A 62-year-old man had chronic hepatitis B virus （HBV） infection and was diagnosed with liver cirrhosis. At the time of diagnosis the patient＇s virologic markers were positive for hepatitis B surface antigen （HBsAg...A 62-year-old man had chronic hepatitis B virus （HBV） infection and was diagnosed with liver cirrhosis. At the time of diagnosis the patient＇s virologic markers were positive for hepatitis B surface antigen （HBsAg）, antibody to hepatitis B e antigen （anti-HBe） and antibody to hepatitis B core antigen （anti-HBc）, while antibody to hepatitis B surface antigen （anti-HBs） and HBV DNA were negative. Later the patient received chemotherapy for malignancy. However, this was interrupted due to elevated liver enzymes. At the same time HBV DNA became positive. Lamivudine （LMV） therapy was administered immediately. However, the levels of serum aminotransferase and total bilirubin （TB） were still rising. Finally the patient died of fulminant hepatic failure. A sequence revealed HBV genotype C （HBsAg subtype adw） with immune escape mutations, F8L, $34L, F41S, G44V, F93C, V96G, Lll0I, C149Y and F161Y. The high morbidity and mortality of this complication is one of the major obstacles to completing the standard treatment for malignancy in HBV carriers. Therefore, the relative risk of antiviral prophylactic failure should be further assessed and the optimal strategy for antiviral prophylaxis in HBsAg-positive patients with oncologic and hematologic malignancies undergoing chemotherapy should be revised.展开更多
目的了解新生儿常规接种5微克(μg)重组乙型肝炎(乙肝)疫苗(酿酒酵母)[Hepatitis B Vaccine Made by Recombinant Dexyribonucleic Acid(DNA)Techniques inSaccharomyces CerevisiaeYeast,HepB-SCY]后,抗乙肝病毒表面抗原抗体[Antibody ...目的了解新生儿常规接种5微克(μg)重组乙型肝炎(乙肝)疫苗(酿酒酵母)[Hepatitis B Vaccine Made by Recombinant Dexyribonucleic Acid(DNA)Techniques inSaccharomyces CerevisiaeYeast,HepB-SCY]后,抗乙肝病毒表面抗原抗体[Antibody to Hepatitis B Virus(HBV)Surface Antigen(HBsAg),Anti-HBs]的应答状况,并分析其影响因素。方法在山东省4个市选取7～12月龄、已按0、1、6个月免疫程序接种3剂5μg HepB-SCY的健康婴儿4147人,对其进行问卷调查并采集静脉血,采用化学发光微粒子免疫分析法定量检测Anti-HBs,计算抗体应答率和抗体水平,分析与抗体应答有关的因素。结果新生儿常规接种3剂5μgHepB-SCY后,Anti-HBs无应答[<10毫国际单位/毫升(mIU/ml)、且HBsAg及HBV-DNA(脱氧核糖核酸)均阴性]率为1.91%,低应答(≥10mIU/ml、但<100mIU/ml)率为17.31%,正常应答(≥100mIU/ml、但<1000mIU/ml)率为63.75%,高应答(≥1000mIU/ml)率为17.04%;Anti-HBs平均浓度为303.30mIU/ml。多因素分析表明,采血月龄延后、低出生体重、在乡级医院出生、母亲分娩前HBsAg阳性与新生儿低/无应答发生有关。结论新生儿采用5μg HepB-SCY初免后,可获得较好的Anti-HBs应答,新生儿HepB免疫应答受多种因素影响。展开更多
基金National Basic Research Priorities Program of China(2011CB106303)The National Natural Science Foundation of China(31200699)The Fundamental Research Funds for the Central Universities(HUST:2012QN140)
文摘A 62-year-old man had chronic hepatitis B virus （HBV） infection and was diagnosed with liver cirrhosis. At the time of diagnosis the patient＇s virologic markers were positive for hepatitis B surface antigen （HBsAg）, antibody to hepatitis B e antigen （anti-HBe） and antibody to hepatitis B core antigen （anti-HBc）, while antibody to hepatitis B surface antigen （anti-HBs） and HBV DNA were negative. Later the patient received chemotherapy for malignancy. However, this was interrupted due to elevated liver enzymes. At the same time HBV DNA became positive. Lamivudine （LMV） therapy was administered immediately. However, the levels of serum aminotransferase and total bilirubin （TB） were still rising. Finally the patient died of fulminant hepatic failure. A sequence revealed HBV genotype C （HBsAg subtype adw） with immune escape mutations, F8L, $34L, F41S, G44V, F93C, V96G, Lll0I, C149Y and F161Y. The high morbidity and mortality of this complication is one of the major obstacles to completing the standard treatment for malignancy in HBV carriers. Therefore, the relative risk of antiviral prophylactic failure should be further assessed and the optimal strategy for antiviral prophylaxis in HBsAg-positive patients with oncologic and hematologic malignancies undergoing chemotherapy should be revised.
文摘目的了解新生儿常规接种5微克(μg)重组乙型肝炎(乙肝)疫苗(酿酒酵母)[Hepatitis B Vaccine Made by Recombinant Dexyribonucleic Acid(DNA)Techniques inSaccharomyces CerevisiaeYeast,HepB-SCY]后,抗乙肝病毒表面抗原抗体[Antibody to Hepatitis B Virus(HBV)Surface Antigen(HBsAg),Anti-HBs]的应答状况,并分析其影响因素。方法在山东省4个市选取7～12月龄、已按0、1、6个月免疫程序接种3剂5μg HepB-SCY的健康婴儿4147人,对其进行问卷调查并采集静脉血,采用化学发光微粒子免疫分析法定量检测Anti-HBs,计算抗体应答率和抗体水平,分析与抗体应答有关的因素。结果新生儿常规接种3剂5μgHepB-SCY后,Anti-HBs无应答[<10毫国际单位/毫升(mIU/ml)、且HBsAg及HBV-DNA(脱氧核糖核酸)均阴性]率为1.91%,低应答(≥10mIU/ml、但<100mIU/ml)率为17.31%,正常应答(≥100mIU/ml、但<1000mIU/ml)率为63.75%,高应答(≥1000mIU/ml)率为17.04%;Anti-HBs平均浓度为303.30mIU/ml。多因素分析表明,采血月龄延后、低出生体重、在乡级医院出生、母亲分娩前HBsAg阳性与新生儿低/无应答发生有关。结论新生儿采用5μg HepB-SCY初免后,可获得较好的Anti-HBs应答,新生儿HepB免疫应答受多种因素影响。
