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Characterization of hepatitis B virus X gene quasispecies complexity in mono-infection and hepatitis delta virus superinfection 预览
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作者 Cristina Godoy David Tabernero +13 位作者 Sara Sopena Josep Gregori Maria Francesca Cortese Carolina González Rosario Casillas Marcal Yll Ariadna Rando Rosa López-Martínez Josep Quer Gloria González-Aseguinolaza Rafael Esteban Mar Riveiro-Barciela Maria Buti Francisco Rodríguez-Frías 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第13期1566-1579,共14页
BACKGROUND Hepatitis delta virus (HDV) seems to strongly suppress hepatitis B virus (HBV) replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution o... BACKGROUND Hepatitis delta virus (HDV) seems to strongly suppress hepatitis B virus (HBV) replication, although little is known about the mechanism of this interaction. Both these viruses show a dynamic distribution of mutants, resulting in viral quasispecies. Next-generation sequencing is a viable approach for analyzing the composition of these mutant spectra. As the regulatory hepatitis B X protein (HBx) is essential for HBV replication, determination of HBV X gene (HBX) quasispecies complexity in HBV/HDV infection compared to HBV monoinfection may provide information on the interactions between these two viruses.AIM To compare HBV quasispecies complexity in the HBX 5’ region between chronic hepatitis delta (CHD) and chronic HBV mono-infected patients. METHODS Twenty-four untreated patients were included: 7/24 (29.2%) with HBeAgnegative chronic HBV infection (CI, previously termed inactive carriers), 8/24 (33.3%) with HBeAg-negative chronic hepatitis B (CHB) and 9/24 (37.5%) with CHD. A serum sample from each patient was first tested for HBV DNA levels. The HBX 5’ region [nucleotides (nt) 1255-1611] was then PCR-amplified for subsequent next-generation sequencing (MiSeq, Illumina, United States). HBV quasispecies complexity in the region analyzed was evaluated using incidencebased indices (number of haplotypes and number of mutations), abundancebased indices (Hill numbers of order 1 and 2), and functional indices (mutation frequency and nucleotide diversity). We also evaluated the pattern of nucleotide changes to investigate which of them could be the cause of the quasispecies complexity. RESULTS CHB patients showed higher median HBV-DNA levels [5.4 logIU/mL, interquartile range (IQR) 3.5-7.9] than CHD (3.4 logIU/mL, IQR 3-7.6)(P = n.s.) or CI (3.2 logIU/mL, IQR 2.3-3.5)(P < 0.01) patients. The incidence and abundance indices indicated that HBV quasispecies complexity was significantly greater in CI than CHB. A similar trend was observed in CHD patients, although only Hill numbers of order 2 showed statisti 展开更多
关键词 HEPATITIS B VIRUS HEPATITIS DELTA VIRUS HEPATITIS B X gene Next-generation sequencing Viral QUASISPECIES HEPATITIS B virus-hepatitis DELTA VIRUS interaction
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Reactivation of hepatitis B virus infection in patients with hemolymphoproliferative diseases,and its prevention 预览
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作者 Caterina Sagnelli Mariantonietta Pisaturo +3 位作者 Federica Calo Salvatore Martini Evangelista Sagnelli Nicola Coppola 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第26期3299-3312,共14页
Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver dam... Reactivation of hepatitis B virus(HBV)replication is characterized by increased HBV-DNA serum values of about 1 log or by HBV DNA turning positive if previously undetectable in serum,possibly associated with liver damage and seldom life-threatening.Due to HBV reactivation,hepatitis B surface antigen(HBsAg)-negative/anti-HBc-positive subjects may revert to HBsAg-positive.In patients with hemo-lymphoproliferative disease,the frequency of HBV reactivation depends on the type of lymphoproliferative disorder,the individual's HBV serological status and the potency and duration of immunosuppression.In particular,it occurs in 10%-50%of the HBsAg-positive and in 2%-25%of the HBsAg-negative/anti-HBc-positive,the highest incidences being registered in patients receiving rituximab-based therapy.HBV reactivation can be prevented by accurate screening of patients at risk and by a pharmacological prophylaxis with anti-HBV nucleo(t)sides starting 2-3 wk before the beginning of immunosuppressive treatment and covering the entire period of administration of immunosuppressive drugs and a long subsequent period,the duration of which depends substantially on the degree of immunodepression achieved.Patients with significant HBV replication before immunosuppressive therapy should receive anti-HBV nucleo(t)sides as a long-term(may be life-long)treatment.This review article is mainly directed to doctors engaged every day in the treatment of patients with onco-lymphoproliferative diseases,so that they can broaden their knowledge on HBV infection and on its reactivation induced by the drugs with high immunosuppressive potential that they use in the care of their patients. 展开更多
关键词 HEPATITIS B VIRUS REACTIVATION HEPATITIS B VIRUS infection Hemolymphoproliferative DISEASES IMMUNOSUPPRESSIVE THERAPY HEPATITIS B VIRUS THERAPY HEPATITIS B VIRUS prophylasis
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Hepatitis C virus antigens enzyme immunoassay for one-step diagnosis of hepatitis C virus coinfection in human immunodeficiency virus infected individuals 预览
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作者 Ke-Qin Hu Wei Cui +1 位作者 Susan D Rouster Kenneth E Sherman 《世界肝病学杂志:英文版(电子版)》 2019年第5期442-449,共8页
BACKGROUND Current diagnosis of hepatitis C virus(HCV)infection requires two sequential steps:testing for anti-HCV followed by HCV RNA PCR to confirm viremia.We have developed a highly sensitive and specific HCV-antig... BACKGROUND Current diagnosis of hepatitis C virus(HCV)infection requires two sequential steps:testing for anti-HCV followed by HCV RNA PCR to confirm viremia.We have developed a highly sensitive and specific HCV-antigens enzyme immunoassay(HCV-Ags EIA)for one-step diagnosis of viremic HCV infection.AIM To assess the clinical application of the HCV-Ags EIA in one-step diagnosis of viremic HCV infection in human immunodeficiency virus(HIV)-coinfected individuals.METHODS The study blindly tested HCV-Ags EIA for its performance in one-step diagnosing viremic HCV infection in 147 sera:10 without HCV or HIV infection;54 with viremic HCV monoinfection;38 with viremic HCV/HIV coinfection;and 45 with viremic HCV and non-viremic HIV coinfection.RESULTS Upon decoding,it was 100%accordance of HCV-Ags EIA to HCV infection status by HCV RNA PCR test.In five sera with HCV infection,HCV RNA was as low as 50-59 IU/mL,and four out of five tested positive for HCV-Ags EIA.Likewise,it was also 100%accordance of HCV-Ags EIA to HCV infection status by HCV RNA PCR in 83 sera with HCV and HIV coinfection,regardless if HIV infection was active or not.CONCLUSION The modified HCV-Ags EIA has a lower detection limit equivalent to serum HCV RNA levels of approximately 100 IU/mL.It is highly sensitive and specific in the setting of HIV coinfection,regardless of HIV infection status and CD4 count.These data support the clinical application of the HCV-Ags EIA in one-step diagnosis of HCV infection in HIV-infected individuals. 展开更多
关键词 HEPATITIS C VIRUS HEPATITIS C VIRUS ANTIGENS HEPATITIS C VIRUS core antigen HEPATITIS C VIRUS DIAGNOSTIC test DIAGNOSTIC assay Enzyme immunoassay
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Towards the worldwide eradication of hepatitis B virus infection:A combination of prophylactic and therapeutic factors 预览
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作者 Caterina Sagnelli Evangelista Sagnelli 《世界临床传染病学杂志》 2019年第2期11-22,共12页
Hepatitis B virus(HBV)is still a global health problem,mostly because of the intermediate/high rates of HBV chronic carriers living in most Asian,African and eastern European countries.The universal HBV vaccination of... Hepatitis B virus(HBV)is still a global health problem,mostly because of the intermediate/high rates of HBV chronic carriers living in most Asian,African and eastern European countries.The universal HBV vaccination of new-borns undertaken in most nations over the last 3 decades and effective HBV antiviral treatments(nucleos(t)ide analogue with high genetic barrier to viral resistance)introduced in the last decade have shown their beneficial effects in inducing a clear reduction of HBV endemicity in the countries where they have been extensively applied.Great hopes are now placed on new antiviral and immunotherapeutic drugs that are now at an advanced stage of study.It is in fact already conceivable that the synergistic use of new drugs targeting more than one HBV-lifecycle steps(covalent closed circular DNA destruction/silencing,HBV entry inhibitors,nucleocapsid assembly modulators targeting viral transcripts)and of some new immunotherapeutic agents might eliminate the intrahepatic covalent closed circular DNA and achieve the eradication of HBV infection.In spite of this,a strong effort should be given to extensive educational and screening programs for the at-risk population and to the implementation of HBV vaccination in developing countries. 展开更多
关键词 HEPATITIS B VIRUS Chronic HEPATITIS B infection HEPATITIS B VIRUS prevention VACCINATION
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病毒性肝炎的性传播 预览
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作者 曹杨维 李用国 《临床肝胆病杂志》 CAS 北大核心 2019年第5期1106-1108,共3页
性传播作为病毒性肝炎的一种重要传播方式尚存在争议,目前大量流行病学调查证实,在高危成人人群中,病毒性肝炎的传播与性接触密切相关。阐述了甲型、乙型和丙型肝炎性传播的流行病学研究现状,探讨其病因和发病机制,以期引起对病毒性肝... 性传播作为病毒性肝炎的一种重要传播方式尚存在争议,目前大量流行病学调查证实,在高危成人人群中,病毒性肝炎的传播与性接触密切相关。阐述了甲型、乙型和丙型肝炎性传播的流行病学研究现状,探讨其病因和发病机制,以期引起对病毒性肝炎性传播的更多认识和关注。 展开更多
关键词 甲型肝炎 乙型肝炎 丙型肝炎 性传播疾病 综述
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High prevalence of occult hepatitis C infection in predialysis patients 预览
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作者 Luís Henrique Bezerra Cavalcanti Sette Edmundo Pessoa de Almeida Lopes +3 位作者 Nathália Campello Guedes dos Anjos Lucila Maria Valente Sávio Augusto Vieira de Oliveira Norma Lucena-Silva 《世界肝病学杂志:英文版(电子版)》 2019年第1期109-118,共10页
BACKGROUND Occult hepatitis C virus (HCV) infection (OCI) may be associated with extrahepatic diseases and it is known that the patients with chronic kidney disease (CKD) who are on hemodialysis (HD) present a higher ... BACKGROUND Occult hepatitis C virus (HCV) infection (OCI) may be associated with extrahepatic diseases and it is known that the patients with chronic kidney disease (CKD) who are on hemodialysis (HD) present a higher prevalence of this type of infection than the general population, with a worse clinical outcome. However, there are no data in the literature to assess the presence of OCI in patients prior to the initiation of renal replacement therapy (RRT). Therefore, this study aimed to evaluate the occurrence and epidemiological aspects of OCI in patients with Predialysis CKD. We hypothesize that this infection could occur before RRT initiation. AIM To research the status in predialysis patients when HD patients have high prevalence of OCI. METHODS A cross-sectional study was conducted between 2015 and 2017. Adults with creatinine clearance < 60 mL/min·1.73 m^2 (predialysis patients) were recruited to the study. Pregnant and postpartum women, patients with glomerulopathies, and patients showing positivity for serological markers of hepatitis B virus (HBV), HCV or human immunodeficiency virus infection were excluded. Patients were diagnosed with OCI according to test results of anti-HCV antibody negativity and HCV RNA positivity in either ultracentrifuged serum or, if serum-negative, in peripheral blood mononuclear cells. RESULTS Among the 91 total patients included in the study, the prevalence of OCI was 16.5%. Among these 15 total OCI patients, 1 was diagnosed by 14 ultracentrifuged serum results and 14 were diagnosed by peripheral blood mononuclear cell results. Compared to the non-OCI group, the OCI patients presented higher frequency of older age (P = 0.002), patients with CKD of mixed etiology (P = 0.019), and patients with markers of previous HBV infection (i.e., combined positivity for anti-hepatitis B core protein antibody and anti-hepatitis B surface protein antibody)(P = 0.001). CONCLUSION Among predialysis patients, OCI involved the elderly, patients with CKD of mixed etiology, and patients with prev 展开更多
关键词 OCCULT HEPATITIS infection CHRONIC HEPATITIS C CHRONIC kidney disease HEMODIALYSIS HEPATITIS C virus-RNA PERIPHERAL blood MONONUCLEAR cells
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轻微转氨酶升高慢性乙型肝炎患者抗病毒治疗的研究 预览
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作者 张雪珍 谢能文 +5 位作者 邹波 钟青梅 章萍 熊墨龙 何金秋 肖影群 《当代医学》 2019年第24期58-60,共3页
目的探讨轻微转氨酶升高(ALT 1~2×ULN)慢性乙型肝炎(CHB)患者抗病毒治疗效果。方法选取2016年1月至2017年12月收治的慢性乙型肝炎患者108例作为研究对象,经《慢性乙型肝炎防治指南》标准确诊为ALT水平<2倍ULN但经肝组织活检术,... 目的探讨轻微转氨酶升高(ALT 1~2×ULN)慢性乙型肝炎(CHB)患者抗病毒治疗效果。方法选取2016年1月至2017年12月收治的慢性乙型肝炎患者108例作为研究对象,经《慢性乙型肝炎防治指南》标准确诊为ALT水平<2倍ULN但经肝组织活检术,肝穿刺活检示炎症坏死≥G2与纤维化≥S2的慢性乙型肝炎56例为观察组,而ALT≥2倍ULN的慢性乙型肝炎患者52例为对照组,所有患者给予恩替卡韦抗病毒治疗,经12周、24周、36周、48周后检测肝功能、HBV DNA、乙肝五项,且再次复查观察组部分患者肝脏炎症与纤维化程度。结果两组患者治疗前E抗原状态、HBV DNA水平差异无统计学意义,两组患者ALT水平差异具有统计学意义(P<0.05);两组24周、48周的ALT复常率、DNA转阴率、E抗原血清转换率对比差异无统计学意义;两组患者治疗24周、48周后ALT复常率、DNA阴转率比较差异无统计学意义;两组治疗前HBV DNA差异无统计学意义,两组治疗24周、48周后HBV DNA显著降低,且观察组低于对照组,组间差异具有统计学意义(P<0.05);1例患者从G2S3转为G1S2,1例患者从G1S3转为G1S2,1例患者从G2S3转为G1S1患者肝脏组织学损害程度较前好转。结论ALT<2×ULN的慢性乙型肝炎患者抗病毒治疗期中,HBeAg转阴率持续时间长。 展开更多
关键词 丙氨酸氨基转移酶 肝炎 乙型肝炎
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Antiviral treatment for chronic hepatitis B: Safety, effectiveness, and prognosis 预览
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作者 Ya-Li Wu Cheng-Li Shen Xin-Yue Chen 《世界临床病例杂志》 2019年第14期1784-1794,共11页
The goal of chronic hepatitis B (CHB) therapy is to improve the patient prognosis through the sustained inhibition of viral replication. However, due to the uncertainty and potentially unlimited duration of the treatm... The goal of chronic hepatitis B (CHB) therapy is to improve the patient prognosis through the sustained inhibition of viral replication. However, due to the uncertainty and potentially unlimited duration of the treatment course, nucleus(t)ide analogue (NA) resistance and safety, financial costs and patient compliance, different endpoints of antiviral treatment have been proposed in CHB prevention and treatment guidelines. Different treatment endpoints are closely associated with the safety of drug withdrawal and improvements in prognosis. Antiviral treatment suppresses HBV DNA replication, drug withdrawal leads to relapse, and long-term treatment causes drug safety and resistance issues. Although hepatitis B e antigen seroconversion based on HBV DNA inhibition is considered as “a satisfactory endpoint”, drug withdrawal still leads to high relapse rates. Hepatitis B surface antigen (HBsAg) clearance is the “ideal endpoint” in terms of the safety of drug withdrawal and improvements in prognosis. However, the HBsAg clearance rate is low using the conventional single drug treatment and fixed course regimens. Recently, the application of an “optimized antiviral treatment strategy” has improved the HBsAg clearance rate, and make an “ideal endpoint” possible. This article reviews the different antiviral treatment endpoints in terms of the safety of drug withdrawal, improvements in prognosis and relevant advances. 展开更多
关键词 Chronic HEPATITIS B ANTIVIRAL treatment ENDPOINT SAFETY PROGNOSIS improvement HEPATITIS B surface ANTIGEN clearance
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Human immunodeficiency virus and hepatotropic viruses comorbidities as the inducers of liver injury progression 预览
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作者 Murali Ganesan Larisa Y Poluektova +1 位作者 Kusum K Kharbanda Natalia A Osna 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第4期398-410,共13页
Hepatotropic viruses induced hepatitis progresses much faster and causes more liver-related health problems in people co-infected with human immunodeficiency virus(HIV).Although treatment with antiretroviral therapy h... Hepatotropic viruses induced hepatitis progresses much faster and causes more liver-related health problems in people co-infected with human immunodeficiency virus(HIV).Although treatment with antiretroviral therapy has extended the life expectancy of people with HIV,liver disease induced by hepatitis B virus(HBV)and hepatitis C virus(HCV)causes significant numbers of non-acquired immune deficiency syndrome(AIDS)-related deaths in coinfected patients.In recent years,new insights into the mechanisms of accelerated fibrosis and liver disease progression in HIV/HCV and HIV/HBV co-infections have been reported.In this paper,we review recent studies examining the natural history and pathogenesis of liver disease in HIV-HCV/HBV co-infection in the era of direct acting antivirals(DAA)and antiretroviral therapy(ART).We also review the novel therapeutics for management of HIV/HCV and HIV/HBV coinfected individuals. 展开更多
关键词 Human IMMUNODEFICIENCY VIRUS HEPATITIS C VIRUS HEPATITIS B VIRUS FIBROSIS Stiffness Treatment
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Hepatocellular carcinoma in non-cirrhotic liver: A comprehensive review 预览
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作者 Aakash Desai Sonia Sandhu +1 位作者 Jin-Ping Lai Dalbir Singh Sandhu 《世界肝病学杂志:英文版(电子版)》 2019年第1期1-18,共18页
Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide. Despite being the 6th most common cancer it is the second leading cau... Hepatocellular carcinoma (HCC) is the most common type of primary liver cancer, which in turns accounts for the sixth most common cancer worldwide. Despite being the 6th most common cancer it is the second leading cause of cancer related deaths. HCC typically arises in the background of cirrhosis, however, about 20% of cases can develop in a non-cirrhotic liver. This particular subgroup of HCC generally presents at an advanced stage as surveillance is not performed in a non-cirrhotic liver. HCC in non-cirrhotic patients is clinically silent in its early stages because of lack of symptoms and surveillance imaging; and higher hepatic reserve in this population. Interestingly, F3 fibrosis in non-alcoholic fatty liver disease, hepatitis B virus and hepatitis C virus infections are associated with high risk of developing HCC. Even though considerable progress has been made in the management of this entity, there is a dire need for implementation of surveillance strategies in the patient population at risk, to decrease the disease burden at presentation and improve the prognosis of these patients. This comprehensive review details the epidemiology, risk factors, clinical features, diagnosis and management of HCC in non-cirrhotic patients and provides future directions for research. 展开更多
关键词 HEPATOCELLULAR carcinoma Non-cirrhotic liver HEPATITIS B HEPATITIS C Risk factors Clinical features DIAGNOSTIC MODALITIES Management strategies Future DIRECTIONS
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细胞角蛋白7在肝硬化病理诊断中的作用 预览
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作者 王彦坤 马俊骥 张明 《临床荟萃》 CAS 2019年第2期124-127,共4页
目的探讨细胞角蛋白7(cytokeratin 7,CK7)在慢性肝病肝硬化诊断中的作用。方法回顾性分析2014年1月至2018年5月首都医科大学附属北京佑安医院病理科行肝脏病理检查的病例。本研究纳入病例802例,男性563例,女性239例,平均年龄(51±11... 目的探讨细胞角蛋白7(cytokeratin 7,CK7)在慢性肝病肝硬化诊断中的作用。方法回顾性分析2014年1月至2018年5月首都医科大学附属北京佑安医院病理科行肝脏病理检查的病例。本研究纳入病例802例,男性563例,女性239例,平均年龄(51±11)岁。分析不同疾病并发肝硬化时肝组织病理CK7免疫组织化学染色阳性表达比率的不同。结果肝组织CK7阴性表达患者中男性比率较大,而肝组织CK7阳性表达患者中女性比率较CK7阴性患者高。肝硬化肝组织CK7免疫组织化学染色表达阴性的病例年龄较CK7阳性病例大。非病毒性肝硬化肝组织CK7免疫组织化学染色阳性率较病毒性肝硬化组高。与慢性乙型肝炎肝硬化和自身免疫性肝炎引起的肝硬化相比,原发性胆汁性胆管炎(Primary Biliary Cholangitis,PBC)肝硬化患者CK7肝组织阳性表达率明显增加。结论CK7免疫组织化学染色在区分病毒性和非病毒性肝硬化中发挥一定的指导价值。CK7对于鉴别PBC与自身免疫性肝炎和慢性乙型肝炎肝硬化具有重要作用。 展开更多
关键词 肝硬化 肝脏病理 肝炎 病毒性 胆管炎 肝炎 自身免疫性
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Autoimmune hepatitis and IgG4-related disease 预览
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作者 Kosuke Minaga Tomohiro Watanabe +1 位作者 Hobyung Chung Masatoshi Kudo 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第19期2308-2314,共7页
IgG4-related disease (IgG4-RD) is a chronic-fibroinflammatory disorder affecting a wide range of organs. Elevation of serum IgG4 concentrations and abundant infiltration of IgG4-expressing plasma cells are key diagnos... IgG4-related disease (IgG4-RD) is a chronic-fibroinflammatory disorder affecting a wide range of organs. Elevation of serum IgG4 concentrations and abundant infiltration of IgG4-expressing plasma cells are key diagnostic features of this autoimmune disease. Although common organ involvement of IgG4-RD includes the salivary glands, pancreas, and bile duct, hepatic involvement is less well established. Recently, five studies identified a subtype of autoimmune hepatitis (AIH), called IgG4-associated AIH (IgG4-AIH). IgG4-AIH is diagnosed based on significant accumulation of IgG4-expressing plasmacytes in the liver in patients who met the diagnostic criteria for classical AIH. Although four of the five reports regarded IgG4-AIH based on hepatic accumulation of IgG4-positive cells alone, one report diagnosed IgG4-AIH based on both hepatic accumulation of IgG4-positive cells and elevated serum concentrations of IgG4. IgG4-AIH diagnosed based on the latter criteria may be a hepatic manifestation of IgG4-RD whereas IgG4-AIH diagnosed based on the former criteria may be a subtype of AIH. In this review article, we summarize and discuss clinicopathological features of IgG4-AIH. 展开更多
关键词 AUTOIMMUNE HEPATITIS IGG4 IgG4-related DISEASE IgG4-associated AUTOIMMUNE HEPATITIS
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聚乙二醇干扰素α-2b治疗慢性乙型肝炎的疗效探讨 预览
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作者 曾芬 《世界复合医学》 2019年第7期183-185,共3页
目的探究将聚乙二醇干扰素α-2b治疗应用于治疗慢性乙型肝炎患者中的效果,评价其临床应用意义。方法选择2015年4月—2018年5月间收入的92例慢性乙型肝炎患者作为实验对象,将所有患者随机分为对照组(n=46)与实验组(n=46)。对照组患者应... 目的探究将聚乙二醇干扰素α-2b治疗应用于治疗慢性乙型肝炎患者中的效果,评价其临床应用意义。方法选择2015年4月—2018年5月间收入的92例慢性乙型肝炎患者作为实验对象,将所有患者随机分为对照组(n=46)与实验组(n=46)。对照组患者应用恩替卡韦单药进行治疗。实验组患者应用聚乙二醇干扰素α-2b进行治疗,对比两组患者治疗总有效率,并评价患者的各项肝功能指标,评价治疗效果。结果在实验完成后,实验组患者的平均血清总胆红素(TBIL)、平均清蛋白(ALB)、平均谷丙转氨酶(ALT)数据较对照组来说明显更优,差异有统计学意义(P<0.05)。同时实验组患者的治疗总有效率数据为40例(86.96%),对照组患者的治疗总有效率数据为27例(58.70%),差异有统计学意义(χ^2=19.5928,P=0.0000)。结论在对慢性乙型肝炎患者进行治疗时,选择聚乙二醇干扰素α-2b作为治疗药物有助于对患者的肝功能进行改善,对于后续治疗工作的开展来说也有积极意义,值得推广使用。 展开更多
关键词 聚乙二醇干扰素Α-2B 恩替卡韦 治疗方案 肝炎 慢性乙型肝炎
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Hepatitis B reactivation in patients with hepatitis B core antibody positive and surface antigen negative on immunosuppressants 预览
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作者 Clement Chun-Ho Wu Rajneesh Kumar 《世界荟萃分析杂志》 2019年第5期209-217,共9页
Hepatitis B viral(HBV)reactivation in the immunosuppressed is a significant problem even in patients who have achieved serological clearance due to the persistence of HBV as cccDNA.HBV reactivation will continue to po... Hepatitis B viral(HBV)reactivation in the immunosuppressed is a significant problem even in patients who have achieved serological clearance due to the persistence of HBV as cccDNA.HBV reactivation will continue to pose a significant healthcare burden given the high prevalence of HBV and increasing use of immunosuppressants.Screening of hepatitis B surface antigen,antibody to Hepatitis B core antigen antibody and HBV DNA levels should be done routinely in all patients planned for significant immunosuppressant use.We aimed to examine the factors affecting reactivation risk.This depended on HBV disease status,the underlying disease requiring immunosuppression,and the specific immunosuppressive regime.While antiviral prophylaxis can prevent reactivation,it increases cost and still has risk of delayed reactivation after stopping antivirals and close follow-up and on-demand treatment is a good alternative for patients at risk of reactivation. 展开更多
关键词 PREVIOUS HEPATITIS B exposure IMMUNOSUPPRESSION COST-EFFECTIVENESS HEPATITIS B REACTIVATION
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感染性疾病甲肝、戊肝的免疫学检验效果研究
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作者 于红博 王海波 《智慧健康》 2019年第9期15-16,共2页
目的本次研究主要针对感染性疾病甲肝、戊肝的免疫学检验效果展开分析。方法开展本次研究的时间段为2018年1月至2018年7月,研究内容为我院纳入医治的感染性疾病甲肝、戊肝的80例患者的标本,其中有40例患者标本运用肝炎病毒快速检测试剂... 目的本次研究主要针对感染性疾病甲肝、戊肝的免疫学检验效果展开分析。方法开展本次研究的时间段为2018年1月至2018年7月,研究内容为我院纳入医治的感染性疾病甲肝、戊肝的80例患者的标本,其中有40例患者标本运用肝炎病毒快速检测试剂术为参照组,剩下40例患者标本运用酶联免疫法为研究组。结果研究组的检测准确度显著比参照组高,P<0.05。结论在对甲肝、戊肝进行免疫学检验时运用酶联免疫法具有更高的准确性,值得在临床上感染性疾病甲肝、戊肝检验中推荐广泛应用。 展开更多
关键词 感染性疾病 甲肝 戊肝 免疫学检验 准确度
Serum hepatitis B virus RNA is a predictor of HBeAg seroconversion and virological response with entecavir treatment in chronic hepatitis B patients 预览
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作者 Hao Luo Xia-Xia Zhang +5 位作者 Li-Hua Cao Ning Tan Qian Kang Hong-Li Xi Min Yu Xiao-Yuan Xu 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第6期719-728,共10页
BACKGROUND Characteristics of alterations of serum hepatitis B virus(HBV)RNA in different chronic hepatitis B(CHB)patients still cannot be fully explained.Whether HBV RNA can predict HBeAg seroconversion is still cont... BACKGROUND Characteristics of alterations of serum hepatitis B virus(HBV)RNA in different chronic hepatitis B(CHB)patients still cannot be fully explained.Whether HBV RNA can predict HBeAg seroconversion is still controversial.AIM To investigate whether HBV RNA can predict virological response or HBeAg seroconversion during entecavir(ETV)treatment when HBV DNA is undetectable.METHODS The present study evaluated 61 individuals who were diagnosed and treated with long-term ETV monotherapy at the Department of Infectious Diseases of Peking University First Hospital(China)from September 2006 to December 2007.Finally,30 treatment-naive individuals were included.Serum HBV RNA were extracted from 140μL serum samples at two time points.Then they were reverse transcribed to cDNA with the HBV-specific primer.The product was quantified by real-time quantitative PCR(RT-PCR)using TAMARA probes.Statistical analyses were performed with IBM SPSS 20.0.RESULTS Level of serum HBV RNA at baseline was 4.15±0.90 log10 copies/mL.HBV RNA levels showed no significant difference between the virological response(VR)and partial VR(PVR)groups at baseline(P=0.940).Serum HBV RNA significantly decreased among patients who achieved a VR during ETV therapy(P<0.001).The levels of HBV RNA in both HBeAg-positive patients with seroconversion group and those with no seroconversion increased after 24 wk of treatment.Overall,HBV RNA significantly but mildly correlated to HBsAg(r=0.265,P=0.041),and HBV RNA was not correlated to HBV DNA(r=0.242,P=0.062).Furthermore,serum HBV RNA was an independent indicator for predicting HBeAg seroconversion and virological response.HBeAg seroconversion was more likely in CHB patients with HBV RNA levels below 4.12 log10 copies/mL before treatment.CONLUSION The level of serum HBV RNA could predict HBeAg seroconversion and PVR during treatment.In the PVR group,the level of serum HBV RNA tends to be increasing. 展开更多
关键词 Chronic HEPATITIS B HEPATITIS B virus RNA Virological response HBeAg SEROCONVERSION ENTECAVIR
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Study on application value of HBV DNA, AFP and GP73 in diagnosis of chronic hepatitis B severity and liver fibrosis
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作者 Hai-Lin Bao Qun Xie 《海南医科大学学报(英文版)》 2019年第9期62-65,共4页
Objective: To explore the application of hepatitis B virus (HBV) DNA, alpha-fetoprotein (AFP), and Golgi transmembrane glycoprotein 73 (GP73) in the diagnosis of chronic hepatitis B (CHB) severity and liver fibrosis. ... Objective: To explore the application of hepatitis B virus (HBV) DNA, alpha-fetoprotein (AFP), and Golgi transmembrane glycoprotein 73 (GP73) in the diagnosis of chronic hepatitis B (CHB) severity and liver fibrosis. Methods: A total of 160 patients with CHB were selected from August 2017 to August 2018. The severity of the disease was classified into mild, moderate, severe and hepatic failure according to the standard of the guidelines for the prevention and treatment of chronic hepatitis B. Fibrosis was classified according to Masson staining, and S2-S4 was fibrosis. The 40 healthy persons in the same period were selected as the control group. The levels of HBV DNA, AFP, and GP73 in peripheral blood of all patients were detected. The healthy person in the same period was selected as the control group. Results: The levels of AFP and GP73 in CHB patients were significantly higher than those in the control group (P<0.05). And with the increase of severity, the levels of AFP and GP73 also increased significantly (P<0.05). With the increase of liver fibrosis in CHB patients, the levels of HBV DNA, AFP and GP73 were significantly increased (P<0.05). There was a significant positive correlation between the severity of AFP, GP73, and CHB and degree of fibrosis (P<0.05). There was a positive correlation between HBV DNA and fibrosis (P<0.05). The AUC of AFP and GP73 on the severity of CHB were 0.711 and 0.729, respectively. The AUC of HBV DNA, AFP, and GP73 on CHB liver fibrosis were 0.534, 0.745, and 0.758, respectively. Conclusions:AFP, GP73, and CHB are positively correlated with severity and fibrosis, and they have certain diagnostic value for CHB disease and fibrosis. HBV DNA also has a certain value for the degree of liver fibrosis in patients with CHB. 展开更多
关键词 Chronic HEPATITIS B HEPATITIS B virus Alpha fetoprotein GOLGI TRANSMEMBRANE GLYCOPROTEIN
Immune response pattern varies with the natural history of chronic hepatitis B 预览
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作者 Wen-Tao Wang Xue-Qi Zhao +9 位作者 Gui-Ping Li Yi-Zhi Chen Lin Wang Mei-Fang Han Wei-Na Li Tao Chen Guang Chen Dong Xu Qin Ning Xi-Ping Zhao 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第16期1950-1963,共14页
BACKGROUND Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant (IT), immune active (IA), inactive carrier (IC) and hepatitis B envelope antigen (HBeAg)-negative ... BACKGROUND Chronic hepatitis B is a highly heterogeneous disease that can be divided into four phases: Immune tolerant (IT), immune active (IA), inactive carrier (IC) and hepatitis B envelope antigen (HBeAg)-negative hepatitis (ENEG). AIM To investigate the immune status of natural killer (NK) and T cells in different phases of chronic hepatitis B. METHODS The frequency, phenotype and function of circulating NK cells, as well as nonantigen-specific and hepatitis B virus (HBV)-specific T cell responses were detected by flow cytometry in healthy and HBV-infected subjects. RESULTS The ability of NK cells to produce IFN-γ was markedly attenuated in HBVinfected patients overall but was less compromised in IC patients. Patients in the IT and IA phases also displayed significantly lower TNF-α production compared to healthy subjects. NK cells were phenotypically activated in the IA and ENEG phases, as evidenced by the upregulation of NKp44 in CD56bright NK cells and CD69 in CD56dim NK cells. Furthermore, global T-cells from the ENEG phase displayed a proinflammatory cytokine profile with upregulated IFN-γ and TNF-α expression, while this profile was suppressed in IT and IA patients. Finally, core and S antigen-specific T cell responses were significantly stronger after in vitro expansion in the IC phase compared to other phases. CONCLUSION Our findings demonstrate the changes in immune response pattern during the natural history of HBV infection. Both NK and T cells are functionally impaired in the IT and IA phases. With the spontaneous clearance of HBeAg and hepatitis B surface antigen decline, NK cell cytokine production and HBV-specific T responses are partially restored in IC phase, and the ENEG phase is dominated by nonantigen-specific T cell responses. 展开更多
关键词 Chronic HEPATITIS HEPATITIS B virus NATURAL KILLER CELLS Global-T CELLS Virusspecific T CELLS NATURAL HISTORY Heterogeneity
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肝脏内脏幼虫移行症一例
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作者 汪春年 黄春鑫 +1 位作者 殷永芳 杨芳 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第7期561-562,共2页
报道1例肝脏内脏幼虫移行症,国内报道很少,临床医务人员对其缺乏足够的认识,容易误诊。
关键词 肝炎 诊断 内脏幼虫移行症
恩替卡韦联合安络化纤丸治疗肝炎肝硬化临床观察
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作者 巴德玛其其格 《智慧健康》 2019年第11期35-37,共3页
目的分析研讨恩替卡韦联合安络化纤丸治疗肝炎肝硬化的临床疗效。方法随机从我院2017年1月至2018年12月收治的肝炎肝硬化患者中抽取90例进行讨论,用随机数字法将其分组,其中45例接受恩替卡韦治疗(对照组),另45例接受恩替卡韦联合安络化... 目的分析研讨恩替卡韦联合安络化纤丸治疗肝炎肝硬化的临床疗效。方法随机从我院2017年1月至2018年12月收治的肝炎肝硬化患者中抽取90例进行讨论,用随机数字法将其分组,其中45例接受恩替卡韦治疗(对照组),另45例接受恩替卡韦联合安络化纤丸治疗(研究组),观察比较治疗疗效。结果研究组血清HBV DNA阴转率86.67%、血清HbeAg阴转率64.44%高于对照组46.67%、37.78%,数据差异较大(P<0.05)。比较肝功能指标、肝纤维化、血清炎性因子指标,治疗前,数据差异较小(P>0.05),治疗后,研究组AST、ALT、TBIL低于对照组,研究组CⅣ、PCⅢ、LN、HA低于对照组,研究组hs-CRP、IL-8、IL-6、TNF-α均低于对照组,数据差异较大(P<0.05)。结论恩替卡韦联合安络化纤丸治疗肝炎肝硬化,可更好地改善肝功能,抗肝纤维作用突出,进而提升疗效,值得推广。 展开更多
关键词 肝炎 肝硬化 安络化纤丸 恩替卡韦
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