclofosfamida , Doxorrubicina , Humanos , Linfoma Difuso de Grandes Células B/complicações , Linfoma Difuso de Grandes Células B/genética , Prognóstico , Estudos Retrospectivos , Rituximab , Vincristina
20.
West Afr J Med ; 37(3): 260-267, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476120

RESUMO

BACKGROUND: HIV has direct and indirect effects on the liver, just as hepatitis B and C viral infections are both hepatotropic viruses. Co-infection is an emerging clinical problem among HIV infected individuals, therefore its prevalence and impact on hepatic functions in children requires evaluation. METHODS: A cross sectional hospital-based study was conducted among HIV infected children and adolescents aged 2 months to 18 years on antiretroviral therapy at the University of Abuja Teaching Hospital from October 2017 to March 2018. Determination of hepatitis B surface antigen, antibody to hepatitis C, liver function tests and liver sizes were carried out on the children. RESULTS: Of a total of 153 subjects recruited, 89(58.2%) were males, 69 (45.1%) were adolescents and 117(76.5%) from lower socio-economic class. Hundred and forty (91.5%) subjects were mono-infected, 7(4.6%) had co-infection with HBsAg, 1(0.7%) had HBsAg/HBeAg, 6(3.9%) had HCV, while none had triple infection. No under-five had co-infection with HBV and no variable had significant association with HBV coinfection. There was however significant association of HCV co-infection with age (p=0.00), blood transfusion (p=0.03), and religion (p=0.01) and all the infected were less than 10 years. The mean values for alanine transaminase, aspartate transaminase, alkaline phosphatase, liver sizes of the mono and co-infected were all within normal and none had severe or life threatening hepatotoxicity. CONCLUSION: The prevalence and impact of HIV co-infection on liver function in this study was low. Use of liver biopsy, the gold standard for assessing disease severity in liver conditions may also be required for in-depth assessment.


Assuntos
Terapia Antirretroviral de Alta Atividade , Coinfecção/epidemiologia , Infecções por HIV/tratamento farmacológico , Hepatite B/complicações , Hepatite C/complicações , Adolescente , Alanina Transaminase/sangue , Criança , Pré-Escolar , Estudos Transversais , Feminino , Infecções por HIV/sangue , Infecções por HIV/epidemiologia , Hepacivirus/isolamento & purificação , Hepatite B/sangue , Hepatite B/epidemiologia , Antígenos de Superfície da Hepatite B , Vírus da Hepatite B/isolamento & purificação , Hepatite C/sangue , Hepatite C/epidemiologia , Humanos , Lactente , Testes de Função Hepática , Masculino , Nigéria/epidemiologia , Prevalência
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