Socio-Demographic and Occupational Aspects of HIV-HBV Co-Infection in Bangui, Central African Republic (CAR): Hospital-Based Cross-Sectional Study

Objective: HIV-HBV co-infection is a major public health problem that has not been sufficiently explored in the Central African workplace. The aim of this study was to assess the frequency of HIV-HBV co-infection among people who living with HIV (PLHIV) in the infectious and tropical diseases department of the Centre Hospitalier Universitaire de lAmiti Sino-Centrafricaine in Bangui. Methods: A retrospective study was carried out from January 1, 2010 to December 31, 2021 in the Infectious and Tropical Diseases Department at the Amiti Sino-Centrafricaine University Hospital. It included the files of all PLHIV, which included the results of HBV serology. A standardized form was used to collect socio-demographic and professional data by documentary review. Data was analysed using Epi-Info 7 software. Means, proportions were calculated as well as Chi square witch was significant if p-value was below 0.05. Results: The study included 265 patients, 188 were women (70.1%) and 77 men (29.1%), giving a sex ratio of 0.45. Mean age was 35.8 years, higher in men (40 years) than in women (35.8 years) (p 0.0001). The age groups 25 to 34 (37.7%) and 35 to 44 (33.6%) were in the majority (71.3%). The majority of PLHIV were unemployed (57.1%), including housewives (43.0%). HBV prevalence was 14.3%, including 7.2% among the unemployed, who account for half of all co-infections. The search for associations between HIV-HBV co-infection and all socio-demographic characteristics (age, sex, marital status) and socio-professional categories showed no significant difference (p 0.05). Conclusion: PLHIV were predominantly young adults, female, and unemployed;no occupation was significantly associated with co-infection. The vast majority of co-infected people were not covered by the occupational health system (unemployed or informal sector). Urgent action is needed to improve workers access to occupational medicine in CAR.

DYNAMICAL BEHAVIOR OF A STOCHASTIC HBV INFECTION MODEL WITH LOGISTIC HEPATOCYTE GROWTH

This paper is concerned with a stochastic HBV infection model with logistic growth. First, by constructing suitable stochastic Lyapunov functions, we establish sufficient conditions for the existence of ergodic stationary distribution of the solution to the HBV infection model. Then we obtain sufficient conditions for extinction of the disease. The stationary distribution shows that the disease can become persistent in vivo.

GLOBAL ASYMPTOTICAL PROPERTIES FOR A DIFFUSED HBV INFECTION MODEL WITH CTL IMMUNE RESPONSE AND NONLINEAR INCIDENCE

This article proposes a diffused hepatitis B virus （HBV） model with CTL immune response and nonlinear incidence for the control of viral infections. By means of different Lyapunov functions, the global asymptotical properties of the viral-free equilibrium and immune-free equilibrium of the model are obtained. Global stability of the positive equilibrium of the model is also considered. The results show that the free diffusion of the virus has no effect on the global stability of such HBV infection problem with Neumann homogeneous boundary conditions.

Prevalence of occult HBV infection in haemodialysis patients with chronic HCV

AIM： To study the prevalence and clinical effects of occult HBV infection in haemodialysis patients with chronic HCV.METHODS： Fifty chronic hemodialysis patients with negative HbsAg, and positive anti-HCV were included in the study. These patients were divided into two groups： HCV-RNA positive and HCV-RNA negative, based on the results of HCV-RNA PCR. HBV-DNA was studied using the PCR method in both groups.RESULTS： None of the 22 HCV-RNA positive patients and 28 HCV-RNA negative patients revealed HBV-DNA in serum by PCR method. The average age was 47.2±17.0 in the HCV-RNA positive group and 39.6±15.6 in the HCV-RNA negative group.CONCLUSION： The prevalence of occult HBV infection is not high in haemodialysis patients with chronic HCV in our region. This result of our study has to be evaluated in consideration of the interaction between HBsAg positivity （8%-10%） and frequency of HBV mutants in our region.

Significant increase in HBV, HCV, HIV and syphilis infections among blood donors in West Bengal, Eastern India 2004-2005: Exploratory screening reveals high frequency of occult HBV infection

AIM: To evaluate the prevalence of markers of hepatitis B virus (HBV) and hepatitis C virus (HCV) and human immunodeficiency virus (HIV) among blood donors in Kolkata, Eastern India for two consecutive years and to conduct a pilot study to explore the presence of HBV DNA among hepatitis B surface antigen (HBsAg) negative but anti-HBc positive blood donors. METHODS: Seroprevalence of HBsAg, anti-HCV and anti-HIV was studied among 113 051 and 106 695 voluntary blood donors screened in 2004 and 2005, respectively. Moreover, a pilot study on 1027 HBsAg negative donors was carried out for evaluating the presence of HBV DNA by PCR on HBsAg negative/anti- HBc positive donors. RESULTS: A statistically significant increase in the prevalence of HBV (1448 vs 1768, P < 0.001), HIV (262 vs 374, P < 0.001), HCV (314 vs 372, P = 0.003) and syphilis (772 vs 853, P = 0.001) infections was noted among blood donors of Kolkata West Bengal in 2005 as compared to 2004. Moreover, the exploratory study on 1027 HBsAg negative donors revealed that 188 (18.3%)of them were anti-HBc positive out of which 21% were positive for HBV DNA. CONCLUSION: The findings of this study underscore the significantly increasing endemicity of hepatitis viruses, syphilis and HIV among the voluntary blood donors of our community. The pilot study indicates a high rate of prevalence of HBV DNA among HBsAg negative/anti-HBc positive donors and thus emphasizes the need for a more sensitive and stringent screening algorithm for blood donations.

Efficiency and safety of lamivudine therapy in patients with chronic HBV infection, dialysis or after kidney transplantation

AIM: To analyze the effectiveness and safety of lamivudine treatment in patients with chronic HBV infection undergoing hemodialysis or after kidney transplantation, and to study the frequency of tyrosine - methionine - aspartate - aspartate (YMDD) mutation occurrence after lamivudine treatment. METHODS: We analyzed 91 patients with chronic hepatitis B, among whom, 16 patients underwent hemodialysis, 7 patients had kidney transplantation and 68 patients had normal function of kidney. The hemodialysis patients were treated by lamivudine 300 mg/wk. patients after kidney transplantation and patiente with normal function of kidney were treated with lamivudine 100 mg/d. Therapy lasted for 12 mo. HBV-DNA, HBsAg, HBeAg and anti-HBe, and anti-HCV antibodies were assessed in sera of patients. The analysis was performed before and 6 mo after the end of lamivudine treatment. Before, during and after the lamivudine therapy, the number of erythrocytes, leukocytes, platelets and hemoglobin concentration, ALT and AST activity, as well as bilirubin, urea and creatinine concentrations were analyzed in sera from patients. RESULTS: After the 12-mo lamivudine treatment, elimination of HBV - DNA was observed in 56% patients undergoing hemodialysis and in 53% patients with normal kidney function. Only 1 from 7 (14%) kidney-transplanted patients eliminated HBV-DNA. Furthermore, HBeAg elimination was observed in 36% hemodialysis patients, in 51% patients with normal function of kidneys and in 43% kidney transplanted patients. Among the patients undergoing dialysis, no YMDD mutation was found after 12 mo of therapy, while it was detected in 9 patients (13%) with normal function of kidney and in 2 kidney-transplanted patients (29%, P<0.006). We did not observe significant side effecte of lamivudine treatment in studied patiente. CONCLUSION: Effectiveness of lamivudine therapy in dialysis patients is comparable with that in patiente with normal function of kidney. Lamivudine treatment is well tolerated and safe in patiente with renal insufficiency undergoing hemodialysis and kidney-transplantation. However, in the latter group, high incidence of YMDD mutation after lamivudine treatment was observed.

Prevention of de novo HBV infection by the presence of anti-HBs in transplanted patients receiving core antibody-positive livers

AIM： To analyze whether the presence of anti-HBs in liver transplant recipients is effective in preventing HBV infection. METHODS： Twenty-three patients receiving anti-HBc positive liver were studied. Nine recipients were anti-HBc positive as a result of previous HBV infection. Of them, one also received HBV vaccine during the pre-liver transplantation period. Fourteen recipients were anti-HBs positive due to HBV vaccine administered during the pretransplant period. Liver biopsy was obtained in 10/14 anti-HBc negative/anti-HBs positive recipients and in 4/9 anti-HBc positive recipients. RESULTS： After a mean foUow-up period of 46 months, 1 recipient with protective serum anti-HBs levels developed de novo HBV infection as a consequence of immune escape HBV mutants. Among the 14 vaccinated anti-HBc negative/anti-HBs positive recipients, 1/10 patients with available liver biopsy （10%） had liver HBV-DNA at 13 mo post-liver transplantation without serum viral markers and did not develop de novo HBV infection.The vaccinated anti-HBc positive recipient without HBV vaccine response was HBV-DNA positive in serum and liver, viral DNA was continuously negative in the following tests, so a spontaneous seroconversion was diagnosed. CONCLUSION： The presence of anti-HBs as a result of HBV vaccine or past HBV infection seems to be effective at protecting patients receiving livers from anti-HBc positive donors. However, the emergence of immune escape HBV mutants, which can evade the anti-HBs protection, should be considered as a risk of HBV infection.

Synergistic Action of Clonorchiasis,HBV Infection and Alcohol Consumption on Primary Hepatocellular Carcinoma

OBJECTIVE It has been recognized that HBV infection and alcohol consumption are two important risk factors for primary hepatocellular carcinoma （HCC）. Recently, the role of clonorchiasis as a risk factor for HCC is controversial. We aimed to investigate whether these factors increase the risk of HCC in Guangxi, China. METHODS A hospital-based, case-control study of HCC was conducted from July 2005 to July 2007. We enrolled 500 consecutive patients with HCC as an experimental group and 500 patients without tumor in liver as a control group. The risk factors that the patients were exposed to were assessed. RESULTS Comparing the risks of developing the HCC, we found out the following results. The risk of developing HCC for the patients with clonorchiasis was 5 folds of that for the patients without clonorchiasis （OR = 5.0; 95% CI： 3.1-8.1）, and the risk for the patients with alcohol consumption was 3 folds of that for the patients without drinking alcohol （OR = 3.4; 95% CI： 2.3-4.9）, and similarly, the risk for the patients with HBV infection was 21 times of that for the patients without HBV infection （OR = 20.6; 95% CI： 14.3-29.7）. According to crossover analysis, there was significant interaction among clonorchiasis, HBV infection and alcohol consumption, with synergistic indices greater than 1. The etiologic fractions attributed to these interactions [EF （A × B）] are 0.7465, 0.5789 and 0.5506, respectively. CONCLUSION Clonorchiasis, HBV infection and heavy alcohol consumption are independent risk factors for developing HCC in our population in Guangxi, and as they can interact synergistically, the risk of developing HCC is increased. Data from this study may indicate new prevention strategies of developing HCC in high-risk individuals.

Risk factors from HBV infection among blood donors:A systematic review

Objective:To perform a systematic review of the scientific literature to identify risk factors associated with hepatitis B viruses(HBV) infection among blood donors.Methods:The literature search was carried out on Pub Med and Scopus databases using the keywords "risk factors" "HBV infection" and "blood donors".No date or language restrictions were applied to the search.This literature review was completed in March2014.The selection process and the reporting of the review followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses Statement.The Newcastle Ottawa scale was using to evaluate the quality of each single primary study.Results:Out of 172 records resulted in the search,5 papers were included in the final analysis because they are within acceptance criteria.Two of the selected studies were cross-sectional and three of them were case-control studies.Significant association resulted with some demographic and behavioral risk factors,such as marital status,dental treatment/procedure history,no stable relationship or multiple partners and family history of HBV infection.Conclusions:The systematic review performed encourages to conduct further research among blood donors in order to fully understand risk factors among donors in more extensive thus to provide valuable information about surveillance.

A study on the Appearance of HBV DNA in the Liver and Serum of Patients with HDV/HBV Infection

The appearance of HBV DNA in the liver and serum of 15 patients with hepatitisB conifected with HDV was observed and compared with that of 13 HDV-negative cases.Itwas found that HBsAg titer was lower than or equal to 1:4 in 8 HDV-positive patients,inwhom it was temporally negative in 5,and negative during the,two-day hospitalization in 1.No similar result could be observed in the HDV-negative cases.The detection rate of HBVDNA in both the HDV positive and negative groups was 20.0％ (3/15) and 25％ (3.12) in se-rum,and 46.7％ (7/15) and 61.5％ (8/13) in the liver rcspectively.There was no signif-icant statistical difference between the 2 groups.The HBV DNA grains detected with in situ hybridization,with biotinylated HBV DNAprobe were demonstrated in the sparse type of distribution in 3 cases and lightly stained in 2.Itis believed that HBV DNA replication activity might be suppressed by HDV.However activeHRV DNA replication was also present in some HDV-positive patients and HBV DNA was posi-tive in both the liver and serum in 3 such patients.It was concluded that the difference of the detection rate of HBV DNA in HDV-positivepatients might be related to the different stages of HDV infection.

Post-Exposure Prophylaxis against HBV and HIV Infection in Health Care Workers

Healthcare Workers (HCWs) are constantly at risk of exposure to viral infections such as hepatitis B virus (HBV), human immune deficiency virus (HIV) and hepatitis C virus (HCV). We aim at demonstrating the results of a three-year period of a surveillance program in Iran with the prospective follow-up of HCWs exposed to blood-borne viruses. HCWs who had experienced an occupational exposure to HBV, HCV or HIV from September 2005 to 2008 were enrolled in the study. Age, gender, route of exposure, type of fluid, type of virus, job, department, working shift, work experience, wearing gloves when exposed, history of HBV vaccination and the serum level of anti HBs antibody were recorded for all participants through an individual interview. Serum samples were taken from both HCWs and the sources of exposure and were tested by enzyme linked immunosorbent assay (ELISA). The data were gathered through questionnaires completed by a nurse under the supervision of a specialist of infectious diseases. In this study, 100 HCWs who were occupationally exposed to HIV, HCV or HBV were included. Most exposures had occurred among nurses (35%), followed by residents (29%), interns (18%), housekeepers (7%), the lab staff (6%), and specialists (5%). Most of the exposures had occurred in emergency (21%) and surgical (20%) wards. The most common route of exposure was percutaneous injuries (77%) and the most common cases had contacted with needles and angiocaths (71.1%) during injection or opening vein routes (21%). Establishing a surveillance system for registering the occurrence of occupational hazardous exposures, performing prophylactic measures and following up the exposed is a necessity in hospitals so that the number of exposures and occupational diseases among the HCWs can be decreased.

Hepatitis B Virus (HBV) Infection in Pregnancy: Knowledge and Practice of Care Providers in Nigeria

Purpose: To determine the practice of obstetric care providers regarding routine screening for hepatitis B virus infection, and to assess their knowledge of the management of the positive pregnant women. Methods: A cross sectional descriptive study of obstetric care providers in southwestern Nigeria. Mean and standard deviation was used to summarize continuous variables while frequency and percentage was used for categorical variables. Categorical variables were compared with chi-square test and Fisher’s exact tests as appropriate;while continuous variables were compared using the t-test. The level of statistical significance was set at P ≤ 0.05. Scoring of the outcome variables for knowledge was done, and the score categorized into good and poor knowledge, depending on if the respondent scored above or below the mean score. Results: Three hundred and eighty-one (67.4%) of the care givers routinely screen pregnant women for the serum marker (HBSAg) of HBV infection. Two hundred and seventy-four (48.5%) of the respondents had good knowledge score of the management of HBV infection in pregnancy. Routine screening for HBV infection was significantly associated with age (p = 0.002), years of practice (p < 0.001), specialty (p = 0.001) and professional cadre (p < 0.001), while knowledge was significantly associated with age (p = 0.012), years of practice (p = 0.003), specialty (p = 0.047) and types of practice (p = 0.014). Conclusion: Screening for HBV infection in pregnant women is not universal in southwestern Nigeria, and the care providers have poor knowledge of the management of the positive mothers.

HBV and HCV infection and pancreatic ductal adenocarcinoma

Introduction Pancreatic ductal adenocarcinoma(PDAC)is a highly lethal malignancy,with a poor overall fiveyear survival.Its dismal prognosis,even after curative resection,depends on its advanced stage at diagnosis,early metastatic spread,aggressive biological behavior and inefficacy of available systemic therapies.[1]To date,epidemiological studies have identified some risk factors for this cancer,including cigarette smoking habit,family history as well as high dietary fat consumption,alcohol abuse,diabetes mellitus,metabolic syndrome and chronic pancreatitis history.[1]

芍药苷对HBV感染引起小鼠肝组织损伤的保护作用及机制探讨

目的探讨芍药苷(PF)对乙型肝炎病毒(HBV)感染引起的肝组织损伤的作用及机制。方法2022年6月至2023年1月,将40只C57BL/6小鼠按随机数字表法分为假手术(Sham)组、HBV组、5 mg/kg PF组和10 mg/kg PF组,每组10只。除对照组外,其余各组小鼠通过尾静脉注射重组腺病毒载体构建AAV8-1.3HBV感染模型。于造模前24 h至造模后5周,每日为小鼠灌胃给予不同剂量的PF溶液或等体积溶剂。随后,采用生化分析法检测小鼠血清天冬氨酸转氨酶(AST)和丙氨酸转氨酶(ALT)水平;酶联免疫吸附测定(ELISA)检测小鼠血清乙型肝炎e抗原(HBeAg)和乙型肝炎表面抗原(HbsAg)水平;苏木精-伊红(HE)染色检测小鼠肝组织病理变化;Masson染色检测肝组织纤维化情况;ELISA检测小鼠肝组织乳酸脱氢酶(LDH)、白细胞介素-1β(IL-1β)和白细胞介素-18(IL-18)水平;原位末端转移酶标记法(TUNEL)检测小鼠肝组织细胞凋亡情况;蛋白质印迹法检测小鼠肝组织焦亡相关蛋白核因子-κB(NF-κB)、Nod样受体蛋白3(NLRP3)及焦孔素D(GSDMD)的表达。结果Sham组血清AST(44.89±7.82)U/L、ALT为(43.13±5.72)U/L,HBeAg和HbsAg无表达,HBV组AST、ALT、HBeAg和HbsAg分别为(98.76±12.21)U/L、(75.38±1.23)U/L、(52.22±7.15)U/L、(67.33±9.25)U/L,HBV组小鼠各指标显著升高(P<0.05);与Sham组比较,HBV组肝组织内细胞形态发生明显改变,炎性细胞浸润明显,出现大量肝纤维化;HBV组肝组织LDH、IL-1β、IL-18显著高于Sham组(P<0.05),HBV组细胞凋亡明显增加,HBV组NF-κB、NLRP3、GSDMD表达,显著高于Sham组(P<0.05)。与HBV组比较,5 mg/kg PF组和10 mg/kg PF组小鼠血清AST、ALT、HBeAg和HbsAg水平显著降低(P<0.05);肝组织病理损伤明显减轻,肝纤维化程度改善;肝组织LDH、IL-1β及IL-18水平显著降低,细胞凋亡明显降低,NF-κB、NLRP3及GSDMD蛋白表达显著下调(均P<0.05),5 mg/kg PF组和10 mg/kg PF组之间差异有统计学意义(P<0.05)。结论PF可通过调控NLRP3介导的细胞焦亡减轻HBV感染引起的肝组织损伤,PF对HBV感染引起小鼠肝组织损伤有保护作用。

济宁地区无偿献血人群HBV感染现状调查及影响因素分析

目的调查济宁地区无偿献血人群乙型肝炎病毒(hepatitis B virus,HBV)感染现状,并分析其影响因素。方法选取2022年9月—2023年9月济宁地区无偿献血者共计21863名,均接受HBV感染标志物检测,统计HBV感染情况,并进行单因素分析与多因素logistic回归分析以明确无偿献血人群HBV感染的危险因素。结果在21863名无偿献血者中,共有108例检测出HBV感染阳性,感染率为0.49%。感染组男性、高中及以下文化程度、未接种乙肝疫苗、乙肝家族史、不安全性行为、输血史、洗牙/拔牙/补牙史占比高于未感染组,差异有统计学意义(P<0.05)。多因素logistic回归分析结果显示,未接种乙肝疫苗(OR=3.048)、乙肝家族史(OR=3.619)、不安全性行为(OR=2.937)、输血史(OR=3.458)是济宁地区无偿献血人群HBV感染的独立影响因素(P<0.05)。结论济宁地区无偿献血人群具有一定的HBV感染风险,这与未接种乙肝疫苗、乙肝家族史、不安全性行为、输血史相关,应针对上述因素制订科学预防措施,减少HBV感染。

Numerical Procedure for Fractional HBV Infection with Impact of Antibody Immune

The current investigations are presented to solve the fractional order HBV differential infection system(FO-HBV-DIS)with the response of antibody immune using the optimization based stochastic schemes of the Levenberg-Marquardt backpropagation(LMB)neural networks(NNs),i.e.,LMBNNs.The FO-HBV-DIS with the response of antibody immune is categorized into five dynamics,healthy hepatocytes(H),capsids(D),infected hepatocytes(I),free virus(V)and antibodies(W).The investigations for three different FO variants have been tested numerically to solve the nonlinear FO-HBV-DIS.The data magnitudes are implemented 75%for training,10%for certification and 15%for testing to solve the FO-HBV-DIS with the response of antibody immune.The numerical observations are achieved using the stochastic LMBNNs procedures for soling the FO-HBV-DIS with the response of antibody immune and comparison of the results is presented through the database Adams-Bashforth-Moulton approach.To authenticate the validity,competence,consistency,capability and exactness of the LMBNNs,the numerical presentations using the mean square error(MSE),error histograms(EHs),state transitions(STs),correlation and regression are accomplished.

Establishment and Validation of a nomogram for Predicting the Risk of Liver Fibrosis in Chronic HBV Infection

Objective:To establish a non-invasive quantitative and visual predictive model for assessing the occurrence of significant fibrosis in chronic HBV infection,and to present nomogram to validate the efficacy.Methods:A total of 180 patients with chronic HBV infection that were admitted to the Department of Infectious Liver Diseases of the First Affiliated Hospital of Hainan Medical University from January 2019 to December 2021 with informed consent and underwent liver biopsy puncture were selected.131 patients and 49 patients were randomly divided into a model group and a validation group according to randomization.The patients were divided into non-significant fibrosis and significant fibrosis groups in the modeling group.To collect the clinic information,serological examination,liver elastography and liver histopathology results and to establish a rosette model to predict the risk of chronic HBV infection with significant fibrosis.Results:A total of 180 patients with chronic HBV infection were included,and 113 patients(62.7%)had significant fibrosis.In the modeling set,84 patients(64.1%)had significant fibrosis.In the modeled group,comparison of HBV DNA,PLT,ALT,AST,ALP,ALB,PAB,IL-6,HA,PⅢP,CIV,L.N and LSM for non-significant fibrosis and significant fibrosis showed statistically significant differences.The χ^(2) values of the H-L goodness-of-fit test for the modelling and validation groups were 4.988 and 0.527,respectively,corresponding to P values of 0.08 and 0.77,suggesting that the nomogram has good predictive accuracy;the area under the ROC curve of the column line plot predicting the occurrence of significant fibrosis after HBV infection for the modelling and validation groups was 0.843[95%CI(0.775-0.910)]and 0.776[95%CI(0.714-0.838)],suggesting that the column line plot model has good discrimination.Conclusion:After stepwise regression analysis,it was established that ALB,HA,PⅢP,LSM and IL-6 were more closely associated with the occurrence of significant fibrosis after HBV infection,and a visualization of the occurrence of significant fibrosis column line graph model was established by comprehensive assessment,and validation was given that all were superior to the traditional models FIB-4 and APRI.

Establishment and validation of a nomogram for predicting the risk of liver inflammation in chronic HBV infection

Objective:To establish a non-invasive quantitative and visual predictive model for assessing the occurrence of significant inflammation in chronic HBV infection,and to present nomogram to validate the efficacy.Methods:A total of 180 patients with chronic HBV infection that were admitted to the Department of Infectious Liver Diseases of the First Affiliated Hospital of Hainan Medical College from January 2019 to December 2021 with informed consent and underwent liver biopsy puncture were selected,and to prevent overfitting of the model,131 patients and 49 patients were randomly divided into a model group and a validation group according to randomization,to collect the clinic information,serological examination,liver elastography and liver histopathology results.The patients were divided into non-significant inflammation and significant inflammation groups in the modeling group.The R 4.1.1 package and the rms package were used to build the column line graph model,while the Bootstrap method was applied to repeat the sampling 1000 times for internal and external validation,and the H-L goodness of fit test and ROC curve were used to assess the calibration and discrimination of the column line graph model respectively.Results:A total of 180 patients with chronic HBV infection were included,and 92 patients(51.1%)had significant inflammation.In the modeling set,67 patients(51.1%)had significant inflammation.In the modeled group,comparison of HBV DNA,PLT,ALT,AST,ALP,GGT,PAB,H.A,PⅢP,CⅣ,L.N,IL-6,LSM and HBeAg for non-significant inflammation and significant inflammation showed statistically significant differences(P<0.05).Nomogram were obtained using stepwise regression analysis to establish a predictive model for the risk of significant inflammation following chronic HBV infection.The χ^(2) values of the H-L goodness-of-fit test for the modelling and validation groups were 0.279 and 2.098,respectively,corresponding to P values of 0.87 and 0.35,suggesting that the nomogram has good predictive accuracy;the area under the ROC curve of the column line plot predicting the occurrence of significant inflammation after HBV infection for the modelling and validation groups was 0.895[95%CI(0.843-0.948)]and 0.760[95%CI(0.622-0.897)],suggesting that the column line plot model has good discrimination.Conclusion:After stepwise regression analysis,it was established that PLT,Ln(HBV-DNA),AST,C桇and LSM were more closely associated with the occurrence of significant inflammation after HBV infection,and a visualization of the occurrence of significant inflammation nomogram was established by comprehensive assessment,and the effectiveness was good.

HBV C基因型有关的HBsAg阴性HBV DNA阳性患者S区突变对HBsAg的影响

目的通过构建HBV C基因型突变质粒研究HBsAg阴性HBV DNA阳性患者HBV S区突变对HBsAg水平的影响。方法收集2022年8月至2023年4月首都医科大学附属北京佑安医院107例HBsAg-/HBV DNA+患者血液样本,对成功提取扩增的HBV DNA S区进行测序,通过构建HBV C基因型突变质粒对HBV S区突变位点进行细胞功能验证,探讨OBI可能发生的分子机制。结果对成功提取扩增的68例患者进行测序,发现HBV S区存在大量突变,包括免疫逃逸突变(如sG145R、sK122R、sS114T、sT131P等)和跨膜结构域(transmembrane domain,TMD)突变(如sT5A、sG10D、sF20S等)。通过构建HBV C基因型突变质粒,进行细胞转染和细胞免疫荧光实验发现sG145R突变会明显降低HBsAg的表达,但是sK122R、sI26N、sQ29N、sR169H、sS114T、sT131P这6个突变位点并未影响细胞内外HBsAg的表达。结论通过测序发现HBsAg-/HBV DNA+患者HBV S区存在大量突变位点,通过构建sG145R、sK122R、sI26N、sQ29N、sS114T和ST131P等突变质粒发现sG145R突变会明显降低细胞内外HBsAg的表达,但是sK122R、sI26N、sQ29N、sR169H、sS114T、sT131P并未明显降低细胞内外HBsAg的表达。

佳木斯传染病医院2021—2022年HBV感染筛查情况分析

目的:分析某三级甲等传染病专科医院乙型肝炎病毒(HBV)筛查情况。方法:回顾性分析2021年3月—2022年3月佳木斯市传染病医院进行乙型肝炎表明抗原(HBsAg)和普敏HBV DNA检测的1509例患者信息。收集报告HBsAg+/普敏HBV DNA-患者样本以及HBsAg-/普敏HBV DNA-但其他检查指标指向HBV感染的患者血清,采用高敏HBV DNA进行检测,并对患者HBV感染情况以及其他临床检查结果进行追踪。结果:1509例患者中有2例(0.13%)患者HBsAg+/普敏HBV DNA-,高敏HBV DNA检查结果为阳性,4例(0.26%)患者HBsAg-/普敏HBV DNA-,高敏HBV DNA检查结果为阳性。6例高敏HBV DNA检查均值(1.11±0.16 log10 IU/mL);HBsAg与普敏HBV DNA检查在入院筛查应用上具有相同等效性。结论:目前采用HBsAg作为判断患者HBV感染的依据,但依然有0.26%HBV DNA阳性的感染者,高于佳木斯地区一般人群HBsAg-/HBV DNA+(26/31720,0.08%)感染者比例,应采用高灵敏度试剂进行HBV DNA检测,以避免漏检。