免疫激活与发病机制
在基础科学及发病机制领域，第4届国际艾滋病协会大会（International AIDS Society，IAS）的注意力主要集中在HIV感染的潜在机制，尤其是免疫激活对疾病进程的作用。关于这些影响机制，多数研究又集中在病毒复制...免疫激活与发病机制
在基础科学及发病机制领域，第4届国际艾滋病协会大会（International AIDS Society，IAS）的注意力主要集中在HIV感染的潜在机制，尤其是免疫激活对疾病进程的作用。关于这些影响机制，多数研究又集中在病毒复制以及淋巴细胞的耗竭到底在疾病中起何作用。病毒载量是疾病进展的直接预测因素，而体内病毒的复制直接导致淋巴细胞破坏。展开更多
Background and aims: Flares are a well known phenomenon during antiviral treatment for chronic hepatitis B. Little is known about the effect of flares on response. We investigated the timing and characteristics of fla...Background and aims: Flares are a well known phenomenon during antiviral treatment for chronic hepatitis B. Little is known about the effect of flares on response. We investigated the timing and characteristics of flares, in relation to treatment response (hepatitis B e antigen loss). Patients: A total of 266 patients, participating in a global randomised controlled study, were assigned to 52wee ks of 100 μg pegylated (Peg)-interferon a-2b weekly, combined with either dai ly lamivudine 100 mg or placebo. Results: Sixty seven patients (25%) exhibited 75 flares, with 38 (51%) flares in the combination therapy and 37 (49%) in the monotherapy groups. Overall, 30%of patients with and 38%of patients without a flare responded to therapy (p = 0.25). In 24 patients (36%) the flare was foll owed by a decrease in hepatitis B virus (HBV) DNA (host induced flare). In 25 (3 8%) patients the flare was preceded by an increase in HBV DNA (virus induced fl are). In 17 (26%) patients the flare did not meet one of these criteria (indete rminate flare). Of patients with host induced flare, 58%responded whereas only 20%of patientswith virus induced flares responded (p = 0.008). Hepatitis B surf ace antigen loss (n = 8) was exclusively seen in patients experiencing a host in duced flare. Multivariate logistic analysis showed that host induced flares was an independent predictor of response (p = 0.043). Conclusion: Flares are not mor e common in responders than in non-responders to Peginterferon α-2b therapy. Virus induced flares, which occur after an increase in HBV DNA level, and most p robably are indicative for increased expression of viral antigens, did not lead to treatment response. In contrast, host induced flares which were followed by a HBV DNA decrease were highly associated with treatment response.展开更多
Since 1980, the Transfusion-transmitted Viruses Study (TTVS) (1974-1980) has continued to maintain its com-puterized database and stored sera to enable ongoing study of new transfusion events since the 1970s. Most rec...Since 1980, the Transfusion-transmitted Viruses Study (TTVS) (1974-1980) has continued to maintain its com-puterized database and stored sera to enable ongoing study of new transfusion events since the 1970s. Most recently, we have used this resource to study parameters of acute hepatitis C virus (HCV) infection among 94 donor-recipient pairs in which there was transmission. In addition, frequent recipient observations permitted further characterization of the early phase of the infection’s course. Donor RNA load ranged from 3.7 to 3,160,000 IU/mL.Onset of recipient viremia was judged from a total of 67 sera collected during the 4th through 8th days posttransfusion; only 2 of the 67 sera were still RNA nonreactive by that time. The recipients’latent periods to an alanine aminotransferase (ALT) elevation of ≥90 IU/L ranged from 6 to 112 days (median, 46 days) and was shorter with higher donor RNA levels. Descriptors of the recipient’s illness showed several strongly positive and negative correlations. The latent period tended to be shorter in the 37%of cases that were clinically overt. Attributes of donors with genotypes 1 and non-1 and subtypes 1a and 1b did not differ significantly. Recipients with genotype 1 strains had shorter latent intervals than non-1 strains. On multivariate analysis, latent period was significantly associated (negatively) only with the highest ALT level during the first 120 days of follow-up (P = .014). In conclusion, host factors are more important determinants of acute HCV infection dynamics than virus-associated factors.展开更多
文摘免疫激活与发病机制
在基础科学及发病机制领域，第4届国际艾滋病协会大会（International AIDS Society，IAS）的注意力主要集中在HIV感染的潜在机制，尤其是免疫激活对疾病进程的作用。关于这些影响机制，多数研究又集中在病毒复制以及淋巴细胞的耗竭到底在疾病中起何作用。病毒载量是疾病进展的直接预测因素，而体内病毒的复制直接导致淋巴细胞破坏。
文摘Background and aims: Flares are a well known phenomenon during antiviral treatment for chronic hepatitis B. Little is known about the effect of flares on response. We investigated the timing and characteristics of flares, in relation to treatment response (hepatitis B e antigen loss). Patients: A total of 266 patients, participating in a global randomised controlled study, were assigned to 52wee ks of 100 μg pegylated (Peg)-interferon a-2b weekly, combined with either dai ly lamivudine 100 mg or placebo. Results: Sixty seven patients (25%) exhibited 75 flares, with 38 (51%) flares in the combination therapy and 37 (49%) in the monotherapy groups. Overall, 30%of patients with and 38%of patients without a flare responded to therapy (p = 0.25). In 24 patients (36%) the flare was foll owed by a decrease in hepatitis B virus (HBV) DNA (host induced flare). In 25 (3 8%) patients the flare was preceded by an increase in HBV DNA (virus induced fl are). In 17 (26%) patients the flare did not meet one of these criteria (indete rminate flare). Of patients with host induced flare, 58%responded whereas only 20%of patientswith virus induced flares responded (p = 0.008). Hepatitis B surf ace antigen loss (n = 8) was exclusively seen in patients experiencing a host in duced flare. Multivariate logistic analysis showed that host induced flares was an independent predictor of response (p = 0.043). Conclusion: Flares are not mor e common in responders than in non-responders to Peginterferon α-2b therapy. Virus induced flares, which occur after an increase in HBV DNA level, and most p robably are indicative for increased expression of viral antigens, did not lead to treatment response. In contrast, host induced flares which were followed by a HBV DNA decrease were highly associated with treatment response.
文摘Since 1980, the Transfusion-transmitted Viruses Study (TTVS) (1974-1980) has continued to maintain its com-puterized database and stored sera to enable ongoing study of new transfusion events since the 1970s. Most recently, we have used this resource to study parameters of acute hepatitis C virus (HCV) infection among 94 donor-recipient pairs in which there was transmission. In addition, frequent recipient observations permitted further characterization of the early phase of the infection’s course. Donor RNA load ranged from 3.7 to 3,160,000 IU/mL.Onset of recipient viremia was judged from a total of 67 sera collected during the 4th through 8th days posttransfusion; only 2 of the 67 sera were still RNA nonreactive by that time. The recipients’latent periods to an alanine aminotransferase (ALT) elevation of ≥90 IU/L ranged from 6 to 112 days (median, 46 days) and was shorter with higher donor RNA levels. Descriptors of the recipient’s illness showed several strongly positive and negative correlations. The latent period tended to be shorter in the 37%of cases that were clinically overt. Attributes of donors with genotypes 1 and non-1 and subtypes 1a and 1b did not differ significantly. Recipients with genotype 1 strains had shorter latent intervals than non-1 strains. On multivariate analysis, latent period was significantly associated (negatively) only with the highest ALT level during the first 120 days of follow-up (P = .014). In conclusion, host factors are more important determinants of acute HCV infection dynamics than virus-associated factors.
