Risk factors for hepatocellular carcinoma in cirrhosis:A comprehensive analysis from a decade-long study

BACKGROUND Cirrhosis is a significant risk factor for the development of hepatocellular carcinoma(HCC).Variability in HCC risk among patients with cirrhosis is notable,particularly when considering the diverse etiologies of cirrhosis.AIM To identify specific risk factors contributing to HCC development in patients with cirrhosis.METHODS This retrospective study analyzed data from cirrhotic patients at Beijing Youan Hospital from January 1,2012 to September 30,2022 with at least 6 mo of followup.Patient demographics,medical histories,etiologies,and clinical characteristics were examined.Cox regression analysis was used to analyze correlations of the above parameters with hepatocarcinogenesis,while competing risk regression was used to estimate their adjusted hazard ratios accounting for death.The cumulative incidence was plotted over time.RESULTS Overall,5417 patients with cirrhosis(median age:54 years;65.8%males)were analyzed.Hepatitis B virus(HBV)was the most common etiology(23.3%),with 25%(n=1352)developing HCC over a 2.9-year follow-up period.Patients with multiple etiologies had the HCC highest incidence(30.3%),followed by those with HBV-related cirrhosis(29.5%).Significant risk factors included male sex,advanced age,hepatitis C virus(HCV)infection,elevated blood ammonia,and low platelet count.Men had a higher 5-year HCC risk than women(37.0%vs 31.5%).HBV,HCV,and HBV/HCV co-infected patients had 5-year risks of HCC of 45.8%,42.9%,and 48.1%,respectively,compared to 29.5%in nonviral hepatitis cases,highlighting the significant HCC risk from viral hepatitis,especially HBV,and underscores the importance of monitoring these high-risk groups.CONCLUSION In conclusion,HBV-related cirrhosis strongly correlates with HCC,with male sex,older age,viral hepatitis,elevated blood ammonia,and lower albumin and platelet levels increasing the risk of HCC.

Serological prevalence and risk factor analysis of hepatitis G virus infection in Hubei Province of China

Hepatitis G virus (HGV),also known as GB virus C, is a recently cloned virus which may be associated with human non A-E hepatitis[1，2] It is parenterally transmitted and usually coinfected or superinfected with hepatitis B or hepatitis C virus[3-5]. Some investigations have been reported on the seroprevalence and molecular prevalence of HGV infection in different areas and different population[6-15]. Current infection of HGV is diagnosed by detection of HGV RNA, and past infection with HGV is detectable by testing anti-HGV envelope protein (E2)[16-17]. To investigate the prevalence of HGV in Hubei Province, a central area of the People's Republic of China, ELISA and RT-PCR were employed to detect serum anti-HGV and HGV RNA in 1516 patients who were divided into 16 groups.

Epidemiological profiles of human immunodeficiency virus and hepatitis C virus infections in Malian women:Risk factors and relevance of disparities

AIM:To document the epidemiologic patterns and risk factors of human immunodeficiency virus(HIV)and hepatitis C virus(HCV)infections in Mali in order to develop prevention means for both diseases.METHODS:Two prospective studies were conducted in Bamako in 2009 among 1000 pregnant women(i.e.,young women)who consulted six reference health centers,and in 2010,among 231 older women who attended general practice in two hospitals.Antibody tests and molecular analysis(performed only for HCV)were used to quantify the frequencies of both infections.The data were collected from patients recruited through a questionnaire.Transmission risk factors of both diseases were identified by univariate and multivariate analysis.RESULTS:HCV seroprevalence was 0.2% for young and 6.5% for older women.HIV prevalence was similar in both populations(4.1% vs 6.1%).In older women,the analysis of risk factors highlighted an association between HCV infection and episodes of hospitalization(P < 0.01).The study did not show an association between HIV infection and the variables such as hospitalization,transfusion,tattoo,dental care,and endoscopy.A significant decrease of HIV seroprevalence was detected in young women who used condoms for contraception more than for other purposes(P < 0.01).By contrast,HIV seroprevalence was significantly increased in young women using condoms mainly to prevent sexual infections rather than for contraception(P < 0.01).No HCV/HIV coinfection was detected in our study.CONCLUSION:Risk factors and epidemiologic data of HIV and HCV as well as the absence of co-infection strongly suggest epidemiological disparities between these diseases.

Prevalence and risk factors of asymptomatic hepatitis C virus infection in Egyptian children

AIM: To identify the prevalence, risk factors and manifestations of asymptomatic hepatitis C virus (HCV) infection in Egyptian children. METHODS: Children at the age of 1-9 years were screened for HCV antibodies and alanine aminotransferase (ALT) levels. Every child with elevated ALT and/or detectable HCV antibodies was tested for HCV RNA by RT-PCR and compared with two negative controls for risk factors and signs and symptoms of liver disease.RESULTS: We screened 1042 children, six of them had elevated ALT, negative HCV antibody and positive RNA, likely representing acute hepatitis C cases. Fifteen children were HCV seropositive, 5 of them were HCV RNA positive. Asymptomatic HCV infection was present in 2.02% (positive results for either HCV antibodies or HCV-RNA or both). Symptoms such as diarrhea, abdominal pain, history of fatigue and school absence because of illness and risk factors such as dental care were significantly more common among HCV positive cases than among controls. None of the HCV positive children was diagnosed as having signs of advanced liver disease upon clinical or ultrasonographic examination. CONCLUSION: Asymptomatic HCV infection is detectable in 2.02% Egyptian children.

Hepatitis C virus genotypes distribution and transmission risk factors in Luxembourg from 1991 to 2006

AIM： To analyze the Hepatitis C virus （HCV） genotype distribution and transmission risk factors in a population of unselected patients in Luxembourg.METHODS： Epidemiological information （gender, age and transmission risks） were collected from 802 patients newly diagnosed for hepatitis C and living in Luxembourg, among whom 228 patients referred from prison. Genotyping using 5＇noncoding （5＇NC） sequencing was performed. We compared categorical data using the Fisher＇s exact F-test and odds ratios （OR） were calculated for evaluating association of HCV genotype and risk factors.RESULTS： The sex ratio was predominantly male （2.2） and individuals aged less than 40 years represented 49.6% of the population. Genotype 1 was predominant （53.4%） followed by genotype 3 （33%）. Among risk factors, intravenous drug usage （IVDU） was the most frequently reported （71.4%） followed by medical-related transmission （17.6%） including haemophilia, transfusion recipients and other nosocomial reasons. Genotype 3 was significantly associated to IVDU （OR = 4.84, P 〈 0.0001） whereas genotype 1 was significantly associated with a medical procedure （OR = 2.42, P 〈 0.001）. The HCV genotype distribution from inmate patients differed significantly from the rest of the population （Chi-square test with four degrees of freedom, P 〈 0.0001） with a higher frequency of genotype 3 （46.5% vs 27.5%） and a lower frequency of genotype 1 and 4 （44.7% vs 56.8% and 5.3% vs 9.6%, respectively）. IVDU was nearly exclusively reported as a risk factor in prison.CONCLUSION： We report the first description of the HCV genotype distribution in Luxembourg. The repartition is similar to other European counties, with one of the highest European prevalence rates of genotype 3 （33%）. Since serology screening became available in 2992, IVDU remains the most common way of HCV transmission in Luxembourg.

Risk factors affecting the mother-to-infant transmission of hepatitis B virus: a meta analysis

Objective：To search for risk factors that affect mother-to-infant transmission of hepatitis B virus（HBV）. Methods：To obtain studies eligible for meta-analysis, China biological medicine discs and MEDLINE citations were surveyed. Mother HBV DNA or HBeAg positivity,neonate HBeAg positivity, mode of delivery, threatened abortion and threatened premature labor were processed with meta analysis. Criteria for selection of published studies for meta analysis were based on principle by Abdolmaleky HM. Odds ratio （OR） was calculated and summarized by fixed effect model or random-effects model using RevMan software. The heterogeneity of the group of ORs was assessed using an X^2 test. The significance of the pooled OR was determined by the u-test. The strength of association was assessed using the OR. An OR〉1. 0 indicated a positive association between the risk factor and neonate HBV infection. Results： After meta analysis of factors concerned, a significant association was found between the positivity of HBeAg in mother and neonate, of HBV DNA in mother peripheral serum, and HBV mother-to-infant transmission, with a pooled OR equal to 19.43 （95% CI=8. 77-43. 06）, 36.5 （95% CI= 19.85-67. 11）, and 36.5 （95 % CI= 19.85-67.11 ） respectively. Mode of delivery, threatened abortion and threatened premature labor proved not to be of risk factors on the mother-to-infant transmission of HBV. Conclusion： Mother HBV DNA or HBeAg positivity and neonate HBeAg positivity were proved to be of risk factors affecting the transmission of HBV from mother to fetal.

Prevalence and Risk Factors of Hepatitis B Virus in Jazan Region, Saudi Arabia: Cross-Sectional Health Facility Based Study

Objectives: The objectives of this study were to estimate the prevalence of the HBV infection in Jazan, Kingdom of Saudi Arabia (KSA) and to correlate serologic findings with epidemiological data and known risk factors. Methods: Cross-sectional study conducted in 10 health facilities Jazan province. Study participants (2041) were interviewed using a structured questionnaire. HBsAg was tested in the blood samples collected from the study participants using commercially available kits. Results: The overall prevalence of hepatitis B among study participants was 8.3% (95% CI: 7.2 - 9.6). The prevalence of HBsAg was found to be the highest (22.4%) among those who were over 60 years old (95% CI: 13.2 - 35.0). For participants under 20 years old, the prevalence was the lowest, at only 2.5%. For males the HBV prevalence was 11.2% (95% CI: 9.3 - 13.3), compared to 7.0% (95 CI: 5.5% - 8.8%) for females. Subjects with a family history of HBV (p = 0. 002) and dental procedures (p = 0.008) were found to be associated with higher risk for HBV infection. Conclusion: The prevalence of HBsAg in adults in Jazan remains highly relative to KSA national level. Results showed a marked reduction in HBV among participants under 20 years old. This could be mainly attributed to the successful implementation of the children’s HB immunization programs in the region. Additional efforts to control HBV and vaccination for adults are highly recommended.

Liver histopathological lesions is severe in patients with normal alanine transaminase and low to moderate hepatitis B virus DNA replication

BACKGROUND Chronic hepatitis B virus(HBV)infection remains a major global public health problem.Chronic hepatitis B(CHB)patients can be divided into treatment indication and non-treatment indication individuals according to alanine transaminase(ALT),HBV DNA,serum hepatitis B e antigen status,disease status[liver cirrhosis,hepatocellular carcinoma(HCC),or liver failure],liver necroinflammation or fibrosis,patients’age,and family history of HCC or cirrhosis.For example,normal ALT patients in‘immune-tolerant’phase with HBV DNA higher than 10^(7)or 2×10^(7)IU/mL,and those in‘inactive-carrier’phase with HBV DNA lower than 2×10^(3)IU/mL do not require antiviral therapy.However,is it reasonable to set the defined values of HBV DNA as the fundamental basis to estimate the disease state and to determine whether to start treatment?In fact,we should pay more attention to those who do not match the treatment indications(grayzone patients both in the indeterminate phase and in the‘inactive-carrier’phase).AIM To analyze the correlation of HBV DNA level and liver histopathological severity,and to explore the significance of HBV DNA for CHB with normal ALT.METHODS From January 2017 to December 2021,a retrospective cross-sectional set of 1299 patients with chronic HBV infection(HBV DNA>30 IU/mL)who underwent liver biopsy from four hospitals,including 634 with ALT less than 40 U/L.None of the patients had received anti-HBV treatment.The degrees of liver necroinflammatory activity and liver fibrosis were evaluated according to the Metavir system.On the basis of the HBV DNA level,patients were divided into two groups:Low/moderate replication group,HBV DNA≤10^(7)IU/mL[7.00 Log IU/mL,the European Association for the Study of the Liver(EASL)guidelines]or≤2×10^(7)IU/mL[7.30 Log IU/mL,the Chinese Medical Association(CMA)guidelines];high replication group,HBV DNA>10^(7)IU/mL or>2×10^(7)IU/mL.Relevant factors(demographic characteristics,laboratory parameters and noninvasive models)for liver histopathological severity were analyzed by univariate analysis,logistics analysis and propensity score-matched analysis.RESULTS At entry,there were 21.45%,24.29%,and 30.28%of the patients had liver histopathological severities with≥A2,≥F2,and≥A2 or/and≥F2,respectively.HBV DNA level(negative correlation)and noninvasive model liver fibrosis 5 value(positive correlation)were independent risk factors for liver histopathological severities(liver necroinflammation,liver fibrosis,and treatment indication).The AUROCs of the prediction probabilities(PRE_)of the models mentioned above(<A2 vs≥A2,<F2 vs≥F2,<A2 and<F2 vs≥A2 or/and≥F2)were 0.814(95%CI:0.770-0.859),0.824(95%CI:0.785-0.863),and 0.799(95%CI:0.760-0.838),respectively.HBV DNA level(negative correlation)was still an independent risk factor when diagnostic models were excluded,the P values(<A2 vs≥A2,<F2 vs≥F2,<A2 and<F2 vs≥A2 or/and≥F2)were 0.011,0.000,and 0.000,respectively.For the propensity score-matched pairs,whether based on EASL guidelines or CMA guidelines,the group with significant liver histology damage(≥A2 or/and≥F2)showed much lower HBV DNA level than the group with non-significant liver histology damage(<A2 and<F2).Patients in the moderate replication group(with indeterminate phase)had the most serious liver disease pathologically and hematologically,followed by patients in the low replication group(with‘inactive-carrier’phase)and then the high replication group(with‘immune-tolerant’phase).CONCLUSION HBV DNA level is a negative risk factor for liver disease progression.The phase definition of CHB may be revised by whether the level of HBV DNA exceeds the detection low limit value.Patients who are in the indeterminate phase or‘inactive carriers’should receive antiviral therapy.

Assessing recent recurrence after hepatectomy for hepatitis Brelated hepatocellular carcinoma by a predictive model based on sarcopenia

BACKGROUND Sarcopenia may be associated with hepatocellular carcinoma(HCC)following hepatectomy.But traditional single clinical variables are still insufficient to predict recurrence.We still lack effective prediction models for recent recurrence(time to recurrence<2 years)after hepatectomy for HCC.AIM To establish an interventable prediction model to estimate recurrence-free survival(RFS)after hepatectomy for HCC based on sarcopenia.METHODS We retrospectively analyzed 283 hepatitis B-related HCC patients who underwent curative hepatectomy for the first time,and the skeletal muscle index at the third lumbar spine was measured by preoperative computed tomography.94 of these patients were enrolled for external validation.Cox multivariate analysis was per-formed to identify the risk factors of postoperative recurrence in training cohort.A nomogram model was developed to predict the RFS of HCC patients,and its predictive performance was validated.The predictive efficacy of this model was evaluated using the receiver operating characteristic curve.RESULTS Multivariate analysis showed that sarcopenia[Hazard ratio(HR)=1.767,95%CI:1.166-2.678,P<0.05],alpha-fetoprotein≥40 ng/mL(HR=1.984,95%CI:1.307-3.011,P<0.05),the maximum diameter of tumor>5 cm(HR=2.222,95%CI:1.285-3.842,P<0.05),and hepatitis B virus DNA level≥2000 IU/mL(HR=2.1,95%CI:1.407-3.135,P<0.05)were independent risk factors associated with postoperative recurrence of HCC.Based on the sarcopenia to assess the RFS model of hepatectomy with hepatitis B-related liver cancer disease(SAMD)was established combined with other the above risk factors.The area under the curve of the SAMD model was 0.782(95%CI:0.705-0.858)in the training cohort(sensitivity 81%,specificity 63%)and 0.773(95%CI:0.707-0.838)in the validation cohort.Besides,a SAMD score≥110 was better to distinguish the high-risk group of postoperative recurrence of HCC.CONCLUSION Sarcopenia is associated with recent recurrence after hepatectomy for hepatitis B-related HCC.A nutritional status-based prediction model is first established for postoperative recurrence of hepatitis B-related HCC,which is superior to other models and contributes to prognosis prediction.

Hepatitis E virus infections

Hepatitis E virus(HEV)infection is now endemic worldwide.Most patients with acute infection recover uneventfully.Outbreaks and sporadic cases,particularly in high-risk individuals are emerging increasingly.The patients with risk factors like pregnancy and pre-existing chronic liver disease,present with or progress rapidly to severe disease.Immuno-suppression in post-transplant patients is an additional risk factor.Standardized FDA-approved diagnostic tests are the need of the hour.Further studies are needed to establish guideline-based treatment regimen and outbreak preparedness for HEV to decrease global morbidity,mortality,and healthcare burden.Policies for screening donors and transplant cases are requi-red.

Risk factors for liver-related mortality in chronic hepatitis C patients:A deceased case-living control study

AIM: To investigate the risk factors for liver-related mortality in chronic hepatitis C (CHC) patients.

Management of hepatitis C virus infection in hemodialysis patients

The prevalence of hepatitis C virus(HCV) infection in patients on maintenance hemodialysis(MHD) is relatively higher than those without MHD. Chronic HCV infection detrimentally affects the life quality and expectancy, leads to renal transplant rejection, and increases the mortality of MHD patients. With the application of erythropoietin to improve uremic anemia and avoid blood transfusion, the new HCV infections during MHD in recent years are mainly caused by the lack of stringent universal precautions. Strict implementation of universal precautions for HCV transmission has led to markedly decreased HCV infections in many hemodialysis units, but physicians still should be alert for the antiHCV negative HCV infection and occult HCV infection in MHD patients. Standard interferon alpha and pegylated interferon alpha monotherapies at a reduced dose arecurrently the main treatment strategies for MHD patients with active HCV replication, but how to increase the sustained virological response and decrease the side effects is the key problem. IFNα-free treatments with two or three direct-acting antivirals without ribavirin in MHD patients are waiting for future investigations.

Seroepidemiology of hepatitis C and its risk factors in Khuzestan Province, South-West of Iran:A case-control study

AIM：To evaluate possible risk factors for the spread of hepatitis C infection and to analyze the characteristics of the epidemiological and clinical patterns among the patients with hepatitis C infection. METHODS： During a five-year period a cross-sectional study was conducted among HCV positive individuals referred to the Ahwaz JundiShapour University Hospitals （AJSUH） and Hepatitis Clinic from 1 Sept 1999 to 1 Sept 2003. The control group consisted of first time blood donors referred to the Regional Blood Transfusion organization. Enzyme-linked immunosorbent assay and recombinant immunoblot assay anti-hepatitis C virus （HCV） tests were performed for two groups. Positive serum specimens were retested using polymerase chain reaction （PCR） for HCV RNA. Risk factors were evaluated using a questionnaire. Reported risk factors among infected subjects （＂HCV-positive＂） were compared to those of subjects never exposed （＂HCV-negative＂） to HCV. RESULTS： A total of 514 subjects were studied for HCV, of which 254 were HCV-positive and 260 HCV- negative donors comprised the control group. Mean age of the patients was 28.4 （Std 15.22） years. HCV-positive subjects were more likely to be of male gender （63% versus 37%）. Transfusion 132 （52%）, non-intravenous （n-iv） drug abuse and iv drug abuse 37 （14.5%）, haemodialysis 25 （10%）, receiving wounds at war and extramarital sexual activities （2.4%）, tattooing （3.6%） were found to be independent risk factors of being HCV-positive. No apparent risk factors could be demonstrated in 29 （11.2%） of the positive cases. CONCLUSION： Our data indicate that a history of transfusion and iv drug abuse and haemodialysis are important risk factors for HCV infection in our area and that more careful pretransfusion screening of blood for anti- HCV must be introduced in our blood banks. Improvements in certain lifestyle patterns, and customs in this area may be essential to prevent transmission of the infection.

Risk Factors, Clinical Features, Baseline Alanine Aminotransferase and CD4+ Count of Children with HIV Co-Infection with Hepatitis B and C at a Tertiary Hospital in Southwest Nigeria

Background: Human immunodeficiency virus and hepatitis B and C viruses are endemic in sub- Saharan African countries including Nigeria. Researchers have studied the burden of co-infection of HIV with hepatitis B and hepatitis C but the risk factors and clinical presentation have not been much addressed especially in children. Methodology: This was a prospective cross sectional study that determined the prevalence, risk factors, clinical features, baseline CD4+ count, CD4+ percentage, and alanine aminotransferase (ALT) of newly diagnosed, HAART na?ve HIV co-infection among children who were managed at a Tertiary Hospital in Ilorin, Nigeria. Result: Of the 60 HIV- infected children recruited, 11.7% had HIV co-infection with HBV or HCV. Children with co-infec- tions (mean age 8.43 ± 2.37 years) were significantly older than their HIV mono-infected counterparts (mean age 5.25 ± 3.96 years) (p = 0.011). There was no significant difference between HIV monoinfection and HIV co-infection with respect to gender (p = 0.758), ethnicity (p = 0.707), religion of parents (p = 0.436), family type (p = 0.184), social class (p = 0.535), previous transfusion (p = 0.053), scarification (p = 0.612), female genital mutilation (p = 0.778), and sharing of clippers (p = 0.806). The mean BMI, immunological staging (p = 0.535), baseline ALT (p = 0.940), and mean baseline CD4+ count (p = 0.928) were comparable. However, the body mass index of HIV co-infec- ted children decreased with age up till age 10 years. Conclusion: There were no risk factors, nor clinical features predictive of co-infection identified in this study. Co-infection did not negatively impact baseline, CD4+ count and ALT.

Risk factors and molecular characterization of acute sporadic symptomatic hepatitis E virus infection in Thailand

Objective:To report clinical outcomes and viral genotypes of acute symptomatic hepatitis E virus(HEV)infection in Thailand.Methods:Forty patients with acute symptomatic HEV infection were recruited during 2009-2013.Clinical,demographic and laboratory data were collected.Diagnosis was accomplished by detection of anti-HEV IgM and/or HEV RNA in the serum or stool.HEV genotypes were classified by direct sequencing of RT-PCR products and phylogenetic analysis.Results:The high risk group,comprising immune-compromised,liver cirrhosis and very elderly(>80 years)patients(17 cases),had higher levels of serum alkaline phosphatase at presentation compared with the low risk group.Two fatal cases resulted from acute hepatitis E in the high risk group,initial clinical presentation did not show statistically significant differences.In six cases(6/40),the virus could be detected in serum or stool by RT-PCR and sequencing.Upon molecular characterization,the viruses were classified as HEV genotype 3f and were in the same cluster as Thai swine HEV.Conclusions:Our data showed that acute HEV infection has various clinical presentations and outcomes.Higher levels of serum alkaline phosphatase were observed in high risk patients.All isolated viruses were identified as HEV genotype 3f possibly originating from swine.

Is chronic hepatitis C virus infection a risk factor for breast cancer?

AIM:To evaluate the prevalence of breast tumors in adult females with chronic hepatitis C virus(HCV) infection.METHODS:Prospective,single-center study,based on female outpatients consulting in a liver unit,for 1 year.The study group included females with present and/or past history of chronic infection by HCV.Patients with spontaneous recovery were excluded.Chronic hepatitis had been proved by liver biopsy in the majority of cases and/or biological markers of inflammation and fibrosis.The control group included female patients with other well documented chronic liver diseases:chronic hepatitis B,alcoholic liver disease,autoimmune hepatitis,hemochromatosis,non alcoholic liver disease,chronic cholangitis.Participating patients were prospectively questioned during consultation about past breast history and follow-up by mammography.RESULTS:Breast carcinoma was recorded in 17/294 patients with HCV infection(5.8%,95% CI:3.1-8.4) vs 5/107 control patients(4.7%,95% CI:0.67-8.67).Benign tumors of the breast(mastosis,nodules,cysts) were recorded in 75/294 patients with HCV infection(25.5%,95% CI:20.5-30.5) vs 21/107(19.6%,95% CI:12.1-27.1) in the control group.No lesion was noted in 202 patients with HCV(68.7%,95% CI:63.4-74) vs 81 control patients(75.7%,95% CI:67.6-83.8).Despite a trend to an increased prevalence in the group with HCV infection,the difference was not significant compared to the control group(P=NS).In patients over 40 years,the results were,respectively,as follows:breast cancer associated with HCV:17/266 patients(6.3%,95% CI:3.4-9.3) vs 5/95 patients(5.2%,95% CI:0.7-9.7) in the control group;benign breast tumors:72/266 patients with HCV infection(27%,95% CI:21.7-32.4) vs 18/95 patients(18.9%,95% CI:11-26.8) in the control group;no breast lesion 177/266(66.5%,95% CI:60.9-72.2) in patients with HCV infection vs 72/95(75.7%,95% CI:67.1-84.4) in the control group.The differences were not significant(P=NS).CONCLUSION:These results suggest that chronic HCV infection is not a strong promoter of breast carcinoma in adult females of any age.

Hepatitis B virus reinfection after liver transplan- tation: related risk factors and perspective

BACKGROUND: In recent years, liver transplantation (LT) has been acknowledged as an acceptable option for patients with hepatitis B virus (HBV) related end-stage liver diseases. However, HBV reinfection is an important event affecting the long-term survival of recipients. This paper was to review the risk factors related to HBV reinfection after LT. DATA SOURCES: English literature was reviewed based on MEDLINE focusing on the potential factors related to HBV reinfection after LT. RESULTS: HBV reinfection attributes to the unfavorable prognosis after LT. Many related factors may be responsible for it, including recipent factors (ethnical background, preoperative HBV replication status, extrahepatic HBV existence status), donor factors (compromised donor liver, HLA-A, -B compatibilities), perioperative treatment (use of antiviral agents, drug resistance, virus mutation, immu-nosuppressants protocol, blood transfusion) and others. CONCLUSIONS: The successful management of HBV reinfection will only be achieved by perfect clarification of its mechanism. The new strategies include new antiviral agents, gene therapy and immune intervention, reliable use of the compromised donor livers, and so on.

Detection of hepatitis G virus RNA in hepatitis C patients and hepatitis C virus infected hemodialysis patients

Two sets of PCR primers in the 5’ non-coding region were designed according to published hepatitis G virus (HGV) sequence. Using these primers, a nested reverse transcription PCR was carried out in 47 hepatitis C patients and 10 HCV RNA (+ ) hemodialysis patients. Ten of the hepatitis C patients and one of the hemodialysis patients (11/57, 19. 3% ) were found to be positive for HGV RNA. The PCR products from two HGV RNA positive patients were cloned and sequenced. The cDNA homologies were 83% -90% as compared with the published sequences. The results show that HGV infection is rather common in hepatitis C-infected patients, suggesting that it is necessary to investigate the effect of HGV on the course of HCV infection.

Follow-up study of hepatitis C virus infection in uremic patients on maintenance hemodialysis for 30 months

INTRODUCTIONA high prevalence of antibodies to hepatitis C virus(HCV)(range from 3.3%-80%)has beenreported in hemodialysis(HD)patients,andworrisome as it often becomes chronic and induceschronic liver disease,therefore thenephrologists face a major challenge of how toprevent it.The main route of HCV transmission