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Hepatotropic viruses:Is Roma population at risk? 认领
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作者 Anna Mrzljak Lucija Bajkovec Tatjana Vilibic-Cavlek 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第2期143-151,共9页
Roma people make up a significant ethnic minority in many European countries,with the vast majority living in Central and Eastern Europe.Roma are a vulnerable population group in social,economic,and political terms.Fr... Roma people make up a significant ethnic minority in many European countries,with the vast majority living in Central and Eastern Europe.Roma are a vulnerable population group in social,economic,and political terms.Frequent migrations,life in segregated communities,substandard housing,poverty,and limited access to quality health care,including low immunization coverage,affect their health status and predispose them to various diseases,including viral hepatitis.Hepatitis A,B,and E are highly prevalent among Roma and mainly associated with low socioeconomic status.In contrast,hepatitis C does not seem to be more frequent in the Roma population.Enhanced efforts should be directed towards the implementation of screening programs,preventive measures,and treatment of viral hepatitis in Roma communities throughout Europe. 展开更多
关键词 Roma population Hepatitis A virus Hepatitis B virus Hepatitis C virus Hepatitis E virus EUROPE
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Human hepatitis viruses-associated cutaneous and systemic vasculitis 认领
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作者 Chrong-Reen Wang Hung-Wen Tsai 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第1期19-36,共18页
Human hepatitis viruses(HHVs)include hepatitis A virus,hepatitis B virus(HBV),hepatitis C virus(HCV),hepatitis delta virus,and hepatitis E virus and can cause liver inflammation in their common human host.Usually,HHV ... Human hepatitis viruses(HHVs)include hepatitis A virus,hepatitis B virus(HBV),hepatitis C virus(HCV),hepatitis delta virus,and hepatitis E virus and can cause liver inflammation in their common human host.Usually,HHV is rapidly cleared by the immune system,following acute HHV invasion.The morbidities associated with hepatitis A virus and hepatitis E virus infection occur shortly after their intrusion,in the acute stage.Nevertheless,the viral infectious process can persist for a long period of time,especially in HBV and HCV infection,leading to chronic hepatitis and further progressing to hepatic cirrhosis and liver cancer.HHV infection brings about complications in other organs,and both acute and chronic hepatitis have been associated with clinical presentations outside the liver.Vascular involvement with cutaneous and systemic vasculitis is a well-known extrahepatic presentation;moreover,there is growing evidence for a possible causal relationship between viral pathogens and vasculitis.Except for hepatitis delta virus,other HHVs have participated in the etiopathogenesis of cutaneous and systemic vasculitis via different mechanisms,including direct viral invasion of vascular endothelial cells,immune complex-mediated vessel wall damage,and autoimmune responses with stimulation of autoreactive B-cells and impaired regulatory T-cells.Cryoglobulinemic vasculitis and polyarteritis nodosa are recognized for their association with chronic HHV infection.Although therapeutic guidelines for HHV-associated vasculitis have not yet been established,antiviral therapy should be initiated in HBV and HCV-related systemic vasculitis in addition to the use of corticosteroids.Plasma exchange and/or combined cyclophosphamide and corticosteroid therapy can be considered in patients with severe life-threatening vasculitis manifestations. 展开更多
关键词 Human hepatitis viruses Hepatitis B virus Hepatitis C virus Cryogobulinemic vasculitis Polyarteritis nodosa Antiviral therapy
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Elevated soluble 4-1BB is associated with serum markers of hepatitis B virus in patients with chronic hepatitis B 认领
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作者 Meng-Ru Zhan Xiu-Zhu Gao +4 位作者 Chang Wang Fei Peng Xiao-Mei Wang Hong-Qin Xu Jun-Qi Niu 《世界临床病例杂志》 SCIE 2021年第7期1619-1630,共12页
BACKGROUND Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection.However,up to now,there are few studies about 4-1BB in chronic... BACKGROUND Previous studies have suggested that the costimulatory molecule 4-1BB plays pivotal roles in regulating immunity during chronic viral infection.However,up to now,there are few studies about 4-1BB in chronic hepatitis B(CHB).AIM To clarify this issue,we report our comprehensive study results on the expression levels of 4-1BB in patients with CHB.METHODS From September 2018 to June 2019,a total of 64 patients with CHB were recruited from the Department of Hepatology,The First Hospital of Jilin University.Peripheral blood samples were collected from 52 treatment-naïve and 12 entecavir-treated patients with CHB as well as 37 healthy donors(including 24 healthy adults and 13 healthy children).The levels of soluble 4-1BB(s4-1BB)in plasma were measured by ELISA.4-1BB mRNA expression in peripheral blood mononuclear cells was detected by real-time quantitative PCR.RESULTS The s4-1BB levels in the plasma of patients with CHB were significantly higher than those in healthy adults(94.390±7.393 ng/mL vs 8.875±0.914 ng/mL,P<0.001).In addition,the s4-1BB level in plasma was significantly increased in patients with a higher viral load and a disease flare up.However,there were no significant differences between treatment-naïve and entecavir-treated patients.Interestingly,among treatment-naïve patients with CHB,the levels of s4-1BB in plasma had a significant positive correlation with hepatitis B surface antigen,hepatitis B virus DNA,hepatitis B e antigen,and triglyceride levels(r=0.748,P<0.001;r=0.406,P=0.004;r=0.356,P=0.019 and r=-0.469,P=0.007,respectively).The 4-1BB mRNA expression was higher in the peripheral blood mononuclear cells of patients with CHB than in the peripheral blood mononuclear cells of healthy adults,but the difference was not statistically significant.CONCLUSION These results suggest that the levels of s4-1BB may be associated with pathogenesis of hepatitis B virus and therefore may be a promising biomarker for disease progression. 展开更多
关键词 Hepatitis B virus Hepatitis B CHRONIC 4-1BB Soluble 4-1BB Hepatitis B virus serum marker
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Cascade of care for children and adolescents with chronic hepatitis C 认领
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作者 Michael Evan Rogers William F Balistreri 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第12期1117-1131,共15页
Chronic hepatitis C virus(HCV)infection presents a significant global public health burden.In 2015,over 400000 deaths worldwide were attributed to HCV infection.This led the World Health Organization(WHO)in 2016 to se... Chronic hepatitis C virus(HCV)infection presents a significant global public health burden.In 2015,over 400000 deaths worldwide were attributed to HCV infection.This led the World Health Organization(WHO)in 2016 to set the ambitious goal of eliminating HCV by 2030.Adult-centered guidelines have been established in order to provide direction for healthcare professionals,allowing integration of the newest screening policies and therapeutic strategies into their practices.However,for children and adolescents,HCV is a significant,unrecognized public health problem.HCV infection rates in the United States in women of childbearing age and those who are pregnant have increased in parallel with the rising opioid epidemic.An estimated 29000 women with HCV infection gave birth each year from 2011 to 2014 in the United States,with approximately 1700 of their infants being infected with HCV.Newer HCV-specific therapeutics,namely direct acting antivirals(DAA),has brought a new and highly successful approach to treatment of hepatitis C.Recent studies have confirmed similar levels of effectiveness and safety of DAA therapies in the pediatric population.Thus,an enhanced cascade of care,which should include the population under 18 years of age,can help achieve the WHO goal by focusing on elimination in the youngest populations.This review will present an overview of the natural history,clinical features,and management of HCV in children and adolescents. 展开更多
关键词 Hepatitis C virus Hepatitis C education Hepatitis C elimination
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文章速递2008年和2018年广州市HBV易感人群的流行病学特征 认领
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作者 鲁影 黄勇 +3 位作者 汪慧 杨琼英 张周斌 张春焕 《中华疾病控制杂志》 CAS CSCD 北大核心 2021年第3期341-345,共5页
目的分析比较2008年和2018年广州市1~59岁HBV易感人群的流行病学特征,评价免疫策略效果。方法采用二阶段整群抽样法,于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。结果2008年和2018年调查显示,广州市1~59... 目的分析比较2008年和2018年广州市1~59岁HBV易感人群的流行病学特征,评价免疫策略效果。方法采用二阶段整群抽样法,于2008年和2018年在广州市随机抽取1~59岁常住人口进行乙肝血清流行病学调查。结果2008年和2018年调查显示,广州市1~59岁人群中HBV易感率分别为17.34%(95%CI:16.29%~18.39%)和19.77%(95%CI:18.54%~21.01%),7~16岁人群易感率(2008年23.93%,2018年36.22%)较其他年龄组高。广州市1~59岁人群中单项HBcAb阳性率分别为6.63%(95%CI:5.94%~7.33%)和2.76%(95%CI:1.62%~3.91%),下降(58.34%)。有乙肝疫苗免疫史人群单项HBcAb阳性率降幅达81.73%。结论对易感人群,包括单项HBcAb阳性成年人补种、加强或重新接种乙肝疫苗,提高人群免疫水平,降低易感性。 展开更多
关键词 肝炎 血清流行病学 易感 乙型肝炎病毒核心抗体 乙型肝炎疫苗
Hepatitis D virus and liver transplantation: Indications and outcomes 认领
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作者 Haris Muhammad Aniqa Tehreem +3 位作者 Muhammad Baraa Hammami Peng-Sheng Ting Ramzan Idilman Ahmet Gurakar 《世界肝病学杂志:英文版(电子版)》 2021年第3期291-299,共9页
Hepatitis D virus(HDV)is a dependent virus that relies on hepatitis B virus for its replication and transmission.Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease.Curre... Hepatitis D virus(HDV)is a dependent virus that relies on hepatitis B virus for its replication and transmission.Chronic hepatitis D is a severe form of viral hepatitis that can result in end stage liver disease.Currently,pegylated interferon alpha is the only approved therapy for chronic HDV infection and is associated with significant side effects.Liver transplantation(LT)is the only treatment option for patients with end-stage liver disease,hepatocellular carcinoma,or fulminant hepatitis due to coinfection with HDV.As LT for HDV and hepatitis B virus coinfection is uncommon in the United States,most data on the long-term impact of LT on HDV are from international centers.In this review,we discuss the indications and results of LT with treatment options in HDV patients. 展开更多
关键词 Hepatitis delta virus Liver transplant Hepatitis B immunoglobins Hepatocellular carcinoma
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Negative conversion of autoantibody profile in chronic hepatitis B:A case report 认领
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作者 Xun Zhang Qin-Xiu Xie Dong-Mei Zhao 《世界临床病例杂志》 SCIE 2021年第5期1196-1203,共8页
BACKGROUND Autoimmune antibodies are detected in many diseases.Viral infections are accompanied by several immunopathological manifestations.Some autoimmune antibodies have been associated with the immune response ind... BACKGROUND Autoimmune antibodies are detected in many diseases.Viral infections are accompanied by several immunopathological manifestations.Some autoimmune antibodies have been associated with the immune response induced by virus or drugs.Thus,a comprehensive diagnosis of chronic hepatitis B combined with autoimmune hepatitis is required,and immunosuppressant or antiviral therapy should be carefully considered.CASE SUMMARY We present a case of a patient who had negative transformation of autoimmune antibodies during chronic active hepatitis B.A 50-year-old female who had a history of asymptomatic hepatitis B virus carriers for more than 10 years presented to the hospital with the complaint of weakness for 1 wk.Blood tests revealed elevated liver enzymes;the detection of autoantibodies was positive.Hepatitis B viral load was 72100000 IU/mL.The patient started tenofovir alafenamide fumigate 25 mg daily.Liver biopsy was performed,which was consistent with chronic active hepatitis B.The final diagnosis of the case was chronic active hepatitis B.The autoimmune antibodies turned negative after 4 wk of antiviral therapy.The patient recovered and was discharged with normal liver function.There was no appearance of autoantibodies,and liver function was normal at regular follow-ups.CONCLUSION Autoimmune antibodies may appear in patients with chronic active hepatitis.It is necessary to differentiate the diagnosis with autoimmune hepatitis. 展开更多
关键词 AUTOANTIBODIES Autoimmune hepatitis Chronic hepatitis B Immune responses Case report
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Serum vitamin D and vitamin-D-binding protein levels in children with chronic hepatitis B 认领
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作者 Cai-Zhi Huang Jie Zhang +3 位作者 Lin Zhang Cui-Hua Yu Yi Mo Li-Ya Mo 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第3期255-266,共12页
BACKGROUND Vitamin D is an essential fat-soluble secosteroid hydroxylated by the liver to form the intermediate metabolite calcidiol{25-hydroxy vitamin D[25(OH)D]},which is a reliable indicator to investigate individu... BACKGROUND Vitamin D is an essential fat-soluble secosteroid hydroxylated by the liver to form the intermediate metabolite calcidiol{25-hydroxy vitamin D[25(OH)D]},which is a reliable indicator to investigate individual vitamin D status.Vitamin-D-binding protein(VDBP)is a multifunctional glycoprotein mainly synthesized in the liver and the major transport protein for vitamin D and its metabolites.Serum vitamin D and VDBP are both associated with hepatitis B.However,few studies have reported the relationship and clinical significance of vitamin D and VDBP with hepatitis B virus(HBV)replication and hepatic fibrosis in children with chronic hepatitis B(CHB).AIM To explore vitamin D and VDBP serum levels in children with CHB and the association of vitamin D and VDBP with HBV replication and hepatic fibrosis.METHODS We enrolled 204 children with CHB admitted to Hunan Children’Hospital in summer and autumn between 2018 and 2019 and 170 healthy controls.CHB patients included:164 hepatitis B e antigen(HBeAg)positive and 40 HBeAg negative;193 hepatitis B surface antigen(HBsAg)positive and 11 HBsAg negative;164 with detectable HBV deoxyribonucleic acid(DNA)and 40 with undetectable HBV DNA;131 with HBV genotype B and 23 with HBV genotype C;and 27 without hepatic fibrosis and 97 with hepatic fibrosis.Serum levels of 25(OH)D,VDBP,liver function markers,and other clinical parameters were collected to analyze their association with vitamin D and VDBP.Mann-Whitney U test,Kruskal-Wallis H test,or t test was used to analyze serum 25(OH)D and VDBP levels in different groups.Spearman rank correlation test was utilized to analyze the correlation of 25(OH)D and VDBP with other markers.Statistically significant factors determined by univariate analysis were further analyzed by binary multivariate logistic regression analysis.P<0.05 was considered statistically significant.RESULTS Children with CHB had lower serum 25(OH)D(56.64±17.89 nmoL/L)and VDBP[122.40(70.74-262.84μg/L)]levels than healthy controls had(P<0.001).Serum 25(OH)D and 展开更多
关键词 Chronic hepatitis B CHILDREN Vitamin D Vitamin-D-binding protein Hepatitis B virus
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Histopathological evaluation of long-term tenofovir disoproxil fumarate treatment in patients with hepatitis be antigen-negative chronic hepatitis B 认领
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作者 Bahri Abayli Cansu Abaylı Genco Gencdal 《世界胃肠药理与治疗学杂志:英文版(电子版)》 2021年第2期32-39,共8页
BACKGROUND Hepatitis B virus is a universal health problem.There are approximately 250 million people living with hepatitis B worldwide,and approximately 600000 of these people die every year due to the virus.AIM To c... BACKGROUND Hepatitis B virus is a universal health problem.There are approximately 250 million people living with hepatitis B worldwide,and approximately 600000 of these people die every year due to the virus.AIM To compare the pretreatment and post-treatment histopathological results of patients with hepatitis be antigen(HBeAg)-negative chronic hepatitis B(CHB)who had been receiving tenofovir disoproxil fumarate(TDF)treatment at our clinic for at least 5 years.METHODS Patients with HBeAg-negative CHB who were being treated with TDF(245 mg/d)were included in the study.Liver biopsies of patients before TDF treatment and liver biopsies after 5 years of TDF treatment were retrospectively compared.RESULTS A total of 50 HBeAg-negative CHB patients were included in the study(mean age:47.9±10.4 years,men:27.54%).Histological improvement was observed in 78%(39)of the patients after 5 years of treatment.After the 5 years of treatment,the mean Ishak score of the patients was 1.3±1.3,and the mean histologic activity index score was 4.1±2.8.A 1.53 point reduction in Ishak fibrosis score was detected after long-term TDF treatment.CONCLUSION Liver biopsies after 5 years of TDF treatment revealed a significant histological response and a regression of the necroinflammatory score compared to pretreatment liver biopsies.To better understand the effects of antiviral treatments on the improvement of liver histology,long-term studies involving larger numbers of patients are needed. 展开更多
关键词 Hepatitis B TENOFOVIR Chronic hepatitis BIOPSY Liver FIBROSIS
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Association of interferon lambda-4 rs12979860 polymorphism with hepatocellular carcinoma in patients with chronic hepatitis C infection 认领
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作者 Jóice Teixeira de Bitencorte Tássia Flores Rech +3 位作者 Vagner Ricardo Lunge Deivid Cruz dos Santos Mário ReisÁlvares-da-Silva Daniel Simon 《世界肝病学杂志:英文版(电子版)》 CAS 2021年第1期109-119,共11页
BACKGROUND Hepatitis C virus(HCV)infection is a public health concern worldwide.Several factors,including genetic polymorphisms,may be evolved in the progression of HCV infection to liver diseases.Interferon lambdas(I... BACKGROUND Hepatitis C virus(HCV)infection is a public health concern worldwide.Several factors,including genetic polymorphisms,may be evolved in the progression of HCV infection to liver diseases.Interferon lambdas(IFNLs)modulate the immune response during viral infections.IFNLs induce antiviral activity,interfering in the viral replication by promoting the expression of several genes that regulate immunological functions.The interferon lambda-4(IFNL4)rs12979860 polymorphism,which is characterized by a C to T transition in intron 1,is associated with spontaneous and treatment-induced clearance of HCV infection and may play a role in the development of HCV-associated liver diseases,including hepatocellular carcinoma(HCC).AIM To investigate the association of IFNL4 rs12979860 polymorphism with fibrosis,cirrhosis,and HCC in patients with chronic HCV infection.METHODS This study was comprised of 305 chronic HCV-infected patients(53 fibrosis,154 cirrhosis,and 98 HCC cases).The control group was comprised of 260 HCVnegative healthy individuals.The IFNL4 rs12979860 polymorphism was genotyped using the TaqMan assay.Fibrosis was diagnosed based on liver biopsy findings,while cirrhosis was diagnosed through clinical,laboratory,anatomopathological,and/or imaging data.HCC was diagnosed through imaging tests,tumor,and/or anatomopathological markers.RESULTS The T allele was observed in the three groups of patients(fibrosis,cirrhosis,and HCC)at a significantly higher frequency when compared with the control group(P=0.047,P<0.001,and P=0.01,respectively).Also,genotype frequencies presented significant differences between the control group and cirrhosis patients(P<0.001)as well as HCC patients(P=0.002).The risk analysis was performed using the codominant and dominant T allele models.In the codominant model,it was observed that the CT genotype showed an increased risk of developing cirrhosis in comparison with the CC genotype[odds ratio(OR)=2.53;95%confidence interval(CI):1.55-4.15;P<0.001]as well as with HCC(OR=2.54;95%CI:1.44-4 展开更多
关键词 Hepatitis C Hepatitis C virus Cirrhosis Hepatocellular carcinoma Genetic polymorphism Interferon-lambda
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Hepatitis E in solid organ transplant recipients:A systematic review and meta-analysis 认领
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作者 Panupong Hansrivijit Angkawipa Trongtorsak +9 位作者 Max M Puthenpura Boonphiphop Boonpheng Charat Thongprayoon Karn Wijarnpreecha Avishek Choudhury Wisit Kaewput Shennen A Mao Michael A Mao Caroline C Jadlowiec Wisit Cheungpasitporn 《世界胃肠病学杂志:英文版》 SCIE CAS 2021年第12期1240-1254,共15页
BACKGROUND Hepatitis E virus(HEV)infection is underdiagnosed due to the use of serological assays with low sensitivity.Although most patients with HEV recover completely,HEV infection among patients with pre-existing ... BACKGROUND Hepatitis E virus(HEV)infection is underdiagnosed due to the use of serological assays with low sensitivity.Although most patients with HEV recover completely,HEV infection among patients with pre-existing chronic liver disease and organ-transplant recipients on immunosuppressive therapy can result in decompensated liver disease and death.AIM To demonstrate the prevalence of HEV infection in solid organ transplant(SOT)recipients.METHODS We searched Ovid MEDLINE,EMBASE,and the Cochrane Library for eligible articles through October 2020.The inclusion criteria consisted of adult patients with history of SOT.HEV infection is confirmed by either HEV-immunoglobulin G,HEV-immunoglobulin M,or HEV RNA assay.RESULTS Of 563 citations,a total of 22 studies(n=4557)were included in this metaanalysis.The pooled estimated prevalence of HEV infection in SOT patients was 20.2%[95%confidence interval(CI):14.9-26.8].The pooled estimated prevalence of HEV infection for each organ transplant was as follows:liver(27.2%;95%CI:20.0-35.8),kidney(12.8%;95%CI:9.3-17.3),heart(12.8%;95%CI:9.3-17.3),and lung(5.6%;95%CI:1.6-17.9).Comparison across organ transplants demonstrated statistical significance(Q=16.721,P=0.002).The subgroup analyses showed that the prevalence of HEV infection among SOT recipients was significantly higher in middle-income countries compared to high-income countries.The pooled estimated prevalence of de novo HEV infection was 5.1%(95%CI:2.6-9.6)and the pooled estimated prevalence of acute HEV infection was 4.3%(95%CI:1.9-9.4).CONCLUSION HEV infection is common in SOT recipients,particularly in middle-income countries.The prevalence of HEV infection in lung transplant recipients is considerably less common than other organ transplants.More studies examining the clinical impacts of HEV infection in SOT recipients,such as graft failure,rejection,and mortality are warranted. 展开更多
关键词 Hepatitis E virus Hepatitis E virus infection Solid organ transplant PREVALENCE
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Knowledge, Attitude and Practices towards Hepatitis B Infection and Vaccination among Public Health Students in Ghana 认领
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作者 Augustine Kumah Emmanuel Tormeti +7 位作者 Gideon Dzando Hillary Selassi Nutakor Wonder Andrea Yayra Amenuvor Charles Komla Anagblah Honore Mordenu Evans Awutey Hope Akpeke Prosper Kpobi 《预防医学期刊(英文)》 2021年第1期43-53,共11页
<strong>Background: </strong>Hepatitis-B (Hep-B) infection is a global public health problem of great concern which affects more than 5% of the local population in Sub-Saharan Africa. This study assessed s... <strong>Background: </strong>Hepatitis-B (Hep-B) infection is a global public health problem of great concern which affects more than 5% of the local population in Sub-Saharan Africa. This study assessed students’ knowledge, attitude and practices towards Hepatitis B infection and vaccination at the University of Health and Allied Sciences, Ghana. <strong>Methods:</strong> A cross-sectional quantitative descriptive survey was conducted among 262 Public Health students of the University of Health and Allied Science of the Volta region of Ghana, using a multi-stage sampling technique in selecting participants. A structured questionnaire was used to collect data from the participants. Data was analyzed using SPSS Version 20.1. <strong>Results: </strong>Study respondents were mostly males, forming 69.8% as against 30.2% of their female counterparts. All (262) respondents had knowledge on Hep-B infection and the availability of a vaccine for preventing Hepatitis infection. However, despite their knowledge of existence, the majority (56.9%) of the respondents felt they did not need to be protected from Hep-B infection. Majority (58.8%) of the total respondents have been vaccinated against Hep-B infection. The study identified the cost of vaccines as a major setback to non-vaccination. However, out of the 41.2% respondents who were not vaccinated against Hep B infection, majority (50.9%) of them were not willing to be vaccinated even if it was offered to them at no cost. <strong>Conclusion:</strong> There was a significantly high level of knowledge on Hep-B infection and the availability of vaccine for Hep-B infection among students. However, the majority of the respondents felt they did not need to be protected from Hep-B infection. More education is needed on the importance of vaccination as an effective measure for controlling Hepatitis infection. 展开更多
关键词 KNOWLEDGE Practice ATTITUDE Hepatitis B STUDENTS Ghana
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伴自身免疫性肝炎特征的原发性胆汁性胆管炎的临床特征 认领
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作者 杨宁 孙可帅 +3 位作者 田思远 刘雁声 贾桂 韩英 《解放军医学杂志》 CAS 北大核心 2021年第1期36-41,共6页
目的分析伴自身免疫性肝炎(AIH)特征的原发性胆汁性胆管炎(PBC)患者的临床特征。方法纳入2008年12月-2018年12月空军军医大学附属西京医院消化内科确诊的PBC患者461例,根据PBC-AIH重叠综合征(PBC-AIH OS)、AIH-PBC及PBC的诊断标准分为PB... 目的分析伴自身免疫性肝炎(AIH)特征的原发性胆汁性胆管炎(PBC)患者的临床特征。方法纳入2008年12月-2018年12月空军军医大学附属西京医院消化内科确诊的PBC患者461例,根据PBC-AIH重叠综合征(PBC-AIH OS)、AIH-PBC及PBC的诊断标准分为PBC-AIH OS组(n=50)、AIH-PBC组(n=178)与单纯PBC组(n=233),分析各组一般临床症状(黄疸、乏力、瘙痒等)、生化免疫指标[谷丙转氨酶(ALT)、谷草转氨酶(AST)、碱性磷酸酶(ALP)、γ-谷氨酰转肽酶(GGT)、免疫球蛋白G/M(IgG、IgM)、总/直接胆红素(TBIL、DBIL)、白/球蛋白(ALB、GLB)]、自身抗体[抗核抗体(ANA)、抗线粒体抗体(AMA)、抗平滑肌抗体(ASMA)]、肝脏炎症纤维化分级分期、基于4因子的纤维化指数(FIB-4)和天门冬氨酸氨基转移酶/血小板比值指数(APRI),以及5年不良事件累积发生率等。结果 AIH-PBC组及单纯PBC组黄疸、纳差发生率均明显低于PBC-AIH OS组(P<0.05)。各组ALT、AST、TBIL、IgG、IgM、GLB水平差异有统计学意义(P<0.05),多以AIH-PBC组及PBC-AIH OS组较高。自身抗体检测结果显示,AIH-PBC组SSA、Ro-52抗体检出率明显高于单纯PBC组,ASMA、可溶性肝抗原/肝胰抗原抗体(SLA/LP)、SSB检出率明显低于PBC-AIH OS组(P<0.05)。AIH-PBC组IgG、IgM水平高于单纯PBC组(P<0.05)。AIH-PBC组和PBC-AIH OS组肝组织病理分级分期及FIB-4、APRI指数明显高于单纯PBC组(P<0.05)。5年累积不良事件发生率PBC-AIH OS组明显高于AIH-PBC组,AIH-PBC组明显高于单纯PBC组(P<0.05)。结论 AIH-PBC患者在临床表现上与PBC-AIH OS及单纯PBC患者有较大差异,长期预后较单纯PBC患者差。 展开更多
关键词 原发性胆汁性胆管炎 肝炎 自身免疫性 临床特征
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Radical resection of hepatic polycystic echinococcosis complicated with hepatocellular carcinoma: A case report 认领
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作者 Baheti Kalifu Yuan Meng +4 位作者 Yusufukadier Maimaitinijiati Zhi-Gang Ma Guang-Lei Tian Jin-Guo Wang XiongChen 《世界临床病例杂志》 SCIE 2021年第3期659-665,共7页
BACKGROUND Hepatic cystic echinococcosis(CE)is an infectious zoonotic parasitic disease,and the insidious onset and slow progression of hepatic CE usually contributes to delayed diagnosis and treatment.Hepatocellular ... BACKGROUND Hepatic cystic echinococcosis(CE)is an infectious zoonotic parasitic disease,and the insidious onset and slow progression of hepatic CE usually contributes to delayed diagnosis and treatment.Hepatocellular carcinoma(HCC)is the fourth most common malignant tumor.Co-existence of CE and HCC is fairly rare in clinical settings and the association between the two is still not well recognized.We report a case of hepatic CE complicated with HCC which are radically resected and raise some questions worth thinking about.CASE SUMMARY A 70-year-old man presented with upper abdominal pain.On admission,laboratory data showed that,except for hepatitis B surface antigen positivity,other indicators were normal,including alpha-fetoprotein.Computed tomography of the abdomen revealed a huge polycystic lesion in left liver lobe,without reinforcement after enhanced scanning and sized about 16.9 cm×12.2 cm,which was considered a type II hydatid cyst.Multiple small solid lesions were also found adjacent to it,and thus it was highly suspected as a malignant tumor.After a multidisciplinary team discussion,the diagnosis of co-occurrence of hepatic CE and HCC was made.According to Romic classification,the case belongs to type IIb,and radical left hemi-hepatectomy was performed.Postoperative pathological examination revealed CE co-existence with welldifferentiated HCC,consistent with the preoperative diagnosis.CONCLUSION With the combination of hepatitis B and obvious extrusion by large hydatid,the HCC risk of a patient might be higher. 展开更多
关键词 Hepatocellular carcinoma Cystic echinococcosis Radical resection COEXISTENCE Parasitic disease Case report Hepatitis B
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血清铁蛋白及其与肝脏疾病的关系研究进展 认领
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作者 沙治林 宋少华 丁国善 《解放军医学杂志》 CAS 北大核心 2021年第2期181-185,共5页
铁作为人体内重要的微量元素之一,参与多种重要的生理过程。血清铁蛋白(SF)是铁的主要贮存蛋白,可调节铁的储存和代谢。尽管铁蛋白检测已在临床应用较长时间,但其部分生物学特性如组织来源、分泌途径、受体相互作用及细胞效应等仍存在... 铁作为人体内重要的微量元素之一,参与多种重要的生理过程。血清铁蛋白(SF)是铁的主要贮存蛋白,可调节铁的储存和代谢。尽管铁蛋白检测已在临床应用较长时间,但其部分生物学特性如组织来源、分泌途径、受体相互作用及细胞效应等仍存在争议。虽然许多研究关注铁蛋白变化与肝脏疾病的关系,但各研究采纳的铁蛋白过高/过低阈值不尽相同,阻碍了对不同研究结果的一致性分析,亟需研究和制定铁蛋白参数的统一标准,以更好地阐明铁蛋白变化所反映的机体内铁状态。该文就铁的体内代谢过程,铁蛋白的结构及病理生理功能,以及SF与肝脏疾病关系的研究进展进行综述,以期为未来的研究提供导向。 展开更多
关键词 铁元素 铁蛋白 肝炎 肝硬化 肝移植
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熊去氧胆酸联合糖皮质激素治疗伴自身免疫性肝炎特征原发性胆汁性胆管炎的效果分析 认领
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作者 杨宁 田思远 +3 位作者 张苗 马硕怡 刘雁声 韩英 《解放军医药杂志》 CAS 2021年第3期72-77,共6页
目的对比观察伴自身免疫性肝炎(autoimmune hepatitis,AIH)特征原发性胆汁性胆管炎(primary biliary cholangitis,PBC)患者采用熊去氧胆酸(UDCA)单药治疗和UDCA联合糖皮质激素治疗的效果差异。方法选取我院2008年12月—2019年12月收治的... 目的对比观察伴自身免疫性肝炎(autoimmune hepatitis,AIH)特征原发性胆汁性胆管炎(primary biliary cholangitis,PBC)患者采用熊去氧胆酸(UDCA)单药治疗和UDCA联合糖皮质激素治疗的效果差异。方法选取我院2008年12月—2019年12月收治的178例伴AIH特征PBC患者,根据治疗方式的不同分为UDCA联合糖皮质激素组(联合治疗组)33例和UDCA单药治疗组(单药治疗组)145例,比较不同治疗方案的疗效差异,并用Logistic回归分析探讨与治疗应答相关的影响因素。结果2组治疗1年后丙氨酸转氨酶(ALT)、天冬氨酸转氨酶、碱性磷酸酶(ALP)、谷氨酰转移酶(GGT)、免疫球蛋白M均显著下降(P<0.05或P<0.01),血清球蛋白(GLB)、免疫球蛋白G(IgG)治疗前后比较差异无统计学意义(P>0.05),但联合治疗组治疗1年后GLB、IgG下降,单药治疗组上升。2组仅GGT、IgG、GLB在部分月份比较差异有统计学意义(P<0.05或P<0.01)。联合治疗组ALP、ALT、IgG生化应答率及组织学缓解率虽均高于单药治疗组,但差异无统计学意义(P>0.05)。多因素Logistic回归分析提示ALP、IgG、抗Ro-52抗体是伴AIH特征PBC患者完全生化应答的影响因素(P<0.05或P<0.01),抗SSA抗体是其组织学缓解的影响因素(P<0.01)。结论UDCA联合糖皮质激素治疗伴AIH特征PBC的效果与UDCA单药治疗无显著差异;对于UDCA单药治疗应答不佳的伴AIH特征PBC患者可考虑联合糖皮质激素治疗。 展开更多
关键词 肝炎 自身免疫性 胆管炎 胆汁性 合并症 熊去氧胆酸 糖皮质激素 治疗结果 影响因素分析
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Nonalcoholic fatty liver disease as a risk factor for cytomegalovirus hepatitis in an immunocompetent patient:A case report 认领
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作者 Bashar Khiatah Laya Nasrollah +1 位作者 Stephen Covington Deborah Carlson 《世界临床病例杂志》 SCIE 2021年第6期1455-1460,共6页
BACKGROUND Almost 80 percent of adults in the United States have had cytomegalovirus(CMV)infection by age 40.The number of symptomatic CMV hepatitis cases has been increasing along with non-alcoholic fatty liver disea... BACKGROUND Almost 80 percent of adults in the United States have had cytomegalovirus(CMV)infection by age 40.The number of symptomatic CMV hepatitis cases has been increasing along with non-alcoholic fatty liver disease(NAFLD)cases in the United States that is estimated to be 25 percent of the population.In this paper,we try to link these two entities together.CASE SUMMARY In this case report,we describe a young female who presented with fever,nausea,and vomiting who was found to have NAFLD and CMV hepatitis that was treated supportively.CONCLUSION In this case report,we describe NAFLD as a risk factor for CMV hepatitis and discuss the possible impact on clinical practice.We believe,it is essential to consider NAFLD and it’s disease mechanisms’localized immu-nosuppression,as a risk factor of CMV hepatitis and severe coronavirus disease 2019 infection. 展开更多
关键词 Non-alcoholic fatty liver disease Cytomegalovirus hepatitis IMMUNOCOMPETENT Female health Global impact HEPATOLOGY Case report
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microRNA在自身免疫性肝病中的作用 认领
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作者 蔡萌强 刘素彤 +2 位作者 刘君颖 张丽慧 赵文霞 《临床肝胆病杂志》 CAS 北大核心 2021年第1期212-215,共4页
microRNA(miRNA)通过抑制靶基因转录后翻译,影响细胞分化、增殖与凋亡等生物学过程,广泛参与调节生物体内的免疫与炎症反应。自身免疫性肝病是一种异常免疫介导的肝胆系统慢性炎症性疾病,miRNA参与的肝组织异常免疫炎症反应与自身免疫... microRNA(miRNA)通过抑制靶基因转录后翻译,影响细胞分化、增殖与凋亡等生物学过程,广泛参与调节生物体内的免疫与炎症反应。自身免疫性肝病是一种异常免疫介导的肝胆系统慢性炎症性疾病,miRNA参与的肝组织异常免疫炎症反应与自身免疫性肝病的发生发展过程密切相关。现就当前miRNA在自身免疫性肝病中的研究进展作一综述。 展开更多
关键词 微RNAS 肝炎 自身免疫性 肝硬化 胆汁性 胆管炎 硬化性
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我院肝炎患者对疾病相关知识的知晓情况及其影响因素 认领
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作者 张晓丽 颜瑶瑶 《中国卫生工程学》 CAS 2021年第1期34-36,共3页
目的探讨我院肝炎患者对疾病相关知识的知晓情况及影响因素。方法选取我院2017年1月至2018年1月期间收治的200例肝炎患者作为研究对象,发放自拟的肝炎传播知识调查表对患者进行现场调查,了解患考对疾病相关知识的知晓情况,内容包括肝炎... 目的探讨我院肝炎患者对疾病相关知识的知晓情况及影响因素。方法选取我院2017年1月至2018年1月期间收治的200例肝炎患者作为研究对象,发放自拟的肝炎传播知识调查表对患者进行现场调查,了解患考对疾病相关知识的知晓情况,内容包括肝炎患者的一般资料和肝炎传播相关知识知晓情况。结果调查显示,男性与女性对肝炎疾病相关知识知晓率接近,差异无统计学意义(P>0.05);在不同文化程度患者中,我院肝炎患者对肝炎疾病相关知识知晓率各异,其中大专及以上文化程度患者的疾病知晓率最高(67.86%),文盲者的疾病知晓率最低(22.22%),差异有统计学意义(P<0.05);在不同年龄组患者中,各年龄阶段对疾病知晓率以及居住地比较差异无统计学意义(P>0.05);另外,住院次数越多的患者,其对疾病知晓率越高(P<0.05);回归分析显示,肝炎患者对肝炎疾病相关知识知晓率与文化程度、入院次数相关,差异有统计学意义(P<0.05),但性别、年龄和居住地和患者对疾病相关知识知晓率不存在相关,差异无统计学意义(P>0.05)。结论我院肝炎患者对疾病相关知识的知晓情况缺乏系统全面的了解,尤其是文化程度较低者和以往未因肝炎疾病入院者,应加强对肝炎患者的疾病防治知识宣教,并加强心理干预和社会支持,提高患者对疾病的认知。 展开更多
关键词 肝炎 疾病知识 知晓率 影响因素
CSOG MFM Committee Guideline: Management of Hepatitis B During Pregnancy and Prevention of Mother-to-Child Transmission of Hepatitis B Virus (2020) 认领
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作者 Maternal-Fetal Medicine Committee,Chinese Society of Obstetrics and Gynecology,Chinese Medical Association Chinese Society of Perinatal Medicine,Chinese Medical Association +4 位作者 Chinese Academy of Maternal-Fetal Medicine Yi-Hua Zhou Yali Hu Xinghui Liu Huixia Yang 《母胎医学杂志(英文)》 2021年第1期7-17,共11页
Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the main cause of chronic hepatitis B. The prevention of MTCT plays a critical role in control chronic hepatitis B. The main purpose of the present cli... Mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the main cause of chronic hepatitis B. The prevention of MTCT plays a critical role in control chronic hepatitis B. The main purpose of the present clinical guidelines is to aid healthcare providers in managing pregnant women with positive HBsAg and in preventing MTCT of HBV. We recommend: (1) all pregnant women require prenatal screen for hepatitis B serological markers;(2) newborn infants of mothers with negative hepatitis B surface (HBsAg) require administration of hepatitis B vaccine on a 0, 1, and 6 month-schedule;(3) newborn infants of mothers with positive HBsAg need hepatitis B immunoglobulin (HBIG) and birth dose vaccine within 12 hours (the sooner the better) after birth, followed by injection of the second and third dose of hepatitis B vaccine at the age of one and six months respectively;(4) in preterm neonates or neonates with poor health conditions born to HBsAg-positive mothers, the immunoprophylaxis measures should be appropriately taken;(5) to further reduce MTCT of HBV, pregnant women with HBV DNA levels >2×105 IU/mL or positive hepatitis B e antigen may receive oral antivirals, starting from 28 to 32 weeks of gestation and discontinuing the drug on the delivery day;(6) cesarean section is not recommended to reduce MTCT of HBV;(7) breastfeeding is recommended in infants of HBsAg-positive mothers, regardless of maternally positive hepatitis B e antigen, maternal nipple injury or bleeding, oral mucosal injury in neonates or infants;(8) breastfeeding is recommended in infants born to HBsAg-positive mothers who require continuation of antiviral therapy after delivery, and the infants should be followed up to observe whether adverse effects develop;and (9) the infants born to HBsAg-positive mothers should be tested for hepatitis B serological markers at the age of 7-12 months, and those who are negative for HBsAg and anti-HBs should receive three doses of hepatitis B vaccine on the 0, 1, and 6 month-schedule as soon as possible. 展开更多
关键词 Antiviral agents Hepatitis B virus IMMUNOPROPHYLAXIS MANAGEMENT Mother-to-child transmission PREGNANCY
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