Journal of Viral Hepatitis最新文献

Oral nucleotide analogues (NAs) and peginterferon-α injections are commonly used for the treatment of patients with chronic hepatitis B (CHB). This study aims to evaluate the effects of different antiviral therapies on the degree of liver inflammation and fibrosis in CHB patients. This was a retrospective cohort study. A total of 101 CHB patients were admitted to the Liver Center of Xiamen Hospital of Traditional Chinese Medicine from 2017 to 2021 and were divided into three groups for different antiviral treatments: NAs therapy group (n = 36), peginterferon-α therapy group (n = 38) and nonantiviral therapy group (n = 27). The differences in degrees of liver inflammation and liver fibrosis between two histopathologic biopsies before and after treatment were analysed and compared to evaluate the efficacy of different treatments. The degrees of liver inflammation and liver fibrosis were improved after NAs or peginterferon-α therapy. In terms of improving the degree of liver inflammation, peginterferon-α therapy (74%) and NAs therapy (44%) were better than nonantiviral therapy (11%, p < 0.05), although no significant difference was shown between peginterferon-α therapy and NAs therapy (p = 0.974). For liver fibrosis improvement, peginterferon-α therapy showed significantly better efficacy than NAs therapy (68% vs. 33%, p = 0.044), while NAs therapy was better than nonantiviral therapy (33% vs. 11%, p = 0.028). Peginterferon-α and NAs can significantly improve the degree of liver inflammation and liver fibrosis in CHB patients. Peginterferon-α is superior to NAs in delaying and reversing liver fibrosis. This study provides a new basis for peginterferon-α therapy to prevent progression of fibrosis in CHB patients.

To investigate the effects of chronic HBV infection on the outcome of in vitro fertilisation-embryo transfer and clinical characteristics of newborns, as well as the factors influencing different outcomes of in vitro fertilisation-embryo transfer (IVF-ET). In this study, a total of 3900 couples undergoing IVF-ET were collected and divided into four groups according to the different HBsAg carrier status of each couple, comparing the general demographic data and clinical characteristics between the four groups, analysing the differences in IVF-ET outcomes between the groups, and using multifactorial analysis of factors influencing their IVF-ET outcomes. The results showed that no significant differences (p > 0.05) were found in IVF-ET outcomes among the four groups, but multifactorial logistic regression showed that male and female age, low literacy level of men, total number of eggs acquired, LH value and P value on HCG day may affect the success rate of different IVF-ET outcomes (embryo outcome, pregnancy outcome and perinatal outcome) to different degrees. We also analysed the clinical data of 952 newborns and there were no statistically significant differences (p > 0.05) in variables including sex distribution, length, weight, health status and Apgar score. Therefore, our study suggests that neither uniparental infection nor biparental HBV infection may affect the outcome of IVF-ET or the clinical characteristics of the newborns, but the outcome of IVF-ET is affected by different factors.

People with mental health disorders have a significant lack of physical health care. They also have higher rates of medical co-morbidity. The aim of this study was to assess the feasibility and the linkage to care of systematic screening for hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) in patients admitted for an acute psychiatric event at the emergency department (ED). This was an observational prospective cohort study for 1 year. Systematic screening was performed for HBV, HCV and HIV for all adult patients presenting to the ED for acute psychiatric reasons. This was a collaborative work between 3 departments (emergency, hepatology and psychiatry). A total of 584 patients were included. The median age was 42 years (range 29–56) with 304 (52%) men. Among all study patients, 50% were hospitalised in the psychiatry ward, and 38 (7%) had a positive serological screening, including 9 (2%), 19 (3%) and 12 (2%), respectively, for HBV, HCV and HIV. Among 19 patients with HCV, 12 had negative HCV RNA, 2 were treated and cured, and 5 were lost to follow-up. This study demonstrated the feasibility of HBV, HCV and HIV screening and linkage to care programmes in people with mental health disorders in the ED. The medical importance for this at-risk population confirms the significant benefit of continuing this screening in hospitals or as outpatients.

Hepatitis C virus (HCV) infection affects approximately 3.9 million people in the United States (U.S.), leading to 8000 to 10,000 deaths annually. Despite advancements in curative treatments since 2014, effective strategies targeting high-risk groups are crucial. This study examines HCV-related mortality trends from 1999 to 2020, focusing on demographic and regional disparities using the CDC WONDER database. A retrospective analysis was conducted using the CDC WONDER database. HCV-related deaths were identified using the International Classification of Diseases, Tenth Revision (ICD-10) codes B17.1 and B18.2. Mortality data were categorised by gender, age, race/ethnicity, region, place of death and urbanisation status. We calculated crude mortality rates (CRs) and age-adjusted mortality rates (AAMRs) per 100,000 population. Joinpoint regression analysis identified significant changes in mortality trends. A total of 324,008 HCV-related deaths were reported. The overall AAMR was 4.27 (95% Confidence Interval [CI]: 4.25 to 4.28). Mortality increased from 1999 to 2014 (1999 to 2007 Annual Percent Change [APC]: 5.00; 2007 to 2014 APC: 1.95) and declined sharply from 2014 to 2020 (APC: −7.11). Males exhibited higher mortality (AAMR: 6.28) than females (AAMR: 2.42). The 55–64 years age group had the highest CR (16.38), while non-Hispanic (NH) American Indians had the highest rate (AAMR: 8.72) among racial groups. Regionally, the South had the highest AAMR (5.80), nearly double that of the West (2.23) and Midwest (2.62). HCV-related mortality trends show significant demographic disparities and regional variations. Targeted interventions are essential to reduce HCV burden, particularly among vulnerable groups.

Hepatocellular carcinoma (HCC) and liver cirrhosis (LC) occur in spite of current antiviral therapies in patients with chronic hepatitis (CHB). It is not yet known why HCC and LC are related to hepatocytes and hepatic stellate cells (HSCs), respectively, in the same inflammation circumstances. The expression of the phosphorylated form of histone H2AX (γ-H2AX), a biomarker of DNA damage, was detected in hepatocytes and interstitial cells within the liver tissues of 69 patients with CHB using immunohistochemical assay and immunofluorescence colocalisation technique. Hydrogen peroxide (H₂O₂) was applied to establish an oxidative DNA damage model. Hepatocytes in CHB patients carried much higher levels of DNA damage than interstitial cells. The DNA damage-carried interstitial cells were confirmed to be HSCs. They lost the damaged DNA during differentiation into myofibroblasts near the foci of inflammatory necrosis. Hepatocyte was much more sensitive to oxidative stress and DNA damage than HSCs, but both MIHA and LX-2 repaired DNA damage efficiently in vitro. Hepatocytes carried much higher levels of DNA damage than HSCs due to their remarkable difference in sensitivity to inflammation-induced oxidative DNA damage. The different sensitivity may render hepatocytes and HSCs to be respectively involved in HCC and LC in the same inflammation circumstances.

The rate of HCV infection is higher in people with psychiatric conditions than in the general population. However, access to somatic care for populations with mental or dual diagnoses remains insufficient. These circumstances could constitute a barrier to the eradication of HCV infection. A retrospective study was performed in the public mental health institution of Ville Evrard. Screening for HCV infection should be systematically proposed to patients attending the institution. On-site assessment of liver disease severity and treatment with direct-acting antivirals prescribed by physicians not specialised in hepatology allowed a better continuum of care. Patients lost to follow-up after a positive HCV serology test without viral load assessment were contacted. Patients hospitalised at least once a year were included. 8520 patients out of 18,439 (46.2%) were screened for HCV infection between 2017 and 2021. The screening rate increased from 40.0% in 2017 to 65.7% in 2021. HCV seroprevalence was 2.2%. A total of 129 HCV PCRs were performed, and 27.1% were positive. In a logistic regression model, patients older than 30 years were at greater risk of having a positive HCV serology test. These positive serologies were 1.9 times higher in men than women (p < 0.001). The assessment of fibrosis was found in 45.7% of patients with a positive HCV PCR. Patients with psychiatric conditions constitute an important HCV reservoir. A strategy of screening and management of HCV infection in this population appears to be feasible. This strategy could contribute to the eradication of chronic HCV infection.

Acute-on-chronic liver failure (ACLF) is a severe clinical condition with high short-term mortality, in part due to the dysfunctional immune response. Identifying immune mechanism under ACLF is critical to understand its pathogenesis and to develop novel targeted therapeutics. Among the immune cells, how are B cells involved in ACLF remains largely unknown. We performed scRNA-seq on peripheral blood mononuclear cells from clinical ACLF patients and healthy controls. Integrated analysis was performed to identify the role of B cells in ACLF. Subsequently, different subsets of B cells in ACLF were validated through flow cytometry based on their highlighted markers. Six B-cell subgroups, including naive B cells, naive B2 cells, nonclass-switched memory B cells, class-switched memory B cells, autoimmune-related B cells and plasma B cells were identified. The proportions of naive B cells significantly expand in ACLF, compared with healthy control. Function enrichment analysis revealed the activation of inflammatory response in naive B cells. Further flow cytometry confirmed the elevated circulating naive B cells in ACLF. Our study uncovered the altered immune landscape of circulating B cells after ACLF. The proportion dynamics and functional perturbation indicate the potential of naive B cells as intervention targets in the future ACLF therapy.