Hepatitis B virus(HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and live...Hepatitis B virus(HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and liver cancer. Several hepatitis B surface antigen(HBs Ag) mutations have been described, most frequently due to a single amino acid substitution and seldom to a nucleotide deletion. The majority of mutations are located in the S region, but they have also been found in the pre-S1 and pre-S2 regions. Single amino acid substitutions in the major hydrophilic region of HBs Ag, called the "a" determinant, have been associated with immune escape and the consequent failure of HBV vaccination and HBs Ag detection, whereas deletions in the pre-S1 or pre-S2 regions have been associated with the development of hepatocellular carcinoma. This review article will focus on the HBs Ag mutants and their biological and clinical implications.展开更多
AIM To evaluate the impact of the Glu167Lys(E167K) transmembrane 6 superfamily member 2(TM6SF2) variant on the biochemical and morphologic expression of liver lesions in human immunodeficiency virus(HIV)/hepatitis C v...AIM To evaluate the impact of the Glu167Lys(E167K) transmembrane 6 superfamily member 2(TM6SF2) variant on the biochemical and morphologic expression of liver lesions in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) co-infected patients.METHODS The study comprised 167 consecutive patients with HIV/HCV coinfection and biopsy-proven chronic hepatitis. A pathologist graded liver fibrosis and necroinflammation using the Ishak scoring system, and steatosis using Kleiner's scoring system. Patients were genotyped for TM6SF2 E167K(rs58542926) by real-time Polymerase chain reaction. The 167 patients, 35 therapy-naive and 132 receiving ART, were prevalently males(73.6%), the median age was 40.7 years and the immunological condition good(median CD4+ cells/mm3 = 505.5).RESULTS The 17 patients with the TM6SF2 E167 K variant, compared with the 150 with TM6SF2-E/E, showed higher AST(P = 0.02) and alanine aminotransferase(P = 0.02) and higher fibrosis score(3.1 ± 2.0 vs 2.3 ± 1.5, P = 0.05). In a multivariate analysis, TM6SF2 E167 K was independently associated with severe fibrosis. The same analysis showed that HCV-genotype 3, present in 42.2% of patients was an independent predictor of severe steatosis. The association of TM6SF2 E167 K with severe steatosis, absent for the whole group of 167 patients, was re-evaluated separately for HCVgenotype 3 and non-3 patients: No factor was independently associated with severe steatosis in the HCV-genotype-3 subgroup, whereas an independent association was observed between severe steatosis and TM6SF2 E167 K in non-3 HCV genotypes. No association between the TM6SF2 E167 K variant and severe liver necroinflammation was observed.CONCLUSION In HIV/HCV coinfection the TM6SF2 E167 K variant is an independent predictor of severe fibrosis, but appears to be independently associated with severe steatosis only for patients with a non-3 HCV genotype.展开更多
AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected patients.METHODS:Th...AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected patients.METHODS:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV infection.Prevalence of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were evaluated.RESULTS:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with steatosis.Group HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV group.In HBV-HCV group,liver fibrosis was not associated with steatosis,IR or PNPLA3.HBV infection was the independent predictor of advanced liver fibrosis.CONCLUSION:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.展开更多
Background:The data on hepatitis b virus(HBV)infection in immigrants population are scanty.The porpoise of this study was to define the demographic,virological,and clinical characteristics of subjects infected with HB...Background:The data on hepatitis b virus(HBV)infection in immigrants population are scanty.The porpoise of this study was to define the demographic,virological,and clinical characteristics of subjects infected with HBV chronic infection in a cohort of immigrants living in Naples,Italy.Methods:A screening for HBV infection was offered to 1,331 immigrants,of whom 1,212(91%)(831 undocumented immigrants and 381 refugees)accepted and were screened for hepatitis B surface antigen(HBsAg)and anti-hepatitis B core antibody(HBc).Those found to be HBsAg positive were further investigated at third-level infectious disease units.Results:Of the 1,212 immigrants screened,116(9.6%)were HBsAg positive,490(40.4%)were HBsAg negative/anti-HBc positive,and 606(50%)were seronegative for both.Moreover,21(1.7%)were anti-human immunodeficiency virus positive and 45(3.7%)were anti-hepatitis C virus positive.The logistic regression analysis showed that male sex(OR:1.79;95%CI:1.28-2.51),Sub-Saharan African origin(OR:6.18;95%CI:3.37-11.36),low level of schooling(OR:0.96;95%CI:0.94-0.99),and minor parenteral risks for acquiring HBV infection(acupuncture,tattoo,piercing,or tribal practices,OR:1.54;95%CI:1.1-2.16)were independently associated with ongoing or past HBV infection.Of the 116 HBsAg-positive immigrants,90(77.6%)completed their diagnostic itinerary at a third-level infectious disease unit:29(32.2%)were asymptomatic non-viremic HBsAg carriers,43(47.8%)were asymptomatic viremic carriers,14(15.6%)had chronic hepatitis,and four(4.4%)had liver cirrhosis,with superimposed hepatocellular carcinoma in two.Conclusions:The data illustrate the demographic,clinical and virological characteristics of HBV infection in immigrants in Italy and indicate the need for Italian healthcare authorities to enhance their support for providing screening,HBV vaccination,treatment,and educational programs for this populations.展开更多
文摘Hepatitis B virus(HBV) infection is a major public health problem in many countries, with nearly 300 million people worldwide carrying HBV chronic infection and over 1 million deaths per year due to cirrhosis and liver cancer. Several hepatitis B surface antigen(HBs Ag) mutations have been described, most frequently due to a single amino acid substitution and seldom to a nucleotide deletion. The majority of mutations are located in the S region, but they have also been found in the pre-S1 and pre-S2 regions. Single amino acid substitutions in the major hydrophilic region of HBs Ag, called the "a" determinant, have been associated with immune escape and the consequent failure of HBV vaccination and HBs Ag detection, whereas deletions in the pre-S1 or pre-S2 regions have been associated with the development of hepatocellular carcinoma. This review article will focus on the HBs Ag mutants and their biological and clinical implications.
文摘AIM To evaluate the impact of the Glu167Lys(E167K) transmembrane 6 superfamily member 2(TM6SF2) variant on the biochemical and morphologic expression of liver lesions in human immunodeficiency virus(HIV)/hepatitis C virus(HCV) co-infected patients.METHODS The study comprised 167 consecutive patients with HIV/HCV coinfection and biopsy-proven chronic hepatitis. A pathologist graded liver fibrosis and necroinflammation using the Ishak scoring system, and steatosis using Kleiner's scoring system. Patients were genotyped for TM6SF2 E167K(rs58542926) by real-time Polymerase chain reaction. The 167 patients, 35 therapy-naive and 132 receiving ART, were prevalently males(73.6%), the median age was 40.7 years and the immunological condition good(median CD4+ cells/mm3 = 505.5).RESULTS The 17 patients with the TM6SF2 E167 K variant, compared with the 150 with TM6SF2-E/E, showed higher AST(P = 0.02) and alanine aminotransferase(P = 0.02) and higher fibrosis score(3.1 ± 2.0 vs 2.3 ± 1.5, P = 0.05). In a multivariate analysis, TM6SF2 E167 K was independently associated with severe fibrosis. The same analysis showed that HCV-genotype 3, present in 42.2% of patients was an independent predictor of severe steatosis. The association of TM6SF2 E167 K with severe steatosis, absent for the whole group of 167 patients, was re-evaluated separately for HCVgenotype 3 and non-3 patients: No factor was independently associated with severe steatosis in the HCV-genotype-3 subgroup, whereas an independent association was observed between severe steatosis and TM6SF2 E167 K in non-3 HCV genotypes. No association between the TM6SF2 E167 K variant and severe liver necroinflammation was observed.CONCLUSION In HIV/HCV coinfection the TM6SF2 E167 K variant is an independent predictor of severe fibrosis, but appears to be independently associated with severe steatosis only for patients with a non-3 HCV genotype.
文摘AIM:To evaluate steatosis,insulin resistance(IR)and patatin-like phospholipase domain-containing 3(PNPLA3) and their relation to disease progression in hepatitis B and C viruses(HCV-HBV) coinfected patients.METHODS:Three hundred and thirty patients with biopsy proven chronic hepatitis were enrolled:66 had HBV-HCV,66 HBV and 198 HCV infection.Prevalence of steatosis,IR and PNPLA3 polymorphisms and their relation to anthropometric,biochemical,virological and histological parameters were evaluated.RESULTS:Prevalence of steatosis in group HBV-HCV was similar to that in HCV(47.0% vs 49.5%,respec-tively);group HBV showed the lowest steatosis(33.3%).Group HBV-HCV had a lesser degree of steatosis than HCV(P = 0.016),lower HCV RNA levels(P = 0.025) and lower prevalence and degree of IR(P = 0.01).PNPLA3 polymorphisms were associated with steatosis.Group HBV-HCV showed higher levels of liver fibrosis than group HCV(P = 0.001),but similar to that ob-served in HBV group.In HBV-HCV group,liver fibrosis was not associated with steatosis,IR or PNPLA3.HBV infection was the independent predictor of advanced liver fibrosis.CONCLUSION:HBV-HCV co-infected patients have lower degree of hepatic steatosis,IR and HCV RNA than HCV mono-infected;co-infected patients showed a more rapid liver fibrosis progression that seems to be due to the double infection and/or HBV dominance.
基金This study was supported in part by a grant from Gilead Sciences S.r.l.‘L’infezione da HBV nelle popolazioni speciali(donne in gravidanza,popolazioni immigrate,popolazioni in etàpediatrica):progetti di awareness ed accesso alla diagnosi’Fellowship Program 2011 and 2013by a grant from 2014 goSHAPE program。
文摘Background:The data on hepatitis b virus(HBV)infection in immigrants population are scanty.The porpoise of this study was to define the demographic,virological,and clinical characteristics of subjects infected with HBV chronic infection in a cohort of immigrants living in Naples,Italy.Methods:A screening for HBV infection was offered to 1,331 immigrants,of whom 1,212(91%)(831 undocumented immigrants and 381 refugees)accepted and were screened for hepatitis B surface antigen(HBsAg)and anti-hepatitis B core antibody(HBc).Those found to be HBsAg positive were further investigated at third-level infectious disease units.Results:Of the 1,212 immigrants screened,116(9.6%)were HBsAg positive,490(40.4%)were HBsAg negative/anti-HBc positive,and 606(50%)were seronegative for both.Moreover,21(1.7%)were anti-human immunodeficiency virus positive and 45(3.7%)were anti-hepatitis C virus positive.The logistic regression analysis showed that male sex(OR:1.79;95%CI:1.28-2.51),Sub-Saharan African origin(OR:6.18;95%CI:3.37-11.36),low level of schooling(OR:0.96;95%CI:0.94-0.99),and minor parenteral risks for acquiring HBV infection(acupuncture,tattoo,piercing,or tribal practices,OR:1.54;95%CI:1.1-2.16)were independently associated with ongoing or past HBV infection.Of the 116 HBsAg-positive immigrants,90(77.6%)completed their diagnostic itinerary at a third-level infectious disease unit:29(32.2%)were asymptomatic non-viremic HBsAg carriers,43(47.8%)were asymptomatic viremic carriers,14(15.6%)had chronic hepatitis,and four(4.4%)had liver cirrhosis,with superimposed hepatocellular carcinoma in two.Conclusions:The data illustrate the demographic,clinical and virological characteristics of HBV infection in immigrants in Italy and indicate the need for Italian healthcare authorities to enhance their support for providing screening,HBV vaccination,treatment,and educational programs for this populations.
