HBV genotype C is independently associated with cirrhosis in community-based population

AIM:To determine the association of hepatitis B virus (HBV) genotypes with probable cirrhosis and fatty liver in community-based populations.METHODS: A multi-stage cluster probability sampling method was applied to recruit 10 167 subjects aged between 6 and 72 years from our epidemiological bases in Eastern China. After excluding the subjects co-infected with hepatitis C or hepatitis D viruses, the hepatitis B surface antigen (HBsAg)-positive subjects were examined for HBV genotype, serum viral load, alanine aminotransferase (ALT), hepatitis B e antigen (HBeAg) status, and ultrasonographic changes. Logistic regression models were used to determine the factors associated with probable cirrhosis and fatty liver.RESULTS: Of 634 HBsAg-positive subjects with HBV genotype determined, 82 had probable cirrhosis (ultrasonographic score ≥5), 42 had ultrasonographic fatty liver. Probable cirrhosis was only found in the HBeAg-negative subjects, and more frequently found in the subjects with genotype C than in those with genotype B (14.8% vs 8.0%, P=0.018). In HBeAg-negative subjects, high viral load was frequently asso-ciated with abnormal ALT level, while ALT abnormality was more frequent in those with probable cirrhosis than those without (19.5% vs 7.8%, P=0.001). Univariate analysis showed that age, sex, HBV genotypes, and viral load were not significantly associated with ultrasonographic fatty liver, whereas ALT abnormality was significantly related to ultrasonographic fatty liver (OR=4.54,95% CI:2.11-9.75, P<0.001). Multivariate analysis demonstrated that HBV genotype C, age (≥45 years), male sex, and ALT abnormality were independently associated with probable cirrhosis (AOR=2.30,95% CI:1.26-4.19; AOR =1.81,95% CI:1.10-2.99;AOR=1.74,95% CI:1.03-2.95; AOR=2.98,95% CI:1.48-5.99, respectively).CONCLUSION: A crude prevalence of probable cirrhosis is 12.9% in the community-based HBV-infected subjects. HBV genotype C is independently associated with probable cirrhosis in the HBeAg-negative subjects.

Clinical value of contrast-enhanced ultrasonography in the characterization of focal liver lesions:a prospective multicenter trial

BACKGROUND: Contrast-enhanced ultrasonography (CEUS) is increasingly accepted in clinical settings for diagnostic imaging of focal liver lesions (FLLs). This study aimed to assess the efficacy of CEUS in the characterization of FLLs in comparison with final diagnosis based on gold standard assessment. METHODS: The study was approved by the local ethics committee and participating patients provided written informed consent. A total of 148 patients with 164 FLLs were studied. Unenhanced ultrasonography (US) and CEUS were performed using fundamental and harmonic imaging, respectively. Contrast enhancement was assessed during the arterial, portal and late vascular phases after intravenous administration of contrast (SonoVue (R), Bracco, Italy). Sensitivity, specificity and diagnostic accuracy of US and CEUS were compared in identifying the lesion as benign, malignant or indeterminate and its actual tumor type. Final diagnosis was established by biopsy (129/164), MR imaging (11/164) or medical history (24/164). RESULTS: When compared to the gold standard, the number of indeterminate diagnoses was reduced from 56.7% (93/164) as assessed by fundamental imaging to 6.1% (10/164) after SonoVue (R) enhanced US examination. Sensitivity and specificity improved from 49% and 25% at baseline US to 93% and 75% with CEUS, respectively (P<0.01). Diagnostic accuracy of CEUS was 88% in contrast to 41% of baseline US. CONCLUSION: SonoVue (R) enhanced US improves the characterization of FLLs and may limit the need for further investigations.

A comparative study of four 20-membered N_2S_4-crown ethers as ionophores for polymeric membrane silver selective electrodes

Four 20-membered N_2S_4-monoazathiacrown ethers have been synthesized and explored as neutral ionophores for Ag^+-selective electrodes.Potentiometric responses reveal that the flexibility of the ligands has great effect on the selectivity and sensitivity to Ag^+ ions.The electrode based on ionophore 9,10,20,25-tetrahydro-5H,12H-tribenzo[b,n,r][1,7,10,16,4,13]tetrathiadiaza cycloicosine 6,13-(7H,14H)-dione(C) with 2-nitrophenyl octyl ether(o-NPOE) as solvent in a poly(vinyl chloride)(PVC) membrane matrix sho...