Serum concentration of sFas and sFasL in healthy HBsAg carriers,chronic viral hepatitis B and C patients

AIM:To estimate the amount of apoptosis among healthy HBsAg carriers,patients with chronic HBV infection treated wibh lamivudine and patients with chronic HCV infection treated with interferon alpha and ribavirin.Activity of apoptosis was evaluated by serum sFas/sFasL concentration measurement. Moreover dependence between apoptosis and HBV-DNA or HCV-RNA levels was studied. METHODS:Eighty-six persons were included into study:34 healthy HBsAg carders,33 patients with chronic HBV infecl^on and 19 patients with chronic HCV infection.Serum levels of sFas/sFasL were measured by ELISA assay.HBV-DNA and HCV-RNA were measured by RT-PCR assay.Levels of sFas/sFasL were determined before and 2 and 12 wk after therapy in patients with chronic hepatitis B and C infection. HBV-DNA or HCV-RNA was detected before treatment and 6 mo after treatment. RESULTS:Twenty-four (71%) healthy HBsAg carders showed HBV-DNA over 10~5/mL,which was comparable to the patients with chronic hepatitis B.independently from HBV-DNA levels, the concentration of sFas among healthy HBsAg carders was comparable to healthy persons.Among patients with chronic hepatitis B and C,the concentration of sFas was significantly higher in comparison to healthy HBsAg carriers and healthy persons.In chronic hepatitis B patients the concentration of sFas was decreased during lamivudine treatment.Among chronic hepatitis C patients the concentration of sFas was increased during IFN alpha and ribavirin treatment,sFasL was not detected in control group.Furbhermore sFasL occurred more frequently in chronic hepatitis C patients in comparison to chronic hepatitis B patients. CONCLUSION:There are no correlations between apoptosis and HBV-DNA levels.However ther is an association between apoptosis and activity of inflammation in patients with chronic HBV infection.Apoptosis can be increased in patients with chronic hepatitis C by effective treatment which may be a result of apoptosis stimulation by IFN-α.

Matrix-derived serum markers in monitoring liver fibrosis in children with chronic hepatitis B treated with interferon alpha

To evaluate prospectively 4 selected serum fibrosis markers （tenascin, hyaluronan, collagen Ⅵ, TIMP-1） before, during and 12 mo after IFN treatment of children with chronic hepatitis B. METHODS： Forty-seven consecutive patients with chronic hepatitis B （range 4-16 years, mean 8 years） underwent IFN treatment （3 MU tiw for 20 wk）. Fibrosis stage and inflammation grade were assessed in a blinded fashion before and 12 mo after end of treatment. Serum fibrosis markers were determined using automated assays.RESULTS： IFN treatment improved histological inflammation but did not change fibrosis in the whole group or in subgroups. Only hyaluronan correlated significantly with histological fibrosis（r = 0.3383, P = 0.022）. Basal fibrosis markers did not differ between responders （42.5%） and nonresponders（57.5%）. During IFN treatment only serum tenascin decreased significantly in the whole group and in nonresponders. When pretreatment values were compared to values 12 mo after therapy, TIMP-1 increased in all patients and in nonresponders, and hyaluronan decreased in all patients and in responders.CONCLUSION： Tenascin reflects hepatic fibrogenesis and inflammation which decreases during IFN treatment of children with chronic hepatitis B. TIMP-1 correlates with nonresponse and hyaluronan with histological fibrosis.

sFRP-4, a potential novel serum marker for chronic hepatitis B-related hepatocellular carcinoma

BACKGROUND：The current methods used for diagnosing hepatocellular carcinoma（HCC）are unsatisfactory.Here,we assessed the serum levels of secreted frizzled related protein 4（s FRP-4）for diagnosing HCC in patients infected with chronic hepatitis B（CHB）.METHODS：In 272 patients with CHB enrolled,142 were pa tients with HCC.Thirty-three healthy subjects were recruited as healthy controls.The CHB patients were assigned to a test group or a validation group based on the time of enrollment. Human antibody arrays were used to screen 15 patients （8 CHB-related HCC patients, 7 CHB patients） for serum mark- ers. Four markers and one candidate marker were assessed in the test group and validation group, respectively. RESULTS： Human antibody assays indicated that the serum levels of sFRP-4 in HCC patients were significantly higher than those in CHB patients （P〈0,05）. Additionally, serum sFRP-4 levels were significantly higher in the HCC patients than those in the non-HCC patients in both test group （79.7 vs 41.3 ng/mL; P〈0.001） and validation group （89.0 vs 39.0 ng/mL; P〈0.001）. Areas under the Receiver Operating Charac- teristic curves （AUCs） for alpha-fetoprotein （AFP） and sFRP-4 were similar in both test group and validation group. In the test group, the combination of sFRP-4 （a sensitivity of 94.4%, a specificity of 60.5% at 46.4 ng/mL） and AFP （a sensitivity of 75.0%, a specificity of 87.2% at 11.3 ng/mL） showed better performance for diagnosing HCC （a sensitivity of 79.2% and a specificity of 95.3%）. The AUC for combined sFRP-4 and AFP increased to 0.941 （95% CI： 0.908-0.975）, and similar results were seen in the validation group. CONCLUSION： sFRP-4 is a candidate serum marker for diagnosing HCC in CHB patients, and the combination of sFRP-4 with AFP may improve the diagnostic accuracy of HCC.

Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B

BACKGROUND Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection.However,up to now,there are few studies about 4-1BB in chronic hepatitis B(CHB).AIM To clarify this issue,we report our comprehensive study results on the expression levels of 4-1BB in patients with CHB.METHODS From September 2018 to June 2019,a total of 64 patients with CHB were recruited from the Department of Hepatology,The First Hospital of Jilin University.Peripheral blood samples were collected from 52 treatment-naïve and 12 entecavir-treated patients with CHB as well as 37 healthy donors(including 24 healthy adults and 13 healthy children).The levels of soluble 4-1BB(s4-1BB)in plasma were measured by ELISA.4-1BB mRNA expression in peripheral blood mononuclear cells was detected by real-time quantitative PCR.RESULTS The s4-1BB levels in the plasma of patients with CHB were significantly higher than those in healthy adults(94.390±7.393 ng/mL vs 8.875±0.914 ng/mL,P<0.001).In addition,the s4-1BB level in plasma was significantly increased in patients with a higher viral load and a disease flare up.However,there were no significant differences between treatment-naïve and entecavir-treated patients.Interestingly,among treatment-naïve patients with CHB,the levels of s4-1BB in plasma had a significant positive correlation with hepatitis B surface antigen,hepatitis B virus DNA,hepatitis B e antigen,and triglyceride levels(r=0.748,P<0.001;r=0.406,P=0.004;r=0.356,P=0.019 and r=-0.469,P=0.007,respectively).The 4-1BB mRNA expression was higher in the peripheral blood mononuclear cells of patients with CHB than in the peripheral blood mononuclear cells of healthy adults,but the difference was not statistically significant.CONCLUSION These results suggest that the levels of s4-1BB may be associated with pathogenesis of hepatitis B virus and therefore may be a promising biomarker for disease progression.

Hepatitis B Surface Antigen Serum Level Is Correlated with Fibrosis Severity in Treatment-Naïve, Chronic Hepatitis B Patients in Côte d’Ivoire (West Africa)?

HBsAg serum level (quantification) may be useful for managing hepatitis B virus (HBV) infection patients. However few studies especially in Africa have evaluated the association between HBsAg serum level and liver fibrosis severity. The objective of this study was to estimate the correlation between HBsAg serum level and liver fibrosis severity with treatment naive chronic hepatitis B patients in Cote d’Ivoire. Methodology: It is a prospective study covering from February 1st, 2014 to April 30st, 2015 at Centre Hospitalier et Universitaire de Yopougon and a private medical office in Abidjan, Cote d’Ivoire. Inclusion criteria for patients were: HBsAg positive, known HBeAg status, serum HBsAg levels, serum HBV DNA levels, complex serum markers and absence of HCV, HDV, or HIV co-infection, drinking more than 30 g/day for men and 20 g/day in women over 10 years, metabolic disease and/or hepatic overload. Pearson’s Chi-square test (r2), Anova, Spearman, T-Student, Pearson’s (r) correlations and Mann Withney’s Test were carried out as appropriate. A p value < 0.05 was taken as significant. Results: We recruited, 105 patients (77 men) of whom the medium age was 39.01 ± 9.72 years. Predominant hepatitis B viral genotype was E (93%). Less than 10% patients had an inactive HBV in HBeAg-negative. Patients had an average high HBsAg serum level (mean 12111.2 ± 10617.4 IU/ml) as well as the one viral load (mean 4.4 e7 ± 7.5 e7). Serum ALAT levels averaged at the upper limit of normal value. The average liver fibrosis score was 0.34 ± 0.22 and the degree of viral activity was 0.19 ± 0.20. Half of our patients had no fibrosis (35.24%) or had mild fibrosis (20.95%). No significant association was observed between HBsAg serum level and patient age (p = 0.3994), genre (p = 0.8075) or serum ALT levels (p = 0, 0787). In multivariate analysis, there’s a significant correlation (r = 0.239, p = 0.014) between HBV DNA levels and HBsAg serum level. There’s a significant correlation (r = 0.923, p < 0.0001) between HBsAg serum level and the dosage of alpha-fetoprotein. HBsAg serum level was not associated with the fibrosis stage (p = 0.281). HBsAg levels average with patients without fibrosis or carry a slight fibrosis (F0, F1) was higher than patients with moderate to severe fibrosis (F2, F3, F4): 13679.2 UI/ml ± 1956.48 versus 10610.52 UI/ml ± 8998.99 (p = 0.29). There’s a negative correlation between HBsAg level and the liver fibrosis score was negative (r = -0.069, p = 0.48). No significant association between HBsAg level and the liver fibrosis patients that were normal (p = 0.7965) or elevated (p = 0.5845). HBV DNA level was significantly associated with fibrosis score (r = 0.30, p = 0.0018). Conclusion: This study shows that there’s a negative correlation between HBsAg serum level and liver fibrosis severity treatment naive with African chronic hepatitis B viral HBeAg-negative patients.

Analysis of the correlation between HBV replication markers and HBV markers and liver function in patients with hepatitis B

Objective:To investigate the correlation between HBV replication markers and HBV markers and liver function in patients with hepatitis B.Methods: A total of 273 cases of chronic hepatitis B patients in our hospital as the hepatitis B group, select 60 healthy people as control group, group monitoring of hepatitis B virus replication index (serum HBV-DNA), HBV serum markers, and monitor the liver function index of the two groups of subjects, analysis of the relationship between serum HBV-DNA level and hepatitis B markers and liver function. Results: HBsAg (+), HBeAg (+), HBcAb (+), the positive rate of HBV-DNA was 100%, HBsAg (+), HBeAb (+), ABcAb (+), the positive rate of HBV-DNA was 47.58%, HBsAg (+), HBeAg (+), HBeAb (+), HBcAb (+) group, the positive rate of HBV-DNA was 69.44%, HBsAg (+), HBcAb (+) group, positive rate of HBV-DNA was 13.64%. The positive rate of HBV-DNA in the greater Sanyang group was significantly higher than that of the other three groups. With the increase of HBV-DNA load, the serum levels of ALT and AST increased significantly, the difference was statistically significant, but there was no significant change in serum CHE level.Conclusion: for hepatitis B patients serum HBV-DNA level in patients with regular monitoring and evaluation of the virus replication, but the HBV-DNA and the degree of liver injury and prognosis of patients with no obvious correlation, also need to pay attention to monitor liver function index of patients, thus accurate assessment and Analysis on the development of the patient's condition.

92031例癌症患者HBV血清标志物特征分析

目的了解癌症患者乙型肝炎病毒(hepatitis B virus,HBV)的感染状态和感染特点。方法回顾性分析2017年7月26日至2023年9月18日于广西医科大学附属肿瘤医院确诊的92031例癌症患者的HBV血清标志物检测结果,以肝癌、非肝癌进行分组,比较未感染(全阴或Anti-HBs阳性)、感染(除外Anti-HBs任何一项阳性)、隐性感染(occult hepatitis B virus infection,OBI;HBsAg阴性、血清或肝组织HBV DNA阳性)的占比。结果92031例癌症患者的HBV总感染率为73.75%(67876/92031),其中肝癌患者的HBV总感染率为97.65%(8922/9137),非肝癌患者的HBV总感染率为71.12%(58954/82894),肝癌组的普通感染率和OBI率均显著高于非肝癌组(均P<0.001)。肝癌组HBV血清标志物中HBsAg、HBeAg、Anti-HBe、Anti-HBc的阳性率明显高于非肝癌组(均P<0.001),但Anti-HBs的阳性率低于非肝癌组(P<0.001)。肝癌组和非肝癌组分别有20种和27种血清标志物组合模式,其中14种模式构成比在两组间差异有统计学意义(均P<0.001);两组均有7种OBI血清组合模式,其中5种模式构成比在两组间的差异有统计学意义(均P<0.05)。结论癌症患者HBV感染状态和血清学组合模式复杂,区分肝癌与非肝癌进行HBV感染统计更利于癌症患者的HBV感染评估。

Staging of liver fibrosis in chronic hepatitis B patients with a composite predictive model:A comparative study

AIM:To evaluate the efficacy of 6 noninvasive liver fibrosis models and to identify the most valuable model for the prediction of liver fibrosis stage in chronic hepatitis B(CHB) patients.METHODS:Seventy-eight CHB patients were consecutively enrolled in this study.Liver biopsy was performed and blood serum was obtained at admission.Histological diagnosis was made according to the METAVIR system.Significant fibrosis was defined as stage score ≥ 2,severe fibrosis as stage score ≥ 3.The diagnostic accuracy of 6 noninvasive liver fibrosis models,including serum aspartate aminotransferase(AST) to platelet ratio index(APRI),FIB-4,Forn's index,Fibrometer,Hepascore,and Shanghai Liver Fibrosis Group's index(SLFG),was investigated.RESULTS:The APRI,FIB-4 and Forn's index under receiver operating characteristic curve(AUROC) for sig-nificant fibrosis were 0.71,0.75 and 0.79,respectively,with a diagnosis accuracy of 67%,77% and 80%,respectively,and 0.80,0.87 and 0.86,respectively,under the AUROC for severe fibrosis.The Hepascore,SLFG,and Fibrometer were 0.80,0.83 and 0.85,respectively under the AUROC for significant fibrosis(P < 0.01).The diagnosis accuracy of Hepascore and SLFG was 86% and 88%,respectively.The Hepascore,SLFG,and Fibrometer were 0.95,0.93,and 0.94,respectively,under the AUROC for severe fibrosis(P < 0.01).CONCLUSION:The models containing direct serum markers have a better diagnostic value than those not containing direct serum markers.

Natural course of chronic hepatitis B is characterized by changing patterns of programmed death type-1 of CD8-positive T cells

AIM:To investigate if and how programmed death type-1(PD-1)expression affects the natural course of hepatitis B virus(HBV)infection. METHODS:Sixty-four patients in different natural stages of chronic HBV infection were enrolled in this study.PD-1 expression in total T cells was detected by flow cytometry.Levels of total CD8+T cell responses and proliferation in relation to PD-1 expression levels were analyzed with intracellular staining and PD-1/ PD-L1 blockage. RESULTS:The PD-1 expression in T cells was dynamically changed during the natural course of chronic HBV infection,did not significantly increase in the immune tolerance phase,and returned to normal in the inactive virus carrier stage.Blockage of the PD-1/PD-L1 pathway could not affect the T-cell response in the immune tolerance and inactive virus carrier stages of chronic HBV infection.However,it could significantly restore the T-cell response in the immune clearance stage of chronic HBV infection.Furthermore,the PD-1 expression level in T cells was associated with the alanine aminotransferase level during the immune clearance stage of chronic HBV infection. CONCLUSION:The PD-l/PD-L1 pathway plays a different role in T-cell response during the natural course of chronic HBV infection.

Programmed death-1 expression is associated with the disease status in hepatitis B virus infection

AIM： TO define the potential role of programmed death-i/programmed death-ligand （PD-1/PD-L） pathway in different hepatitis B virus （HBV） infection disease status; we examined the expression of PD-1 on antigen specific CD8＋T cells in peripheral blood of patients with chronic hepatitis B （CriB） and acute exacerbation of hepatitis B （AEHB） infection. METHODS： The PD-1 level on CD8＋ T lymphocytes and the number of HBV specific CD8＋ T lymphocytes in patients and healthy controls （HCs） were analyzed by staining with pentameric peptide-human leukocyte antigen2 （HLA2） complexes combined with flow cytometry. Real-time quantitative polymerase chain reaction （PCR） was used to measure the serum HBV- DNA levels. RESULTS： The level of PD-1 expression on total CD8＋ T cells in CHB patients （13.86% ± 3.38%） was significantly higher than that in AEHB patients （6.80%± 2.19%, P 〈 0.01） and healthy individuals （4.63% ± 1.23%, P 〈 0.01）. Compared to AEHB patients （0.81% ± 0.73%）, lower frequency of HBV-specific CD8＋ T cells was detected in chronic hepatitis B patients （0.37% ± 0.43%, P 〈 0.05）. There was an inverse correlation between the strength of HBV-specific CD8＋ T-cell response and the level of PD-1 expression. Besides, there was a significant positive correlation between HBV viral load and the percentage of PD-1 expression on CD8＋ T cells in CriB and AEHB subjects （R = 0.541, P 〈 0.01）. However, PD-1 expression was not associated with disease flare-ups as indicated by alanine aminotransferase （ALT） levels （R = 0.066, P 〉 0.05）. CONCLUSION： Our results confirm previous reports that HBV specific CD8＋T-cell response in the peripheral blood is more intense in patients with AEHB than in chronic hepatitis B wlth persistent viral infection. Moreover, there is a negative correlation between the level of PD-1 and the intensity of virus specific CD8＋ T cell response.

Noninvasive assessment of liver damage in chronic hepatitis B

AIM:To evaluate the efficacy of the aspartate aminotransferase/platelet ratio index(APRI)and neutrophillymphocyte(N/L)ratio to predict liver damage in chronic hepatitis B(CHB).METHODS:We analyzed 89 patients diagnosed with CHB by percutaneous liver biopsy and 43 healthy subjects.Liver biopsy materials were stained with hematoxylin-eosin and Masson’s trichrome.Patients’fibrosis scores and histological activity index(HAI)were calculated according to the Ishak scoring system.Fibrosis score was recognized as follows:F0-1 No/early-stage fibrosis,F2-6 significant fibrosis,F0-4 non-cirrhotic and F5-6 cirrhotic.Significant liver fibrosis was defined as an Ishak score of≥2.APRI and N/L ratio calculation was made by blood test results.RESULTS:The hepatitis B and control group showed no difference in N/L ratios while there was a significant difference in terms of APRI scores(P<0.001).Multiple logistic regression analysis revealed that the only independent predictive factor for liver fibrosis in CHB was platelet count.APRI score was significantly higher in cirrhotic patients than in non-cirrhotic patients.However,this significance was not confirmed by multiple logistic regression analysis.The optimum APRI score cut-off point to identify patients with cirrhosis was 1.01with sensitivity,specificity,positive predictive value and negative predictive value of 62%(36%-86%),74%(62%-83%),29%(13%-49%)and 92%(82%-97%),respectively.In addition,correlation analyses revealed that N/L ratio has a negative and significant relationship with HAI(r=-0.218,P=0.041).CONCLUSION:N/L ratio was negatively correlated with HAI.APRI score may be useful to exclude cirrhosis in CHB patients.

Fibrotouch联合血清标志物评估慢性乙型肝炎肝纤维化的价值

目的分析瞬时弹性成像技术(Fibrotouch)评估联合血清标志物在慢性乙型肝炎肝纤维化程度评估中的价值。方法选择厦门市第三医院2019年3月—2021年9月收治的180例慢性乙型肝炎患者作为研究对象。依病理结果分为无纤维化组72例、早期纤维化组68例和进展性纤维化组40例。所有患者均接受Fibrotouch检测肝脏硬度值(liver stiffness measurement,LSM)、血清透明质酸(hyaluronic acid,HA)、黏连蛋白(laminin,LN)、Ⅳ型胶原(collage typeⅣ,CⅣ)和Ⅲ型前胶原(precollagen typeⅢ,PCⅢ)水平。Spearman相关性分析LSM、HA、LN、CⅣ、PCⅢ水平与肝纤维化程度的相关性。受试者工作特征(receiver operating characteristic,ROC)曲线分析上述指标联合检测诊断肝纤维化的价值。结果不同肝纤维程度患者LSM、HA、LN、CⅣ、PCⅢ比较,差异有统计学意义(P<0.05);且进展性纤维化组各指标均高于早期纤维化组、无纤维化组,早期纤维化组各指标均高于无纤维化组(P<0.05);LSM、HA、LN、CⅣ、PCⅢ均与肝纤维化程度呈正相关,相关系数分别为0.949、0.912、0.898、0.867、0.893(P<0.05);ROC曲线分析显示,LSM、HA、LN、CⅣ、PCⅢ、联合检测肝纤维化曲线下面积(area under curve,AUC)分别为0.790、0.839、0.623、0.863、0.804、0.968,联合检测预测效果最好,且联合检测敏感度高于其他各项单独检测指标(P<0.05)。结论慢性乙型肝炎患者LSM、HA、LN、CⅣ、PCⅢ均与肝纤维化程度呈正相关,上述指标联合检查效果最好,敏感度最高,临床可联合检测上述指标诊断肝纤维化。

AFP、PIVKA-Ⅱ和NLR在HBV-HCC中的诊断价值探讨

目的探讨血清甲胎蛋白(AFP)、异常凝血酶原(PIVKA-Ⅱ)与外周血中性粒细胞淋巴细胞比值(NLR)联合检测对乙型肝炎病毒相关肝细胞癌(HBV-HCC)的诊断价值。方法选取2021年1月至2022年12月期间本院接诊的134例乙型肝炎病毒诱导的相关肝细胞癌患者、80例肝硬化患者和90例乙型肝炎病毒患者分别设为肝癌组、肝硬化组和对照组。采用SPSS26.0、Medcalc软件比较三组AFP、PIVKA-Ⅱ与NLR水平,绘制ROC受试者工作曲线,比较曲线下面积(AUC)和灵敏度,评估各血清标志物单独及联合检测在肝癌诊断中的应用价值。Logistic回归分析肝癌发生的危险因素。结果肝癌组AFP、PIVKA-Ⅱ与NLR水平明显高于肝硬化组和对照组,差异有统计学意义(P<0.001)。各项单独分析时,PIVKA-Ⅱ显示了最好的预测效能(AUC 0.858,P<0.001);两两组合时,PIVKA-II+NLR预测性能最佳(AUC=0.874,P<0.001);Ⅲ~Ⅳ期患者PIVKA-Ⅱ与AFP水平高于Ⅰ~Ⅱ期患者(P<0.05);Logistic回归分析显示年龄、PIVKA-Ⅱ和NLR均是肝癌发生的危险因素。三者联合检测AUC为0.902,灵敏度为87.10%,诊断效能有所提高,优于各单项或任意两项联合检测。结论AFP、PIVKA-Ⅱ和NLR对乙型肝炎病毒相关肝癌患者的诊断及分期具有一定的价值,联合检测可以增加HBV-HCC的诊断效能和敏感性。

聚乙二醇干扰素α-2b对慢性乙型肝炎患者血清标志物HBsAg、HBV-pgRNA、HBV-RNA的影响

目的观察聚乙二醇干扰素α-2b(Peg-IFNα-2b)对慢性乙型肝炎(CHB)患者血清乙型肝炎病毒表面抗原(HBsAg)表达水平的影响,并探究其与新型血清标志物乙型肝炎病毒前基因组(HBV-pgRNA)、HBV-RNA的关系。方法收集该院2018年2月至2021年12月初次确诊的36例接受Peg-IFNα-2b治疗6个月的CHB患者血清;使用化学发光法HBsAg测定试剂盒检测血清HBsAg水平;聚合酶链式反应(PCR)荧光探针法检测血清HBV-DNA、HBV-pgRNA、HBV-RNA水平;使用Pearson相关性分析HBV-pgRNA、HBV-RNA与HBsAg之间的相关性。结果与治疗前相比,治疗后CHB患者血清HBsAg、HBV-DNA发生明显降低,HBV-pgRNA、HBV-RNA也明显降低,差异有统计学意义(P<0.05);治疗前血清HBV-pgRNA、HBV-RNA均与HBsAg呈显著的正相关(r=0.751、0.702,均P<0.05);治疗后血清HBV-pgRNA、HBV-RNA与HBsAg也呈正相关(r=0.420、0.625,均P<0.05)。与治疗前相比,治疗后HBV-pgRNA、HBV-RNA与HBsAg的相关系数均明显的降低。结论Peg-IFNα-2b可抑制CHB患者血清HBV-HBsAg,且HBV-pgRNA、HBV-RNA与HBV-HBsAg表达水平呈正相关。

乙肝免疫学标志物定量、血清HBV-DNA载量和老年慢性乙肝病人肝功能的关系研究

目的探讨乙肝免疫学标志物(HBV-M)定量、血清乙肝病毒(HBV-DNA)载量与老年慢性乙肝病人肝功能的关系。方法对2021年4月-2022年9月收治的90名慢性乙肝老年病人通过荧光定量PCR技术定量检测HBV-DNA含量,通过酶联免疫吸附试验(ELISA)检测HBV-M定量,即检测病人肝功能谷丙转氨酶(ALT)、前白蛋白(PA)以及谷草转氨酶(AST)水平。结果大三阳组HBV-DNA定量值平均为(64568.45±4329.52)copy/mL,小三阳组为(20230.23±3419.19)copy/mL,HBcAg+HBcAb阳性组为(15673.54±2108.98)copy/mL,大三阳组的HBV-DNA定量明显高于小三阳组和HBcAg+HBcAb阳性组,对比具备统计学意义(P<0.05);而小三阳组和HBcAg+HBcAb阳性组对比区别不明显,无统计学意义(P>0.05)。三组ALT、PA、AST水平对比中,ALT和AST水平大三阳组、小三阳组及HBcAg+HBcAb阳性组从高到低,而PA水平则由低到高,对比具备统计学意义(P<0.05)。HBV-DNA定量值和年龄存在一定的关系,以65~70岁病人最高。结论慢性乙肝病人HBV-M定量和HBV-DNA载量与病人肝功能之间有着密切关系,对各项指标进行全面检测有助于老年慢性乙肝病人病情的筛查、检测、诊断以及治疗等。

富马酸丙酚替诺福韦与恩替卡韦治疗高血清病毒载量的代偿期乙型肝炎肝硬化患者效果比较研究

目的分析比较富马酸丙酚替诺福韦与恩替卡韦治疗高血清病毒载量的代偿期乙型肝炎肝硬化患者的疗效。方法2020年1月~2023年1月我院收治的64例高血清病毒载量(HBVDNA为1×106 IU/mL或以上)的代偿期乙型肝炎肝硬化患者,被随机分为对照组32例和观察组32例,分别给予恩替卡韦和富马酸丙酚替诺福韦治疗,连续治疗观察12个月。使用高效液相色谱分析法检测尿液乳果糖/甘露醇(L/M)比值,采用比色法检测血清D-乳酸,采用紫外比色法检测血清二胺氧化酶(DAO),采用ELISA法检测血清内霉素和白细胞介素-7(IL-7),采用化学发光免疫分析法检测血清降钙素原(PCT),采用免疫荧光定量法检测肝素结合蛋白(HBP)。结果在观察治疗12个月末,两组均获得病毒学和生化学应答,两组血清TBIL、ALT和AST水平无显著性相差(P>0.05);观察组血清DAO、D-乳酸、内霉素和尿L/M比值分别为(2.8±0.6)U/mL、(7.9±1.8)μg/mL、(0.5±0.1)EU/mL和(7.3±1.6)%,与对照组【分别为(3.0±0.5)U/mL、(7.8±2.2)μg/mL、(0.6±0.1)EU/mL和(8.1±1.9)%,P>0.05】比,无显著性差异;观察组血清PCT、HBP和IL-7水平分别为(0.01±0.00)μg/L、(43.1±3.7)ng/mL和(768.9±20.3)pg/mL,与对照组【分别为(0.02±0.01)μg/L、(47.6±3.2)ng/mL和(743.4±21.5)pg/mL,P>0.05】比,无显著性差异。结论应用富马酸丙酚替诺福韦或恩替卡韦治疗高血清病毒载量的代偿期乙型肝炎肝硬化患者疗效肯定,对肠道屏障功能无明显的影响。

干扰素α-1b联合恩替卡韦治疗高病毒载量慢性乙型肝炎疗效评价

目的探讨干扰素α-1b联合恩替卡韦(ETV)治疗高病毒载量慢性乙型肝炎(CHB)患者的临床疗效。方法 92例高病毒载量(血清HBV DNA≥1×107 IU/ml)CHB患者被分为观察组48例和对照组44例。对照组采用干扰素α-1b治疗,观察组采用干扰素α-1b联合ETV治疗,疗程48 w。比较两组治疗后第12、24、48 w血清丙氨酸氨基转移酶(ALT)复常率、HBV DNA不可检出率、HBe Ag阴转率和HBe Ag转换率。采用ELISA法检测血清乙型肝炎病毒标记物;使用自动生化分析仪检测肝功能指标;采用荧光定量PCR法检测HBV DNA。结果在治疗第24 w和48 w时,观察组血清ALT复常率分别为68.8%和91.7%,显著高于对照组的34.1%和63.6%(P<0.01);在治疗第12 w、24 w和48 w时,观察组血清HBV DNA不可检测率分别为45.8%、72.9%和87.5%,显著高于对照组的11.4%、31.8%和47.7%(P<0.01);在治疗第48 w时,观察组HBe Ag阴转率和HBe Ag转换率分别为67.6%和62.2%,显著高于对照组的42.9%和37.1%(P<0.05)。结论干扰素α-1b联合ETV治疗血清高病毒载量的CHB患者疗效优于单用干扰素α-1b。

化学发光分析法定量检测住院患者HBV血清标志物及临床意义

目的获得西安地区住院患者血清乙型肝炎病毒血清标志物的流行病学资料,为医院院内感染管理以及医护人员的防护提供依据。方法利用Abott Architecti 4000SR(i4000SR)化学发光分析仪定量检测2015年10 593例住院病人血清中乙型肝炎病毒表面抗原(HBsAg)、乙型肝炎病毒表面抗体(HBsAb)、乙型肝炎病毒e抗原(HBeAg)、乙型肝炎病毒e抗体(HBeAb)和乙型肝炎病毒核心抗体(HBcAb),其中男性5 248例,女性5 345例。结果 HBV感染率为7.01%(743/10 593),受检者血清中HBV五项检测结果共有14种模式,其中感染期模式HBsAg,HBeAb和HBcAb均为阳性(模式3)占5.17%(548/10 593),HBsAg,HBeAg和HBcAb均为阳性(模式2)占1.34%(142/10 593),HBsAg和HBcAb均为阳性(模式4)占0.25%(27/10 593),其他非常见感染期模式占0.25%(26/10 593);恢复期模式中HBsAb阳性占21.02%(2227/105 93),HBsAb,HBeAb和HBcAb均阳性(模式6)占13.71%(1 452/10 593),HBsAb和HBcAb均阳性占15.07%(1 596/10 593);五项指标皆阴性的占31.38%(3 324/10 593)。不同性别和不同年龄段的患者中HBV血清标志物结果模式阳性率差异均有统计学意义(P<0.05);感染模式2比例最高的科室为消化内科7.39%(36/487),感染模式3比例最高的科室为消化内科16.43%(80/487),HBsAb阳性比例最高的科室为胸外科89.23%(58/65)。结论了解住院患者乙肝感染特点为管理和控制院内HBV传播和推广乙肝疫苗接种提供了必要的临床资料数据,同时提示需要进一步采取有效措施来降低西安地区HBV的感染率。

HBV病毒载量与血清学标志物和肝功能关系的分析

目的:探讨血清HBV病毒载量与血清学标志物和肝功能之间的关系。方法:用实时荧光定量PCR法测定乙肝病毒载量、ELISE法测定血清学标志物及酶法测定肝功能指标ALT、AST,对5486例乙肝患者血清标本的上述三种指标结果进行分析。结果:在四种常见的血清学模式中,HBeAg阳性的Ⅰ组(HBsAg、HBeAg和Anti-HBc阳性)和Ⅳ组(HBsAg和HBeAg阳性)的HBV病毒载量阳性率为94.8%,明显高于HBeAg阴性的Ⅱ组(HBsAg、Anti-HBe和Anti-HBc阳性)和Ⅲ组(HBsAg和Anti-HBc阳性)38.5%的阳性率,并且在不同的HBV病毒载量拷贝数组中,HBeAg阳性率随着HBV病毒载量拷贝数的增加而升高;血清学模式为Ⅰ、Ⅱ和Ⅲ组病人的肝功能异常率在HBV病毒载量<103copies/ml和>103copies/ml两组中在统计学上均有显著性差异(P<0.01),提示上述三组血清学模式病人中,HBV病毒载量为>103copies/ml组的肝功能异常率与<103copies/ml组比较明显偏高;而Ⅳ组在HBV病毒载量两组中的肝功能异常率在统计学上无显著性差异(P>0.01)。结论:HBV病毒载量与乙肝血清学标志物及肝功能指标ALT、AST之间有一定程度的关联,但又各有特点,临床上只有对三类检测结果进行综合分析,才能更好地对HBV感染的诊断、治疗和预后判断提供帮助。

乙型肝炎病毒前S1抗原与HBV DNA和HBV-M及肝功能的相关性探讨

目的探讨兰州地区乙型肝炎病毒(HBV)感染者血清中前S1抗原(Pre-S1Ag)与HBV DNA、HBV-M及肝功能之间的相关性。方法对905例HBV感染者(HBV感染组)及100例健康体检者(健康对照组)进行Pre-S1Ag、HBV-M、HBV DNA和肝功能检测。结果 905例标本中,Pre-S1Ag和HBV DNA阳性率分别为68.51%(620/905)和67.96%(615/905),差异均无统计学意义(χ2=30.064,P>0.05);570例HBeAg阳性组中,HBV Pre-S1阳性率为85.08%(485/570),显著高于HBeAg阴性组的Pre-SAg1阳性率40.30%(135/335),差异有统计学意义(χ2=108.881,P<0.01)。Pre-S1Ag阳性组与阴性组ALT、AST异常率分别为53.22%、25.96%和51.29%、32.98%,差异有统计学意义(χ2ALT=53.148,P<0.001,χ2AST=66.635,P<0.001)。结论 Pre-S1Ag是乙肝病毒感染与复制的可靠指标,与HBV-DNA阳性相关度高,是对HBeAg的重要补充和加强,可为指导临床治疗提供更及时可靠的实验依据。