Precore/basal core promoter mutants quantification throughout phases of hepatitis B virus infection by Simpleprobe

AIM:To investigate precore/basal core promoter(PC/BCP) mutants throughout hepatitis B virus(HBV) infection and to determine their relationship to hepatitis B early antigen(HBeA g) titers.METHODS:We enrolled 191 patients in various stages of HBV infection at the Huashan Hospital and the Taizhou Municipal Hospital from 2010 to 2012.None of the patients received antiviral therapy.HBV DNA from serum,was quantified by real-time PCR.The HBV genotype was determined by direct sequencing of the S gene.We used the Simpleprobe ultrasensitivequantitative method to detect PC/BCP mutants in each patient.We compared the strain number,percentage,and the changes in PC/BCP mutants in different phases,and analyzed the relationship between PC/BCP mutants and HBe Ag by multiple linear regression and logistic regression.RESULTS:Patients with HBV infection(n = 191) were assigned to groups by phase:Immune tolerance(IT) = 55,Immune clearance(IC) = 67,Low-replicative(LR) = 49,and HBeA g-negative hepatitis(ENH) = 20.Of the patients(male,112; female,79) enrolled,122 were HBe Ag-positive and 69 were HBe Ag-negative.The median age was 33 years(range:18-78 years).PC and BCP mutation detection rates were 84.82%(162/191) and 96.86%(185/191),respectively.In five HBe Ag-negative cases,we detected double mutation G1896A/G1899 A.The logarithm value of PC mutant quantities(log10 PC) significantly differed in IT,IC,and LR phases,as well as in the ENH phase(F = 49.350,P < 0.001).The logarithm value of BCP mutant quantities(log10 BCP) also differed during the four phases(F = 25.530,P < 0.001).Log10 PC and log10 BCP values were high in the IT and IC phases,decreased in the LR phase,and increased in the ENH phase,although the absolute value at this point remained lower than that in the IT and IC phases.PC mutant quantity per total viral load(PC%) and BCP mutant quantity per total viral load(BCP%) differed between phases(F = 20.040,P < 0.001; F = 10.830,P < 0.001),with PC% and BCP% gradually increasing in successive phases.HBeA g titers negatively correlated with PC%(Spearman's rho =-0.354,P < 0.001) and BCP%(Spearman's rho =-0.395,P < 0.001).The negative correlation between PC% and HBeA g status was significant(B =-5.281,P = 0.001),but there was no such correlation between BCP% and HBeA g status(B =-0.523,P = 0.552).CONCLUSION:PC/BCP mutants become predominant in a dynamic and continuous process.Log10 PC,log10 BCP,PC% and BCP% might be combined to evaluate disease progression.PC% determines HBeA g status.

Serum uric acid in patients with acute ST-elevation myocardial infarction

BACKGROUND:Few studies investigated serum uric acid levels in patients with acute STelevation myocardial infarction(STEMI).The study was to assess the clinical value of serum uric acid levels in patients with acute ST-elevation myocardial infarction(STEMI).METHODS:Totally 502 consecutive patients with STEMI were retrospectively studied from January 2005 to December 2010.The level of serum lipid,echocardiographic data and in-hospital major adverse cardiovascular events(MACE) in patients with hyperuricemia(n=119) were compared with those in patients without hyperuricemia(n=383).The relationship between the level of serum uric acid and the degree of diseased coronary artery was analyzed.All data were analyzed with SPSS version 17.0 software for Student's t test,the Chi-square test and Pearson's correlation coefficient analysis.RESULTS:Serum uric acid level was positively correlated with serum triglyceride level.Hyperlipidemia was more common in hyperuricemia patients than in non-hyperuricemia patients(43.7%vs.33.7%,P=0.047),and serum triglyceride level was significantly higher in hyperuricemia patients(2.11±1.24 vs.1.78±1.38,P=0.014).But no significant association was observed between serum uric acid level and one or more diseased vessels(P>0.05).Left ventricular end-diastolic diameter(LVEDd) was larger in hyperuricemia patients than in non-hyperuricemia patients(53.52±6.19 vs.52.18±4.89,P=0.041).The higher rate of left systolic dysfunction and diastolic dysfunction was discovered in hyperuricemia patients(36.4%vs.15.1%,P<0.001;68.2%vs.55.8%,P=0.023).Also,hyperuricemia patients were more likely to have in-hospital MACE(P<0.05).CONCLUSIONS:Serum uric acid level is positively correlated with serum triglyceride level,but not with the severity of coronary artery disease.Hyperuricemia patients with STEMI tend to have a higher rate of left systolic dysfunction and diastolic dysfunction and more likely to have more in-hospital MACE.