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病毒性肝炎疫苗的研究进展
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作者 李国亚 刘达 +1 位作者 鲍秀峰 邢雪琨 《基因组学与应用生物学》 CAS CSCD 北大核心 2019年第8期3893-3900,共8页
病毒性肝炎是由多种肝炎病毒感染肝细胞而引起的世界性常见传染病,传染性强,发病率高。病毒性肝炎分为甲型、乙型、丙型、丁型和戊型五种。由于病毒种类繁多,而且易发生变异,容易感染,治疗方案有限,常规治疗疗效不稳定且价格昂贵。因此... 病毒性肝炎是由多种肝炎病毒感染肝细胞而引起的世界性常见传染病,传染性强,发病率高。病毒性肝炎分为甲型、乙型、丙型、丁型和戊型五种。由于病毒种类繁多,而且易发生变异,容易感染,治疗方案有限,常规治疗疗效不稳定且价格昂贵。因此,接种疫苗是目前较为有效的办法。本综述主要包括四个部分,即甲型、乙型、丙型和戊型病毒性肝炎的相应疫苗的介绍。 展开更多
关键词 疫苗 肝炎 甲型病毒性肝炎 乙型病毒性肝炎 丙型病毒性肝炎 戊型病毒性肝炎
我国新生儿乙型肝炎母婴阻断成就和展望
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作者 崔富强 庄辉 《中国病毒病杂志》 CAS 2019年第5期321-326,共6页
中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感... 中国是乙型肝炎(乙肝)慢性感染者数量最多的国家,每年约有100万例乙肝病毒(hepatitis B virus,HBV)表面抗原(HBsAg)阳性孕妇需要生育,其中约26万例为乙肝病毒e抗原(HBeAg)阳性孕妇。对HBsAg阳性孕妇实施科学的母婴阻断措施,减少新发感染是当前我国进一步控制乙肝面临的主要工作。无论母亲感染状态如何,实施新生儿出生后24 h内接种乙肝疫苗(HepB)是最重要和最根本的策略。对于HBV感染的高病毒载量的孕妇的抗病毒治疗,需要考虑起始时间节点、纳入标准、服药持续时间和停药时间等。做好我国HBV感染母婴阻断,主要策略包含4种:(1)对孕妇进行HBsAg筛查;(2)对HBsAg阳性母亲的新生儿出生12 h内接种HepB和乙肝免疫球蛋白(HBIG),然后完成全程乙肝疫苗免疫;对HBsAg阴性母亲的新生儿出生24 h内接种HepB,然后完成全程乙肝疫苗免疫;(3)仅对HBV DNA高载量的孕妇实施抗病毒预防;(4)对母亲HBsAg阳性的新生儿进行接种后监测并评价阻断效果。 展开更多
关键词 肝炎 乙型 肝炎病毒 乙型 乙型肝炎疫苗 乙型肝炎免疫球蛋白 母婴传播
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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Construction of a replication-competent hepatitis B virus vector carrying secreted luciferase transgene and establishment of new hepatitis B virus replication and expression cell lines 预览
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作者 Jie Ruan Cai-Yan Ping +4 位作者 Shuo Sun Xin Cheng Peng-Yu Han Yin-Ge Zhang Dian-Xing Sun 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第39期5961-5972,共12页
BACKGROUND Previously,we have successfully constructed replication-competent hepatitis B virus(HBV)vectors by uncoupling the P open reading frame(ORF)from the preC/C ORF to carefully design the transgene insertion sit... BACKGROUND Previously,we have successfully constructed replication-competent hepatitis B virus(HBV)vectors by uncoupling the P open reading frame(ORF)from the preC/C ORF to carefully design the transgene insertion site to overcome the compact organization of the HBV genome and maintain HBV replication competence.Consequently,the replication-competent HBV vectors carrying foreign genes,including pCH-BsdR,carrying blasticidin resistance gene(399 bp),and pCH-hrGFP,carrying humanized renilla green fluorescent protein gene(720 bp),were successfully obtained.However,the replication efficiency of the former is higher but it is tedious to use,while that of the latter is poor and cannot be quantified.Hence,we need to search for a new reporter gene that is convenient and quantifiable for further research.AIM To establish a helpful tool for intracellular HBV replication and anti-viral drugs screening studies.METHODS We utilized the replication-competent HBV viral vectors constructed by our laboratory,combined with the secreted luciferase reporter gene,to construct replication-competent HBV vectors expressing the reporter gene secretory Nanoluc Luciferase(SecNluc).HepG2.TA2-7 cells were transfected with this vector to obtain cell lines with stably secreted HBV particles carrying secNluc reporter gene.RESULTS The replication-competent HBV vector carrying the SecNluc reporter gene pCHsNLuc could produce all major viral RNAs and a full set of envelope proteins and achieve high-level secreted luciferase expression.HBV replication intermediates could be produced from this vector.Via transfection with pTRE-sNLuc and selection by hygromycin,we obtained isolated cell clones,named HBV-NLuc-35 cells,which could secrete secNLuc recombinant viruses,and were sensitive to existing anti-HBV drugs.Using differentiated HepaRG cells,it was verified that recombinant HBV possessed infectivity.CONCLUSION Our research demonstrated that a replication-competent HBV vector carrying a secreted luciferase transgene possesses replication and expression 展开更多
关键词 HEPATITIS B VIRUS Replication-competent HEPATITIS B VIRUS vector SECRETED LUCIFERASE gene HEPATITIS B VIRUS cell line
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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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追求治愈的抗乙型肝炎病毒治疗进展
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作者 谢雯 徐小元 《中华肝脏病杂志》 CAS CSCD 北大核心 2019年第8期577-581,共5页
世界卫生组织提出了在2030年消除病毒性肝炎作为重大公共卫生威胁的战略目标,而研发追求慢性乙型肝炎(CHB)患者治愈的新型治疗是其中的重要组成部分。近年来,以HBsAg清除和HBVDNA持续检测不到为标志的功能性治愈或临床治愈逐渐成为国内... 世界卫生组织提出了在2030年消除病毒性肝炎作为重大公共卫生威胁的战略目标,而研发追求慢性乙型肝炎(CHB)患者治愈的新型治疗是其中的重要组成部分。近年来,以HBsAg清除和HBVDNA持续检测不到为标志的功能性治愈或临床治愈逐渐成为国内外临床指南推荐的理想治疗终点。研究显示,CHB患者经过核苷(酸)类似物(NAs)治疗达到长期病毒抑制后加用或换用干扰素类治疗,有提高HBsAg清除率的潜力。但研究中各治疗组患者的HBsAg转阴率仍较低,合理的联合治疗策略和适合的患者人群有待进一步探索。此外,还有一些旨在追求CHB治愈的新型药物正在研发中,许多新药临床试验仍以NAs长期治疗为基础。目前阶段,NAs仍是CHB抗病毒治疗中的基石。 展开更多
关键词 肝炎 病毒性 肝炎 乙型 慢性 抗病毒治疗 治愈
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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Tenofovir is a more suitable treatment than entecavir for chronic hepatitis B patients carrying naturally occurring rtM204I mutations 预览
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作者 Won Hyeok Choe Kijeong Kim +4 位作者 So-Young Lee Yu-Min Choi So Young Kwon Jeong Han Kim Bum-Joon Kim 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第33期4985-4998,共14页
BACKGROUND Hepatitis B virus(HBV) DNA polymerase mutations usually occur to long term use of nucleos(t)ide analogues(NAs), but they can occur spontaneously in treatment-na?ve chronic hepatitis B(CHB) patients. The nat... BACKGROUND Hepatitis B virus(HBV) DNA polymerase mutations usually occur to long term use of nucleos(t)ide analogues(NAs), but they can occur spontaneously in treatment-na?ve chronic hepatitis B(CHB) patients. The naturally occurring HBV DNA polymerase mutations might complicate antiviral therapy with NAs,leading to the generation of drug-resistant viral mutants and disease progression.The most common substitutions are known to be YMDD-motif mutations, but their prevalence and the influence on antiviral therapy is unclear.AIM To investigate prevalence of the naturally occurring rtM204I mutations in treatment-na?ve CHB genotype C2 patients and their influence on antiviral therapy.METHODS A total of 410 treatment-na?ve CHB patients infected with HBV genotype C2 strains were enrolled in this retrospective study. Among the 410 patients, 232 were treated with NAs for at least 12 mo. Significant fibrosis was defined as fibrosis-4 index > 3.25 or aspartate aminotransferase to platelet ratio index > 1.5.Complete viral response(CVR) during NAs was defined as undetectable serum HBV DNA(< 24 IU/m L). The rtM204I variants were analyzed by a newly developed locked nucleotide probe(LNA probe) based real-time PCR(LNA-RTPCR) method.RESULTS The LNA-RT-PCR could discriminate rtM204I mutant-type(17 patients, 4.2%)from rt M204 wild-type(386 patients, 95.8%) in 403 of 410 patients(98.3%sensitivity). Multivariate analysis showed that naturally occurring rtM204I variants were more frequently detected in patients with significant fibrosis [oddratio(OR) 3.397, 95% confidence-interval(CI) 1.119-10.319, P = 0.031]. Of 232 patients receiving NAs, multivariate analysis revealed that achievement of CVR was reversely associated with naturally occurring rtM204I variants prior to NAs treatment(OR 0.014, 95%CI 0.002-0.096, P < 0.001). Almost patients receiving tenofovir achieved CVR at 12 mo of tenofovir, irrespective of pre-existence of naturally occurring rtM204I mutations(CVR rates: patients with rtM204I, 100%;patients without rtM204I, 96.6%), 展开更多
关键词 Chronic HEPATITIS B ENTECAVIR HEPATITIS B virus Liver FIBROSIS Mutation TENOFOVIR
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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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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
Prevalence of hepatocarcinoma-related hepatitis B virus mutants in patients in grey zone of treatment 预览
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作者 Ana Isabel Gil-García Antonio Madejón +8 位作者 Irene Francisco-Recuero Ana López-López Emiliana Villafranca Miriam Romero Araceli García Antonio Olveira Rocío Mena Juan Ramón Larrubia Javier García-Samaniego 《世界胃肠病学杂志:英文版》 SCIE CAS 2019年第38期5883-5896,共14页
BACKGROUND Antiviral treatment of patients with chronic hepatitis B(CHB)in the grey zone of treatment comands risk management in order to optimize the health outcome.In this sense,the identification of HBV mutants rel... BACKGROUND Antiviral treatment of patients with chronic hepatitis B(CHB)in the grey zone of treatment comands risk management in order to optimize the health outcome.In this sense,the identification of HBV mutants related with an increased risk of hepatocellular carcinoma(HCC)could be useful to identify subpopulations with potential indication of antiviral treatment.AIM To analyze the prevalence/persistence of hepatitis B virus(HBV)preS and basal core promoter(BCP)/precore/core variants associated to HCC development in CHB patients in the grey zone.METHODS Work was designed as a longitudinal retrospective study,including 106 plasma samples from 31 patients with CHB in the grey zone of treatment:Hepatitis B e antigen negative,HBV-DNA levels between 12-20000 IU/mL,normal or discordant transaminase levels during follow up and mild/moderate necroinflammatory activity in liver biopsy or Fibroscan(up to 9.5 kPa).Serum HBVDNA was tested using the Abbott Real Time HBV Assay and the BCP/precore/core and the hepatitis B surface antigen(HBsAg)coding regions were analyzed in positive samples by PCR/bulk-sequencing to identify the HCCrelated HBV mutants.RESULTS High-risk HCC related mutants were detected in 24(77%)patients:19(61%)in the BCP/precore/core,and 7(23%)in the HBsAg coding region(2 preS1 and 5 preS2 deletions).The prevalence of preS deletions was genotype-dependent:3/5(60%)patients with preS2 deletions and 1/2 with preS1 deletions were infected with the HBV-E genotype.Since HBV-E was the most prevalent in sub-Saharan patients,a correlation between preS deletions and ethnicity was also found:6/8(75%)sub-Saharan vs 1/19(5%)Caucasian patients had preS deletions(P=0.00016).Remarkably,this correlation was maintained in those patients infected with HBV-A,a minor genotype in sub-Saharan patients:2/2 patients infected with HBV-A from West Africa vs 0/6 of Caucasian origin had preS deletions.The HCC related variants were the major strains and persisted over time(up to 48 mo).Patients with preS deletions had a significant hig 展开更多
关键词 HEPATITIS B VIRUS Hepatocellular carcinoma PreS DELETIONS HEPATITIS B VIRUS TREATMENT GREY ZONE
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