Virus load and virus shedding of SARS-CoV-2 and their impact onpatient outcomes

BACKGROUND Understanding a virus shedding patterns in body fluids/secretions is importantto determine the samples to be used for diagnosis and to formulate infectioncontrol measures.AIM To investigate the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)shedding patterns and its risk factors.METHODS All laboratory-confirmed coronavirus disease 2019 patients with completemedical records admitted to the Shenzhen Third People’s Hospital from January28, 2020 to March 8, 2020 were included. Among 145 patients (54.5% males;median age, 46.1 years), three (2.1%) died. The bronco-alveolar lavage fluid(BALF) had the highest virus load compared with the other samples. The viralload peaked at admission (3.3 × 108 copies) and sharply decreased 10 d afteradmission.RESULTS The viral load was associated with prolonged intensive care unit (ICU) duration.Patients in the ICU had significantly longer shedding time compared to those inthe wards (P < 0.0001). Age > 60 years [hazard ratio (HR) = 0.6;95% confidenceinterval (CI): 0.4-0.9] was an independent risk factor for SARS-CoV-2 shedding,while chloroquine (HR = 22.8;95%CI: 2.3-224.6) was a protective factor.CONCLUSION BALF had the highest SARS-CoV-2 load. Elderly patients had higher virus loads,which was associated with a prolonged ICU stay. Chloroquine was associatedwith shorter shedding duration and increased the chance of viral negativity.

Association of core promoter mutations of hepatitis B virus and viral load is different in HBeAg(+) and HBeAg(-) patients

AIM:To identify the prevalence of hepatitis B e antigen (HBeAg) and to assess the association of hepatitis B virus (HBV) core promoter mutations and viral load in Indonesian patients.METHODS:Sixty-four patients with chronic hepatitis,65 with liver cirrhosis and 50 with hepatocellular carcinoma were included in this study.HBeAg and hepatitis B e antibody (HBeAb) tests were performed using enzyme-linked immunosorbent assay and the mutations were analyzed by sequencing.Viral load was measured by real-time polymerase chain reaction.RESULTS:Of 179 patients,108 (60.3%) were HBeAg(-) and 86 (79.6%) of these HBeAg(-) patients had been seroconverted.The A1896 mutation was not found in HBeAg(+) patients,however,this mutation was detected in 70.7% of HBeAg(-) patients.This mutation was frequently found when HBeAg was not expressed (87.7%),compared to that found in HBeAg seroconverted patients (65.1%).The A1899 mutation was also more prevalent in HBeAg(-) than in HBeAg(+) patients (P=0.004).The T1762/A1764 mutation was frequently found in both HBeAg(+) and HBeAg(-) patients,however,the prevalence of this mutation did not significantly differ among the two groups (P=0.054).In HBeAg(+) patients,the T1762/A1764 mutation was correlated with lower HBV DNA (P < 0.001).The A1899 mutation did not correlate with HBV DNA (P=0.609).In HBeAg(-) patients,the T1762/A1764 mutation alone was not correlated with HBV DNA (P=0.095),however,the presence of either the T1762/A1764 or A1896 mutations was associated with increased HBV DNA (P < 0.001).CONCLUSION:The percentage of HBeAg(-) patients is high in Indonesia,and most of the HBeAg(-) patients had been seroconverted.The A1896 mutation was most likely the major cause of HBeAg loss.The T1762/A1764 mutation alone was associated with lower viral loads in HBeAg(+) patients,but not in HBeAg(-) patients.

The Monitoring Interest of BK Virus Load in Renal Allograft Tunisian Recipients: Prospective Study

BK virus (BKV) may cause nephropathy in renal transplant recipients receiving immunosuppressive therapy, resulting in renal dysfunction and, possibly graft loss. However, the positive and negative predictive values of BK viral load are still controversial. In this prospective, single-center study, BKV DNA was measured 1, 3 and 6 months after transplantation. The viral load in urine and plasma was quantified with the real-time Q-PCR (Argen kit) in 73 renal allograft recipients Three of them showed acute rejection. To determine the cutoff value of viral load, 60 sera samples of healthy blood donors, matched for age and sex, were tested. The mean plasmatic viral load one month post-transplantation was statistically higher in renal transplant recipients (17.23 copies/ml) compared to that in controls (2 copies/ml) (p: 0.06). This difference of the distribution of viremia values is more evident in the third and sixth month (p: 0.002 and 0.010 respectively). Furthermore, analysis of the kinetic of viral load revealed an average rise of viremia at 3 months (1589.14 copies/ml) followed by its decrease at 6 months (249.75 copies/ml). However, the difference was not statistically significant. The same is true for the distribution of values of viruria and in all cases the average viral load was statistically higher in urine than in plasma. In addition, this study did not shown significant relationsheep between viremia/viruria and the occurrence of acute rejection, the renal function deterioration, the source of allograft or immunosuppressive therapy protocol. If the results of this study demonstrate the importance of the replication of BKV in renal transplant patients from the first month compared to that in immunocompetent subjects, the screening of the DNA of this virus does not appear to have a prognostic value in the occurrence of acute rejection. However, the plasma and urine monitoring of BKV load beyond 6 months , not appear to exclude the relationsheep between these two biomarkers and the occurrence of chronic graft dysfunction.

Antiviral treatment of hepatitis C virus infection and factors affecting efficacy

Hepatitis C virus(HCV)infection is the leading cause of chronic liver-related diseases,including cirrhosis,liver failure,and hepatocellular carcinoma.Currently,no effective vaccine is available for HCV infection.Polyethylene glycol interferon-α(PegIFN-α)in combination with ribavirin(RBV)is the standard of care(SOC)for chronic hepatitis C.However,the efficacy of PegIFN-αand RBV combination therapy is less than 50%for genotype 1HCV,which is the dominant virus in humans.In addition,IFN and RBV have several severe side effects.Therefore,strategies to improve sustained virological response(SVR)rates have been an important focus for clinical physicians.The serine protease inhibitors telaprevir and boceprevir were approved by the United States Food and Drug Administration in 2011.The addition of HCV protease inhibitors to the SOC has significantly improved the efficacy of treatments for HCV infection.Several direct-acting antiviral drugs currently in late-stage clinical trials,both with and without pegIFN and RBV,have several advantages over the previous SOC,including higher specificity and efficacy,fewer side effects,and the ability to be administered orally,and might be optimal regimens in the future.Factors affecting the efficacy of anti-HCV treatments based on IFN-αinclude the HCV genotype,baseline viral load,virological response during treatment,host IL28B gene polymorphisms and hepatic steatosis.However,determining the effect of the above factors on DAA therapy is necessary.In this review,we summarize the development of antiHCV agents and assess the main factors affecting the efficacy of antiviral treatments.

Evaluation of the Pathogenicity of a Highly Pathogenic Porcine Reproductive and Respiratory Syndrome Virus Variant in Piglets

Since May 2006,a highly pathogenic porcine reproductive and respiratory syndrome virus （HP-PRRSV） variant characterized by 30 amino acids deletion within its NSP2-coding region emerged and caused extensive economic losses to China＇s pig industry.To investigate the in vivo pathogenicity and immune responses of the newly emerging PRRSV,3 groups of 60-d-old conventional piglets were inoculated intranasally with a representative strain of the HP-PRRSV variant HuN4 with 3 different infection doses （3×103-3×105 TCID50）.The results revealed that the virus variant caused severe disease in piglets and the significant clinical characteristics consisted of persistently high fever （41.0-41.9oC） and high morbidity and mortality （60-100%）,the marked clinical signs of PRRS and severe histopathogenic damages in multiple organs.It induced rapid and intense humoral immune responses and seroconversion was detected in most infected pigs at 7 d post-infection （DPI）.The virus vigorously replicated in vivo and the highest virus average titer was 9.7 log copies mL-1 serum at 7 DPI.Elevated levels of IFN-g and IL-10 cytokine production in serum in this study were also observed.Taken together,our results demonstrated that the HP-PRRSV variant HuN4 strain is highly pathogenic for piglets and suitable to be a reference strain of highly virulent PRRSV for evaluating the efficacy of the new vaccines.

Maternal Blood Milk Saliva Sample Selection and the Transmission of Hepatitis B Virus Infectious Research

Background: Hepatitis B is an infectious disease, which is a main way of vertical transmission of infectious HBV between mother and infant. Hepatitis B virus infection is always a hot topic of social concern, especially in China. The paper studies hepatitis B virus in maternal blood, breast milk, saliva of hepatitis B virus infection model (HBV-M) in Hefei city, Anhui province, PRC. HBV-DNA load and related data in Hefei city are used for risk assessment of the transmission of hepatitis B virus to provide evidence for evidence-based medicine and scientific guidance of infant feeding patterns. Methods: On the principle of informed consent, inpatient hepatitis B maternal blood 695, breast milk, saliva 614,169 copies were used as the object of analysis, using the ELISA method for the detection of HBV-M, using real-time fluorescence quantitative PCR detection of HBV-DNA load. We analyze HBsAg in saliva, milk, the positive rate of HBV-DNA and HBV-M in serum, saliva, milk, and explore the positive rate of HBV-DNA and serum HBV-DNA load correlation. Results: At the age of 18 - 44 years old perinatal women, HBV-DNA positive rates of maternal serum, breast milk, saliva were 157 cases in A group HBsAg, HBeAg positive: 99.36%, 88.06%, 96.77%;in 312 cases in group B, HBeAb HBsAg, HBcAb positive: 17.63%, 2.93%, 54.67%;69 cases in C group HBsAg, HBcAb positive: 63.77%, 27.27%, 28.57%;D group of 71 patients with simple HBcAb positive: 12.68%, 3.13%, 0%;E group and 86 cases in control group HBVM: 1.16%, 0%, 0%. According to the serum and milk testing of Group A and Group B, HBV-DNA chi-square is χ2 = 237.45, P;there is a significant difference in serum and saliva;HBV-DNA chi-square χ2 = 289.49, P < 0.01, the difference has statistical significance. Conclusion: 1) HBV-DNA load high maternal blood, breast milk, saliva are potentially persistent hepatitis B virus infection risk, especially infectious blood. 2) Of maternal milk, saliva and blood HBV-DNA HBV-DNA load were positively correlated (r = 0.96;P ing, breast milk and saliva HBV-DNA positive rates were increased and infectivity enhanced. 3) Maternal blood, breast milk, saliva specimens for any HBV-DNA ≥ 1000 copies/ml are not breastfeeding. 4) The mother who carries the hepatitis B virus cannot do maternal infant feeding, and deep kiss intimate contact, in order to prevent blood, saliva and other ways of infection of hepatitis B virus. 5) Saliva testing is instead of milk inspection, because saliva is easier;

High level of hepatitis B virus DNA after HBeAg-to-anti-HBe seroconversion is related to coexistence of mutations in its precore and basal core promoter

AIM: G1896A mutation in precore or A1762T/G1764Amutations in basal core promoter are suspected to be responsible for patients with detectable level of HBV DNA in serum after seroconversion from HBeAg to anti-Hbe. However, G1896A variant has impaired, while A1762T/ G1764A variant may have intact replication ability. They themselves or their coexistence status may play different roles in such meaningless seroconversion. For these reasons, the significances of these two types of mutations were comparatively investigated in this study. METHODS: One hundred and sixty-five sera with positive anti-Hbe and HBV DNA were collected from different patients. Mutations of G1896A and A1762T/G1764A among these serum samples were detected using competitively differentiated PCR. HBV DNA was demonstrated using real-time quantitative PCR. RESULTS: G1896A and/or A1762T/G1764A mutations were detected in 89.1% (147/165) out of patients with detectable HBV DNA in serum after HBeAg-to-anti-Hbe seroconversion. The positive rate of G1896A variants was significantly higher than that of A1762T/G1764A mutations (77.6% vs 50.3%, X2 = 26.61, P＜0.01). The coexistence positive rate of these two types of mutations was 38.8% (64/165). Coexistence mutations were found in 77.1% (64/83) out of sera with A1762T/G1764A mutations, and in 50.0% (64/128) out of sera with G1896A mutation. Compared with variants with G1896A mutation only, the coexistence mutations were predominant in patients with high level of serum HBV DNA, and related to higher total bilirubin, lower serum albumin and progressive liver diseases. CONCLUSION: The coexistence of G1896A mutation and A1762T/G1764A mutations is very common, and responsible for the major cases with high level of HBV DNA in serum and progressive liver diseases after HBeAg-to-anti-Hbe seroconversion. This coexistence mutation variant may have higher pathogenicity and replication ability.

Rapid quantification of semen hepatitis B virus DNA by real-time polymerase chain reaction

AIM: To examine the sensitivity and accuracy of real-time polymerase chain reaction (PCR) for the quantification of hepatitis B virus (HBV) DNA in semen.METHODS: Hepatitis B viral DNA was isolated from HBV carriers' semen and sera using phenol extraction method and QTAamp DNA blood mini kit (Qiagen, Germany). HBV DNA was detected by conventional PCR and quantified by TaqMan technology-based real-time PCR (quantitative polymerase chain reaction (qPCR)). The detection threshold was 200 copies of HBV DNA for conventional PCR and 10 copies of HBV DNA for real time PCR per reaction.RESULTS: Both methods of phenol extraction and QIAamp DNA blood mini kit were suitable for isolating HBV DNA from semen. The value of the detection thresholds was 500 copies of HBV DNA per mL in the semen. The viral loads were 7.5×107 and 1.67×107 copies of HBV DNA per mL in two HBV infected patients' sera, while 2.L4×105 and 3.02×105 copies of HBV DNA per mL in the semen.CONCLUSION: Real-time PCR is a more sensitive and accurate method to detect and quantify HBV DNA in the semen.

Factors predicting occurrence and prognosis of hepatitis-B-virus-related hepatocellular carcinoma

Primary liver cancer is an important cause of cancer death,and hepatocellular carcinoma(HCC) accounts for 70%-85% of total liver cancer worldwide.Chronic hepatitis B virus(HBV) infection contributes to > 75% of HCC cases.High serum viral load is the most reliable indicator of viral replication in predicting development of HCC.HBV genotype C is closely associated with HCC in cirrhotic patients aged > 50 years,whereas genotype B is associated with development of HCC in non-cirrhotic young patients and postoperative relapse of HCC.Different HBV subgenotypes have distinct patterns of mutations,which are clearly associated with increased risk of HCC.Mutations accumulate during chronic HBV infection and predict occurrence of HCC.Chronic inflammation leads to increased frequency of viral mutation via cellular cytidine deaminase induction.Mutations are negatively selected by host immunity,whereas some immuno-escaped HBV mutants are active in hepatocarcinogenesis.Inflammatory pathways contribute to the inflammation-necrosis-regeneration process,ultimately HCC.Their hallmark molecules can predict malignancy in HBV-infected subjects.Continuing inflammation is involved in hepatocarcinogenesis and closely related to recurrence and metastasis.HBV load,genotype C,viral mutations and expression of inflammatory molecules in HBV-related HCC tissues are significantly associated with poor prognosis.Imbalance between intratumoral CD8+ T cells and regulatory T cells or Th1 and Th2 cytokines in peritumoral tissues can predict prognosis of HBV-related HCC.These factors are important for developing active prevention and surveillance of HBV-infected subjects who are more likely to develop HCC,or for tailoring suitable treatment to improve survival or postpone postoperative recurrence of HCC.

Epidemiology and natural history of hepatitis C virus infection

Hepatitis C virus(HCV)affects 130-210 million people worldwide and is one of the major risk factors for hepatocellular carcinoma.Globally,at least one third of hepatocellular carcinoma cases are attributed to HCV infection,and 350000 people died from HCV related diseases per year.There is a great geographical variation of HCV infection globally,with risk factors for the HCV infection differing in various countries.The progression of chronic hepatitis C to end-stage liver disease also varies in different study populations.A long-term follow-up cohort enrolling participants with asymptomatic HCV infection is essential for elucidating the natural history of HCV-caused hepatocellular carcinoma,and for exploring potential seromarkers that have high predictability for risk of hepatocellular carcinoma.However,prospective cohorts comprising individuals with HCV infection are still uncommon.The risk evaluation of viral load elevation and associated liver disease/cancer in HCV(REVEAL-HCV)study has followed a cohort of 1095 residents seropositive for antibodies against hepatitis C virus living in seven townships in Taiwan for more than fifteen years.Most of them have acquired HCV infection through iatrogenic transmission routes.As the participants in the REVEALHCV study rarely receive antiviral therapies,it provides a unique opportunity to study the natural history of chronic HCV infection.In this review,the prevalence,risk factors and natural history of HCV infection are comprehensively reviewed.The study cohort,data collection,and findings on liver disease progression of the REVEAL-HCV study are described.

Clinical significance of activity of ALT enzyme in patients with hepatitis C virus

AIM: To investigate serum alanine aminotransferase (ALT) levels in relation to the clinical,biochemical,ultrasonographic and histological characteristics of patients with hepatitis C virus. METHODS: Duration of disease,HCV-RNA,liver steatosis,and the hepatitis activity index (HAI) were correlated with serum ALT in 36 patients with HCV. ALT values were also investigated in 16 control subjects without any liver diseases. RESULTS: In bivariate analyses,ALT levels correlated with duration of HCV infection (P < 0.01),HCV-RNA (P < 0.05),and the HAI (P < 0.01). Among the components of the HAI,ALT concentrations were significantly associated with periportal bridging/necrosis (P < 0.01) and fibrosis (P < 0.05). In multivariate analysis,periportal bridging/ necrosis (β = 0.508; P < 0.01),duration of HCV infection (β = 0.413; P < 0.01),and HCV-RNA (β = 0.253; P < 0.05) were independently associated with ALT activity. The normal ALT activity for men and women was < 23 IU/L and < 22 IU/L,respectively. CONCLUSION: In patients with HCV,alterations in the liver tissue as reflected by ALT elevation are mainly associated with periportal bridging/necrosis,viral load and duration of disease. A cut-off value < 23 IU/L distinguished with high diagnostic accuracy healthy controls from patients with HCV.

Hepatitis C virus genotypes in north eastern Algeria: A retrospective study

AIM: To determine the frequency of various hepatitis C virus (HCV) genotypes present in patients from north eastern Algeria. METHODS: This is a retrospective cross-sectional study of 435 HCV infected patients from northeast Algeria, detected in the Sadelaoud laboratory and diagnosed between January 2010 and December 2012. The patients were diagnosed with HCV infection in their local hospitals and referred to be assessed for HCV genotype before the antiviral treatment. Demographic information (sex, age and address), genotype, subtype and viral load were retrieved from the patient medical records. The serum samples were tested by the type-specific genotyping assay.RESULTS: The majority of the patients (82.5%) were from the central part of the examined region (P = 0.002). The mean age of the patients studied was 53.6 ± 11.5 years. HCV genotype 1 was the most frequent (88.7%), followed by genotypes 2 (8.5%), 4 (1.1%), 3 (0.9%) and 5 (0.2%). Genotype 6 was not detected in these patients. Mixed infection across the HCV subtypes was detected in twenty patients (4.6%). The genotype distribution was related to age and region. Genotype 1 was significantly less frequent in the ≥ 60 age group than in the younger age group (OR = 0.2; 95%CI: 0.1-0.5, P < 0.001). Furthermore, genotype 1 was more frequent in the central part of the examined region than elsewhere (P < 0.01). CONCLUSION: The HCV genotype (type 1b was dominant) distribution in Algeria is different from those in other northern countries of Africa.

Quantification of Simian Immunodeficiency Virus by SYBR Green RT-PCR Technique

Plasma viral RNA load is widely accepted as the most relevant parameter to assess the status and progression of Simian immunodeficiency virus (SIV) infections. To accurately measure RNA levels of the virus, a one-step fluorescent quantitative assay was established based on the SYBR green Real-time reverse transcription-polymerase chain reaction (RT-PCR). The lower detection limit of the assay was 10 copies per reaction for the virus. This method was successfully applied to quantify SIVmac251 and SIVmac239 viruses produced in CEM×174 cells. Additionally, the performance of the SYBR green RT-PCR was assessed in a SIVmac251 infected rhesus macaque. The result demonstrated that the method could detect as little as 215 copies per milliliter of plasma and the dynamic pattern of viral load was highly consistent with previous results. With regard to convenience, sensitivity and accuracy our assay represents a realistic alternative to both branched-chain DNA (b-DNA) assays or real-time PCR assays based on TaqMan probes.

湖羊感染羊源性伪狂犬病病毒致病特征的研究

为探讨羊源性伪狂犬病病毒分离株SH1407对湖羊的致病性。将7只健康湖羊随机分成试验组和对照组,其中试验组5只,对照组2只。用分离株SH1407对试验组湖羊进行人工攻毒,取发病死亡羊内脏组织用于组织病理学检查和免疫组化分析。湖羊在攻毒后3 d开始出现症状,第4 d症状进一步加剧,表现为局部奇痒、体温升高、精神沉郁、食欲废绝等症状,4只发病死亡,存活1只,死亡率达到80%。剖检主要表现为脑膜充血,肺淤血,轻度实变。病理组织学检查:大脑、延髓神经元变性,细胞核溶解、消失,呈病理性细胞凋亡;肺脏呈间质性肺炎病变;脾脏、肾脏出血。免疫组化染色显示,PRV在肝脏、肺脏、大脑、脾脏等组织器官广泛存在,病毒在肝脏中主要存在于库弗氏细胞中,在肺脏中主要存在于Ⅱ型肺泡细胞中,在脾脏中主要存在于巨噬细胞、单核细胞中,而在脑组织中,神经元呈现较强的信号,说明病毒主要存在于神经细胞中。实时荧光定量PCR测定内脏器官病毒载量,肝脏、脾脏、肺脏和脑组织中PRV大量增值,其中PRV在脑组织中大量增值导致中枢神经严重的病理改变。

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。

甘蔗条点病毒荧光定量PCR检测方法的建立及应用

【目的】建立一种快速、灵敏、特异的检测甘蔗条点病毒(sugarcane striate virus,SStrV)的SYBR Green I荧光定量PCR方法。【方法】从SStrV基因组保守区域序列设计特异性扩增引物,构建含有SStrV基因组序列的重组质粒pMD19-T-SStrV-qN作为阳性质粒标准品,以其为模板建立SStrV荧光定量PCR检测方法,并对该方法的灵敏性、特异性、稳定性进行了测试,随后用该方法对甘蔗不同组织部位中SStrV载量进行检测。【结果】将含有SStrV基因组序列的重组质粒按10倍比稀释成标准品,将其作为模板进行荧光定量PCR,获得标准曲线y=-3.337 x+38.197,相关系数r2=0.999,说明Cq值与标准品浓度拷贝数的对数呈线性关系;建立的荧光定量PCR最低可以检测到13拷贝重组质粒/μL,是普通PCR灵敏度的100倍。该方法能特异的检测SStrV,特异性高,组内和组间的变异系数在0.13%-0.94%之间,表明该方法重复性良好。SStrV的载量在甘蔗的不同组织部位中差异较大,+4叶中SStrV的载量最高,与其他组织部位达到了显著差异。【结论】建立了能灵敏特异检测SStrV的SYBR Green I荧光定量PCR方法,明确了+4叶是甘蔗中SStrV检测的最佳采样部位。

HBV高载量孕妇孕期抗病毒治疗结合标准阻断措施阻断母婴传播效果

目的:探究乙型肝炎病毒(HBV)高载量孕妇孕期HBV-DNA水平和乙型肝炎病毒e抗原(HBeAg)阳性情况,分析孕期抗病毒治疗结合标准阻断措施对HBV高载量孕妇母婴传播阻断效果。方法:回顾性收集2021年1月-2023年1月本院住院分娩的120例HBV高载量孕妇临床资料,分析孕妇妊娠期、分娩前HBV-DNA水平和HBeAg阳性率,多因素logistic回归分析HBeAg状态影响因素,分析孕期抗病毒治疗对新生儿乙肝母婴传播阻断效果及母婴安全性。结果:120例HBV高载量孕妇中,孕期接受抗病毒治疗93例(治疗组),抗病毒药物分别为替诺福韦占56.6%、拉米夫定占20.8%;未接受治疗27例(未治疗组)。妊娠期,抗病毒治疗组和未治疗组HBV-DNA载量、HBeAg阳性率无差异(P>0.05);分娩前,抗病毒治疗组HBV-DNA载量≥10^(6)IU/ml占比(7.5%)低于未治疗组(92.6%)(P<0.05),而两组HBeAg阳性率(90.3%、92.6%)无差异(P>0.05)。多因素logistic分析,年龄低、HBVDNA载量高影响HBeAg状态的独立危险因素(P<0.05)。新生儿乙肝母婴传播阻断率抗病毒治疗组(100.0%)高于未治疗组(2例,92.6%)(P<0.05)。两组新生儿体质量、早产、剖宫产、妊娠合并症、产时并发症比较无差异(P>0.05)。结论:HBV高载量孕妇HBV-DNA水平较高,HBeAg阳性率与孕妇年龄低、HBV-DNA载量高有关;孕期抗病毒治疗可降低孕妇分娩前HBV-DNA水平,结合标准阻断措施后可提高HBV母婴传播阻断率,且安全性较好。

隐匿性乙型肝炎病毒感染的输血传播风险及防范

乙型肝炎病毒(HBV)感染是我国重大的公共卫生问题,也是输血安全领域的焦点之一。隐匿性乙型肝炎病毒感染(OBI)是HBV感染的一种特殊的临床类型,其特征是在血清或肝脏中检测到HBV DNA,但乙型肝炎表面抗原(HBsAg)呈阴性。对献血者进行HBsAg检测尤其是核酸检测(NAT)能有效地控制大多数HBV传播,但是残余传染风险依然存在。OBI献血者是潜在的HBV传染源,含有极低病毒载量的HBV DNA,即使是高度敏感的单人份核酸检测(ID-NAT)也可能是间歇性检测到或无法检测到。目前对于OBI检测缺乏一种标准化的、经过验证的有效方法。为了提高OBI检测的准确度,需要开发更灵敏、标准化和有效的HBsAg、HBV DNA的检测方法;同时还要深入地了解OBI发展机制,准确诊断OBI以提高输血安全性。

高危型人乳头瘤病毒负荷量与宫颈癌前病变的相关性分析

目的 探讨宫颈癌前病变的发生与高危型人乳头瘤病毒(HR-HPV)负荷量的关系。方法 回顾性分析2022-03—2023-03月于北京市延庆区医院病理科接受HR-HPV分型定量检测及阴道镜活检的233例宫颈癌前病变患者的临床资料,其中低级别鳞状上皮内病变(low-grade squamous intraepithelial lesion, LSIL)(LSIL或CINⅠ级)130例,高级别鳞状上皮内病变(high-grade squamous intraepithelial lesion, HSIL)95例,HSIL中包括CINⅡ级59例和CINⅢ级36例,宫颈原位腺癌8例。结果 233例宫颈活检标本HR-HPV总检出率为87.0%,检出HR-HPV亚型15种,检出率排前4位分别为HPV16(25.3%)、HPV52(17.6%)、HPV58(15.0%)以及HPV51(10.3%);HSIL组HR-HPV负荷量明显高于LSIL组(P<0.05);CINⅠ级、CINⅡ级及CINⅢ级的病毒负荷量呈显著递增趋势(P<0.05)。结论 HR-HPV感染与宫颈癌前病变的发生密切相关,HR-HPV负荷量检测可作为宫颈癌前病变、宫颈癌筛查及病情追踪监测的一项客观指标。

HR-HPV载量与宫颈上皮内病变及宫颈癌相关性的研究进展

宫颈癌为全球第四大恶性肿瘤,且发病率正在不断上升。高危型人乳头瘤病毒(high risk human papilloma virus,HR-HPV)持续感染被认为是宫颈癌的主要致病因素。自2019年开始,很多权威机构都建议采用HPV DNA检测作为宫颈癌初筛手段。但是,这种方法会筛查出大量HPV阳性的女性,因此,准确识别宫颈癌高风险人群,并实施有效的管理很有必要。近来有研究表明,HR-HPV可能是宫颈病变病情进展的一个参考指标,但它们之间的关系仍不明确。因此,本文旨在深入探讨HR-HPV载量与宫颈病变严重程度之间的关系,以期有助于宫颈癌的早期诊断和早期治疗。