Differential gene expression between asymptomatic HBV carriers and normal adults

BACKGROUND: There are more than 100 million wa symptomatic HBV carriers (ASCs) in China and they are at a high risk of developing liver disease, which creates a serious health problem. But more than 90% of normal adults clear virus from primary HBV infection, so the difference of gene expression between ASCs and normal adults determines the differential outcomes. To identify differentially expressed genes in ASCs compared to normal adults, we used suppression subtractive hybridization to compare gene expression. METHODS: cDNA subtracted libraries were constructed by suppression subtracted hybridization from peripheral blood monocytes of ASCs and normal adults, the subtracted clones were prescreened by dot blot hybridization, and the levels of genes of interest were confirmed by real-time reverse transcriptase-polymerase chain reaction (RT-PCR). RESULTS: One hundred and two and 96 positive clones were acquired from the A-N and N-A libraries, respectively, and 14 and 11 clones were identified by dot blot hybridization in the A-N and N-A libraries. Two genes were confirmed as differentially expressed between a set of ASC and normal adult samples by real-time RT-PCR. CONCLUSIONS: Differentially expressed genes in peripheral blood mononuclear cells between ASCs and normal adults were isolated by suppression subtractive hybridization, and included some new genes. Of the upregulated genes in ASCs, checkpoint suppressor I is associated with DNA damage-induced cell cycle arrest. Perforin I is associated with inflammation. The information about such alterations in gene expression could be useful for elucidating the mechanisms of ASC pathogenesis.

Patient with hepatocellular carcinoma related to prior acute arsenic intoxication and occult HBV:Epidemiological,clinical and therapeutic results after 14 years of follow-up

Little is known about the long-term survivors of acute arsenic intoxication. We present here a clinical case report of a man with chronic hepatitis B virus （HBV） infection who developed hepatocellular carcinoma four years after acute arsenic poisoning. HBsAg was detected in serum in 1990 when he voluntarily donated blood. In 1991, the patient suffered from severe psychological depression that led him to attempt suicide by massive ingestion of an arsenic-containing rodenticide. He survived with polyneuropathy and paralysis of the lower limbs, and has been wheelchair-bound since then. During participation in a follow-up study conducted among HBV carders, abdominal ultrasound detected a two-centimeter liver mass consistent with hepatocellular carcinoma. The tumor was confirmed by computed tomography （CT） and magnetic resonance image （MRI）. Because of his significant comorbidity, the patient received palliative treatment with transarterial lipiodol chemoembolization （TACE） on three occasions （1996, 1997 and 1999）. At his most recent visit in lay 2005, the patient was asymptomatic, liver enzymes were normal and the tumor was in remission on ultrasound.

Acute Onset Pancreatitis in the Third Trimester of Pregnancy in HBV Carrier Women Taking Telbivudine for Blocking Mother-to-Infant Transmission

Acute pancreatitis in pregnancy(APIP) is rare and the reasons for APIP are biliary disease and congenital or acquired hypertriglyceridemia, which could occur during any trimester but more than 50% cases happened during the third trimester. In this report, one case of a young pregnant woman, a HBV carrier in her 37 th week + 5 d of gestation, was admitted to Emergency Department due to acute abdominal pain, vomiting and diarrhea. The patient was in antiretroviral treatment with telbivudine from 28 weeks of gestation to prevent motherto-child transmission of HBV. Laboratory tests demonstrated hypertriglyceridemia, abdominal computed tomography scan revealed peripancreatic edema. Hyperlipidemic pancreatitits was primary diagnosed and the patient was admitted to the intensive care unit. Considering the possible role in the pathogenesis of pancreatitis, telbivudine was interrupted after birth giving. After supportive treatment, her condition gradually improved. Since it is the first description of APIP during treatment with telbivudine, the association between pregnancy, hyperlipidemia, telbivudine and acute pancreatitis has been well investigated.

The incidence of liver abnormalities is higher in inactive hepatitis B virus carriers with influenza A infection

1INTRODUCTION China is still at a high risk of hepatitis B virus(HBV)infection and has a large number of inactive HBV carriers(ICs)[1].Chronic hepatitis B viral infection is a global problem,which commonly progresses to liver cirrhosis[2],hepatocellular carcinoma[3],and liver diseaserelated death[4].

Patients with SARS-CoV-2 and HBV coinfection are at risk of greater liver injury

To date,it remains unclear if severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)co-infection exacerbates liver injury in patients with chronic hepatitis B virus(HBV)infection.In this study,we present a retrospective study of 133 hospitalized confirmed mild coronavirus disease 2019(COVID-19)cases,including 116 patients with COVID-19 with negative serum hepatitis B antigen and 17 HBV inactive carriers with COVID-19.We found that there were no significant differences for the discharge rate or duration of hospitalization be-tween the two groups.However,inactive HBV carriers with SARS-CoV-2 co-infection are at a higher risk of abnormal liver function tests.The enhanced liver injury induced by SARS-CoV-2 and HBV co-infection was identified as the hepatocyte type rather than the cholangiocyte type.Moreover,the inflammatory response,including abnormal lactate dehydrogenase,D-dimer and interleukin-6 production,may contribute to this injury following SARS-CoV-2 co-infection.Collectively,SARS-CoV-2 and HBV co-infection exacerbates liver function of the pa-tients with COVID-19.

Advantages of a Novel Model for Predicting Hepatic Fibrosis in Chronic Hepatitis B Virus Carriers Compared with APRI and FIB-4 Scores

Background and Aims:Aspartate aminotransferase-toplatelet ratio index(APRI)and fibrosis-4 index(FIB-4)are widely used to assess liver fibrosis in chronic hepatitis B virus(HBV)infection.Currently,the definition of normal alanine aminotransferase(ALT)is controversial.We aimed to examine the diagnostic value of APRI and FIB-4 in chronic HBV carriers with different upper limits of normal(ULNs)for ALT.Methods:581 chronic HBV carriers were divided into the following four groups based on different ULNs for ALT:chronic HBV carriers I,II,III,and IV.Furthermore,106 chronic HBV carriers formed an external validation group.Predictive values of APRI and FIB-4 were elucidated using the area under the curve(AUC).A liver fibrosis-predictive model-GPSA(named for its measure of gamma glutamyl transpeptidase,platelet count,HBsAg and albumin)was developed using multivariate logistic regression analysis.Results:In chronic HBV carriers I,the AUCs of APRI and FIB-4 were 0.680 and 0.609 for significant fibrosis and 0.678 and 0.661 for cirrhosis,respectively.The AUCs of GPSA for significant fibrosis in the training group,internal group,and external validation group were 0.877,0.837,and 0.871,respectively.The diagnostic value of GPSA differed among chronic HBV carriers I,II,III,and IV,with AUCs for significant fibrosis being 0.857,0.853,0.868,and 0.905 and AUCs for cirrhosis being 0.901,0.905,0.886,and 0.913,respectively.GPSA showed a higher diagnostic value than APRI and FIB-4 for predicting significant fibrosis in the four groups.Conclusions:The GPSA model allows for accurate diagnosis of liver fibrosis in chronic HBV carriers with different ULN for ALT.