简介:丙肝在全球保健上强加重要负担。长期的感染与典型地在肝硬化,机关失败和癌症表明的肝的进步发炎被联系。由精致的避免策略的优点,丙肝病毒(HCV)作为一个坚持的人的病毒成功。它有一个非凡的能力破坏使它能建立长期的感染和联系的肝疾病的有免疫力的反应。Chemokines是低分子的重量调停的趋化性的肽进纸巾的煽动性的房间和进lymphatics和外部血的背的招募。因此,他们对受动器和规章的有免疫力的房间的时间、空间的分发中央。在chemokines和他们的血缘的受体帮助之间的相互作用塑造有免疫力的反应因此,在感染的结果上有主要影响。然而,chemokines包括HCV由病毒为调整代表一个目标。HCV被知道并且可以因此由通过改变的白血球在vivo破坏有免疫力的反应启用它的幸存趋化性导致损害病毒的清理和长期的低档发炎的建立在vitro调制chemokine表示。在这评论,在尖锐、长期的HCV感染的chemokines的角色被描述,一个特别重音作为有免疫力的颠覆的一个工具放了在chemokine调整上。我们提供一在里面部分的深度讨论在调停由chemokines玩了肝的纤维变性当在预示的药为这些chemoattractants探讨潜在的应用时。
简介:瞄准:为了在病人调查胰岛素抵抗和糖尿病的临床的参数的流行,由长期的丙肝(CHC)或长期的肝炎B(CHB)影响了。方法:我们回顾地评估了经历了肝活体检视的852个连续病人(726CHC和126CHB)。我们记录了年龄,性别,中高音,类型2糖尿病或新陈代谢的症候群(MS),身体团索引(BMI),和明显的疾病持续时间(增加)。结果:年龄,增加,BMI,在有温和/中等的肝纤维变性的病人的MS和糖尿病的流行在CHC是显著地更高的。然而,脂肪变性的度和在肝活体检视评估的肝纤维变性没在CHC和CHB病人之间不同。在多变量分析,年龄,性别,BMI,中高音和糖尿病是为在CHC的肝纤维变性的独立风险因素,而仅仅年龄与在CHB的肝纤维变性有关。我们也评估了在重要脂肪变性之间的协会(>30%)并且年龄,性别,BMI,糖尿病,MS和肝纤维变性。糖尿病,BMI和肝纤维变性与脂肪变性>被联系30%在CHC,而仅仅年龄和BMI与在CHB的脂肪变性有关。结论:这些数据可以显示丙肝病毒感染是为胰岛素抵抗的一个风险因素。
简介:Objective:EvaluatingtheauditoryfunctioninpatientswithchronichepatitisCtreatedwithsofosbuvirandribavirin.Methods:Thisstudyinvolved80patientswithchronichepatitisCwhoagreedtoreceivesofosbuvirandribavirin.Allparticipantsweresubjectedtobaselineotologicalandaudiologicalassessmentjustbeforetreatment.Theaudiologicalassessmentincludedstandardpuretoneaudiometry,extendedhighfrequencyaudiometry,immitancemetryandotoacousticemissions(OAEs)(transientanddistortionproduct).Accordingtobaselinehearingthresholdmeasurements,thestudypopulationwasdividedinto2groups.Group1included42patientswithnormalhearingsensitivity(250e8000Hz),andGroup2included38patientswithsensorineuralhearingloss.After24weeksoftherapy,otologicalandaudiologicalassessmentswererepeatedandcomparedbetweenthetwogroupsandbeforeandaftertherapy.Results:Post-treatmenthearingthresholdevaluationshowednosignificantdifferencefrompretreatmentevaluationatalltestedfrequencies.Therewasnostatisticallysignificantdifferencebetweenpreandpost-treatmentotoacousticemissionsresults.Conclusion:TherapywithsofosbuvirandribavirininchronichepatitisChasnonoticeableeffectsoncochlearfunctions.
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简介:ThepurposeofthisstudywastoconstructaneukaryoticDNAvectorencodingamultipleepitopeantigen(MFC)ofhepatitisCvirus(HCV)andahepatitisBsurfaceantigen(HBsAg),andexploretheeffectofHBsAggeneontheimmunityofHCVmultiple-epitopeDNAconstructinvitroandinvivoinmice.AnHCVDNAvector(pVAX1-HBs-MFC)wasconstructedbyfusingHBsAggenetotheNterminalofanHCVmultiple-epitopeantigengene.ThepVAX1-HBs-MFCwastransfectedintoHEK293TcellsanditsexpressionwasmeasuredbyELISAandWesternblotting.BALB/cmicewereintramuscularlyimmunizedwiththepVAX1-HBs-MFC,andanELISAapproachwasappliedtodeterminethespecificantibodytitersandsubtypesinthemouseserum.Thecross-reactivityoftheantibodieswasalsocheckedwithtwosynthesizedHCVhypervariableregion1(HVR1)peptides.TheIFN-γproductionandcellproliferationofthemousespleencellswereevaluatedbyELISAandMTS(3-[4,5-dimethylthiazol-2-yl]-5-[3-carboxymethoxyphenyl]-2-[4-sulfophenyl]-2H-tetrazolium,innersalt)assays,respectively.TheexpressionofpVAX1-HBs-MFCwasdetectableinthetransfectedHEK293Tcells.TheserumantibodyresponsewaseffectivelyelicitedinBALB/cmiceinjectedwithpVAX1-HBs-MFC.ThehighesttiterofantibodyagainstHCV(MFC)was1:1280,andtheratioofIgG2a/IgG1was1.50±0.12atthefifthweekafterfirstimmunization.Moreover,thecollectedmouseserumantibodyhadtheabilitytocross-reactwiththetwosynthesizedHCVHVR1peptides.ThestimulationindexofthemousesplenocytestoMFCwas1.79±0.07,andtheIFN-γlevelwas287±6pg/mlatweek21afterfirstimmunization.ThehighesttiteroftheantibodyincontrolBALB/cmiceimmunizedwithpVAX1-MFCwas1:320,andtheratioofIgG2a/IgG1was1.33±0.11atweek5post-immunization.Furthermore,thestimulationindexofthemousesplenocytescellstoMFCwas1.52+0.06,andtheIFN-γlevelwas225±9.3pg/mlatweek21post-immunization.TheHBsAggenecanenhancetheeffectsofanHCVmultiple-epitope
简介:瞄准:把在病人之间的标准肝炎B(HBV)种痘的反应与长期的丙肝作比较病毒(HCV)感染和健康个人。方法:这是未来的盒子控制研究。有长期的HCV感染和40健康控制的38个病人的一个总数被包括。种痘被20大杯recombinantHBsAg的注射在瞬间0,1和6点执行进三角肌肌肉。Anti-HBs集中是在最后剂量以后决定了3瞬间并且在二个组之间比较了。反应模式是被描绘(1)高反应当anti-HBs抗体效价是>时100IU/L,(2)低反应当效价是10-100IU/L时并且(3)没有反应当效价是<时10IU/L。结果:在耐心的组,有10/38(26.3%)非应答者,8/38(21.1%)低应答者并且20/38(52.6%)高应答者。在控制组的相应价值是2/40(5.0%),7/40(17.5%)和31/40(77.5%)分别地。反应模式在二个组之间是统计上不同的。在里面多变量分析,吸烟是重要confounder,当HCV感染与更低的抗体反应失去了它的重要关联时。结论:有长期的HCV感染的病人趋于与健康个人相比对HBV种痘微弱地作出回应,尽管这关联不是独立的根据多变量分析。
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简介:客观干扰素(IFN)和ribavirin(RBV)的联合是为丙肝的标准治疗病毒(HCV)感染。HCV遗传型2a对治疗证明了更顺从,但是它的功效是还有限的。这研究试图在HCV遗传型2a感染的一种情况中调查差的反应的机制。方法:我们从一个病人分析了HCVRNA的动态变化,与HCV遗传型2a感染了,显示出差的virological回答到是的IFN/RBV判定了12在由HCV的治疗的开始以后的星期克隆定序。然后,我们构造了subgenomic日语有人性化的Gaussia的暴发性的hepatitis-1(JFH1)replicon和不同妄想的replicons酶基因。妄想的replicons从subgenomicJFH1replicon,NS5A区域被病人顺序从pre/posttreatment在代替被导出,并且到IFN的妄想的replicons危险性被相对Gausia酶活动评估。预告的处理HCV定序的结果显得几乎一致,并且quasispecies变化是进一步的在12星期治疗以后简化的更多。而且,quasispecies变化似乎相对,在NS5A更多样化为IFN反应关键的一个区域,和每妄想的replicons展出了不同反应到IFN。结论在长期的感染的功课期间,HCV人口似乎被使适应病人免疫学的系统,并且推进被IFN/RBV治疗的联合选择,显示quasispecies可以完全与IFN的与那些不同的目标由另外的药的增加消除了。另外,到IFN的妄想的replicon的各不同的反应与氨基酸变化在或在在长期的感染和IFN/RBV治疗期间决定NS5A的区域(ISDR)的IFN敏感附近有关是最可能的。
简介:瞄准:为了学习流行和风险因素,与人的免疫不全与三倍的感染联系了在一张城市的诊所人口的病毒(HIV)/hepatitisB(HBV)/hepatitisC病毒(HCV)。方法:5639个病人的回顾的图表评论在纽约城市里在圣卢凯斯鲁塞韦尔特医院HIV诊所(全面照顾的中心)列在后面,从1999年1月的美国到2007年5月。下列人口统计的特征被分析:年龄,性别,种族和HIV冒因素的风险。多重逻辑回归分析被执行在这些病毒的获得上评估人口统计的因素的影响。结果:HIV/HBV,HIV/HCV和HIV/HBV/HCV感染在252/5639(4.47%)被检测,1411/5639(25.02%)和89/5639(1.58%)病人分别地。HIV/HBV合作感染与男性被联系(或1.711;P=0.005),黑色跑(或2.091;P<0.001),人与\O性交人(MSM)(或1.747;P=0.001),静脉内的药使用(IDU)(或0.114;P<0.001),IDU和异性爱的活动(或0.247;P=0.018),或未知(或1.984;P=0.004)。HIV/HCV合作感染与男性被联系(或1.241;P=0.011),黑色跑(或0.788;P=0.036),MSM(或0.565;P<0.001),IDU(或8.956;P<0.001),IDU和异性爱的活动(或9.106;P<0.001),IDU和MSM(或9.179;P<0.001),或输送(或3.224;P<0.001)。HIV/HBV/HCV合作感染与男性被联系(或2.156;P=0.015),IDU(或6.345;P<0.001),IDU和异性爱的活动(或9.731;P<0.001),IDU和MSM(或9.228;P<0.001),或未知(或4.219;P=0.007)。结论:我们的学习证明有HBV/HCV/HIV的合作感染显著地与IDU被联系。这些结果加亮需要加强教育和综合照顾的最佳的模型,特别地为有IDU的人口,到减少病毒的传播的风险。
简介:AbstractBackground:Hepatitis C virus (HCV) genotype 3, particularly subtype 3b, is increasing in prevalence and distribution in China. This study evaluated the prevalence, regional distribution, clinical characteristics, host factors, treatment outcomes, and disease progression of patients with HCV genotype 3 in China.Methods:A 5-year follow-up was preceded by a cross-sectional study. Treatment choices were at the discretion of treating physicians. Estimated infection time to overall-disease-progression (defined by ≥1 of: newly diagnosed cirrhosis; cirrhosis at baseline, Child-Turcotte-Pugh score increased 2 points or more; progression from compensated cirrhosis to decompensated cirrhosis; hepatocellular carcinoma; liver transplantation; or death) was calculated using the Kaplan-Meier method. Cox regression analyses were conducted to evaluate the risk factors for disease progression.Results:The cross-sectional study enrolled 997 patients, including 91 with HCV genotype 3 infection. Among them, subtype 3b (57.1%) was more dominant than subtype 3a (38.5%). Five hundred and twelve patients were included into the follow-up phase. Among patients analyzed for estimated infection time to overall-disease-progression, 52/304 (17.1%) patients with HCV genotype 1 and 4/41 (9.8%) with HCV genotype 3 (4/26 with genotype 3b, 0/13 with genotype 3a, and 0/2 with undefined subtype of genotype 3) experienced overall-disease-progression. Patients with HCV genotype 3 were younger than those with genotype 1 (mean age: 39.5 ± 8.7 vs. 46.9 ± 13.6 years) and demonstrated more rapid disease progression (mean estimated infection time to overall-disease-progression 27.1 vs. 35.6 years).Conclusions:HCV genotype 3, specifically subtype 3b, is associated with more rapid progression of liver disease. Further analysis to compare HCV subtype 3a and 3b is needed in high prevalence regions.Trial registration:NCT01293279, https://clinicaltrials.gov/ct2/show/NCT01293279; NCT01594554, https://clinicaltrials.gov/ct2/show/NCT01594554.
简介:AIM:Toevaluatetheimpactofsociodemographic/clinicalfactorsonearlyvirologicalresponse(EVR)topegin-terferon/ribavirinforchronichepatitisC(CHC)inclinicalpractice.METHODS:Weconductedamulticenter,cross-sectional,observationalstudyinHepatologyUnitsof91Spanishhospitals.CHCpatientstreatedwithpeginterferonα-2aplusribavirinwereincluded.EVRwasdefinedasundetectablehepatitisCvirus(HCV)-ribonucleicacid(RNA)or≥2logHCV-RNAdecreaseafter12wkoftreatment.AbivariateanalysisofsociodemographicandclinicalvariablesassociatedwithEVRwascarriedout.IndependentfactorsassociatedwithanEVRwereanalyzedusingamultipleregressionanalysisthatincludedthefollowingbaselinedemographicandclinicalvariables:age(≤40yearsvs>40years),gender,race,educationallevel,maritalstatusandfamilystatus,weight,alcoholandtobaccoconsumption,sourceofHCVinfection,alanineaminotransferase(ALT)andaspartateaminotransferase(AST)levels,andgammaglutamyltranspeptidase(GGT)(≤85IU/mLvs>85IU/mL),serumferritin,serumHCV-RNAconcentration(<400000vs≥400000),genotype(1/4vs3/4),cirrhoticstatusandribavirindose(800/1000/1200mg/d).RESULTS:Atotalof1014patientswereincludedinthestudy.Meanageofthepatientswas44.3±9.8years,70%weremale,and97%wereCaucasian.ThemainsourcesofHCVinfectionwereintravenousdrugabuse(25%)andbloodtransfusion(23%).SeventyeightpercentwereinfectedwithHCVgenotype1/4(68%hadgenotype1)and22%withgenotypes2/3.TheHCV-RNAlevelwas>400000IU/mLin74%ofpatients.ThemeanALTandASTlevelswere88.4±69.7IU/mLand73.9±64.4IU/mL,respectively,andmeanGGTlevelwas82±91.6IU/mL.Themeanferritinlevelwas266±284.8μg/L.Only6.2%ofpatientspresentedwithcirrhosis.Allpatientsreceived180mgofpeginterferonα-2a.Themostfrequentlyusedribavirindoseswere1000mg/d(41%)and1200mg/d(41%).Theplannedtreatm
简介:瞄准:估计临床,生物化学并且virological在长期的丙肝(CHC)的长期的结果有在加ribavirin的peginterferon(PEG-IFN)以后的持续virological回答(SVR)的病人联合治疗。方法:有在有PEG-IFN正ribavirin的治疗以后的SVR的一百和53个病人在一个单个西班牙的中心在5年的后续研究被包括,基于标准临床的实践。临床的回忆,生物化学的分析,丙肝病毒RNA和alpha-fetoprotein测量,ultrasonography和短暂elastography每年被执行。结果:153个病人的吝啬的后续经期是76??敦瑥吗?
简介:AIM:ToinvestigatehowweightgainafterOLTaffectsthespeedoffibrosisprogression(SFP)duringrecurrenthepatitisCvirus(HCV)infectionofthegraft.METHODS:Ninetyconsecutivepatients(63males,medianage53years;55withHCV-relatedliverdisease),transplantedatasingleinstitution,werestudied.Allwerefollowedforatleast2yearsafterOLTandhadatleastonefollow-upgraftbiopsy,performednotearlierthan1yearafterthetransplantoperation.Foreachbiopsy,asingle,experiencedpathologistgaveanestimateofboththestagingaccordingtoIshakandthedegreeofhepaticsteatosis.TheSFPwasquantifiedinfibrosisunits/month(FU/mo).Thelipidmetabolismstatusofpatientswassummarizedbytheplasmatriglycerides/cholesterol(T/C)ratio.Bodymassindex(BMI)wasmeasuredbeforeOLT,and1and2yearsafterit.RESULTS:IntheHCVpositivegroup,thehighestSFPwasobservedinthefirstpost-OLTyear.Atthattimepoint,aSFP≤0.100FU/mowasobservedmorefrequentlyamongrecipientswhohadreceivedtheirgraftfromayoungdonorandhadapre-transplantBMIvalue>26.0kg/m2.Atcompletionofthefirstpost-transplantyear,aBMIvalue>26.5kg/m2wasassociatedwithaT/Cratio≤1.TheproportionofpatientswithSFP>0.100FU/modescendedinthefollowingorder:femalerecipientswithahighT/Cratio,malerecipientswithhighT/Cratio,andrecipientsofeithergenderwithlowT/Cratio.Hepaticsteatosiswasobservedmorefrequentlyinrecipientswho,inthefirstpost-transplantyear,hadincreasedtheirBMI≥1.5kg/m2incomparisontothepre-transplantvalue.Hepaticsteatosiswasinverselyassociatedwiththestagingscore.CONCLUSION:AmongHCVpositiverecipients,excessweightgainpost-OLTdoesnotrepresentafactorfavoringearlyliverfibrosisdevelopmentandmightevenbeprotectiveagainstit.
简介:AbstractBackground:Antiretroviral therapy (ART) has reduced mortality among people living with HIV (PLWH) in China, but co-infections of hepatitis B virus (HBV) and hepatitis C virus (HCV) may individually or jointly reduce the effect of ART. This study aimed to evaluate the impacts of HBV/HCV coinfections on treatment drop-out and mortality among PLWH on ART.Methods:A retrospective cohort study analysis of 58,239 people living with HIV (PLWH) who initiated antiretroviral therapy (ART) during 2010-2018 was conducted in Guangxi Province, China. Data were from the observational database of the National Free Antiretroviral Treatment Program. Cox proportional hazard models were fitted to evaluate the effects of baseline infection of HBV or HCV or both on death and treatment attrition among PLWH.Results:Our study showed high prevalence of HBV (11.5%), HCV (6.6%) and HBV-HCV (1.5%) co-infections. The overall mortality rate and treatment attrition rate was 2.95 [95% confidence interval (CI): 2.88-3.02] and 5.92 (95% CI: 5.82-6.01) per 100 person-years, respectively. Compared with HIV-only patients, HBV-co-infected patients had 42% higher mortality [adjusted hazard ratio (aHR)=1.42; 95% CI 1.32-1.54], HCV-co-infected patients had 65% higher mortality (aHR=1.65; 95% CI: 1.47-1.86), and patients with both HCV and HBV co-infections had 123% higher mortality (aHR=2.23; 95% CI:1.87-2.66).Conclusions:HBV and HCV coinfection may have an additive effect on increasing the risk of all-cause death among PLWH who are on ART. It is suggested that there is need for primary prevention and access to effective hepatitis treatment for PLWH.