AIM: The role of hepatitis B virus (HBV) genotypes on the clinical features and prognosis of patients with hepatocellular carcinoma (HCC) is currently unknown. The aim of the present study was to evaluate the distribu...AIM: The role of hepatitis B virus (HBV) genotypes on the clinical features and prognosis of patients with hepatocellular carcinoma (HCC) is currently unknown. The aim of the present study was to evaluate the distribution of HBV genotypes and their clinical relevance in Thai patients.METHODS: HBV genotypes were determined by PCR-RFLP in stored sera of 93 asymptomatic carriers, 103 patients with chronic hepatitis, 60 patients with cirrhosis and 76patients with HCC. The clinical data were analyzed in relation to the HBV genotype.RESULTS: HBV genotypes C and B were predominant in Thailand, accounting for 73% and 21%, respectively. The distributions of genotypes B and C were similar in HCC patients compared to the other groups. Genotype C was significantly more common in HCC patients who were under 40 years old than genotype B (18% vs 0%, P= 0.03), but was significantly less common in patients older than 60 years (26% vs 56.5%, P= 0.01). The positive rate of hepatitis B e antigen (HBeAg) in patients with genotype C was significantly higher than that in patients with genotype B (71.6% vs 44.4%, P = 0.03 in chronic hepatitis; 56.8% vs 11.1%,P = 0.01 in cirrhosis). There were no differences between HCC patients with genotypes B and C regarding tumor staging by CLIP criteria and the overall median survival. Multivariate analyses showed that HBV genotype was not an independent prognostic factor of survival in HCC patients.CONCLUSION: Patients with genotype C had a higher positive rate of HBeAg and exhibited earlier progression of cirrhosis and HCC than those with genotype B. However,there were no differences in the risk of developing HCC and its prognosis between patients with these genotypes.展开更多
We present a 27-year-old female patient received for epistaxis associated with gingivorrhagia. In her medical history, she had undergone an oesogastroduodenal fibroscopy one year earlier, which revealed a bulbar ulcer...We present a 27-year-old female patient received for epistaxis associated with gingivorrhagia. In her medical history, she had undergone an oesogastroduodenal fibroscopy one year earlier, which revealed a bulbar ulcer with gastritis. On admission, she presented with a bleeding syndrome, an anemic syndrome with poor hemodynamic tolerance, and epigastric sensitivity. The blood count performed in the emergency on the citrate tube showed a bicy-topenia (regenerative anemia + thrombocytopenia). The HELIKIT test was positive. Thus, the hypothesis of an acute immunological thrombocytopenic purpura associated with a Helicobacter pylori infection seemed to us the most probable with a Khellaf hemorrhagic score of 8. She had benefited from a bolus of methyl prednisone: 15 mg/kg/day for 3 days then relay per os with prednisone 1 mg/kg/day (and adjuvant treatment);the eradicating treatment of Helicobacter pylori had been simultaneously started.展开更多
基金Supported by the Thailand Research Fund and Center of Excellence,Viral Hepatitis Research Unit, Chulalongkorn University
文摘AIM: The role of hepatitis B virus (HBV) genotypes on the clinical features and prognosis of patients with hepatocellular carcinoma (HCC) is currently unknown. The aim of the present study was to evaluate the distribution of HBV genotypes and their clinical relevance in Thai patients.METHODS: HBV genotypes were determined by PCR-RFLP in stored sera of 93 asymptomatic carriers, 103 patients with chronic hepatitis, 60 patients with cirrhosis and 76patients with HCC. The clinical data were analyzed in relation to the HBV genotype.RESULTS: HBV genotypes C and B were predominant in Thailand, accounting for 73% and 21%, respectively. The distributions of genotypes B and C were similar in HCC patients compared to the other groups. Genotype C was significantly more common in HCC patients who were under 40 years old than genotype B (18% vs 0%, P= 0.03), but was significantly less common in patients older than 60 years (26% vs 56.5%, P= 0.01). The positive rate of hepatitis B e antigen (HBeAg) in patients with genotype C was significantly higher than that in patients with genotype B (71.6% vs 44.4%, P = 0.03 in chronic hepatitis; 56.8% vs 11.1%,P = 0.01 in cirrhosis). There were no differences between HCC patients with genotypes B and C regarding tumor staging by CLIP criteria and the overall median survival. Multivariate analyses showed that HBV genotype was not an independent prognostic factor of survival in HCC patients.CONCLUSION: Patients with genotype C had a higher positive rate of HBeAg and exhibited earlier progression of cirrhosis and HCC than those with genotype B. However,there were no differences in the risk of developing HCC and its prognosis between patients with these genotypes.
文摘We present a 27-year-old female patient received for epistaxis associated with gingivorrhagia. In her medical history, she had undergone an oesogastroduodenal fibroscopy one year earlier, which revealed a bulbar ulcer with gastritis. On admission, she presented with a bleeding syndrome, an anemic syndrome with poor hemodynamic tolerance, and epigastric sensitivity. The blood count performed in the emergency on the citrate tube showed a bicy-topenia (regenerative anemia + thrombocytopenia). The HELIKIT test was positive. Thus, the hypothesis of an acute immunological thrombocytopenic purpura associated with a Helicobacter pylori infection seemed to us the most probable with a Khellaf hemorrhagic score of 8. She had benefited from a bolus of methyl prednisone: 15 mg/kg/day for 3 days then relay per os with prednisone 1 mg/kg/day (and adjuvant treatment);the eradicating treatment of Helicobacter pylori had been simultaneously started.
