Liver transplantation(LT)is a considerably effective treatment for patients with end-stage hepatitis B virus(HBV)-related liver disease.However,HBV infection often recurs after LT without prophylaxis.Since the1990s,th...Liver transplantation(LT)is a considerably effective treatment for patients with end-stage hepatitis B virus(HBV)-related liver disease.However,HBV infection often recurs after LT without prophylaxis.Since the1990s,the treatment for preventing HBV reinfection after LT has greatly progressed with the introduction of hepatitis B immunoglobulin(HBIG)and nucleos(t)ide analogues(NAs),resulting in improved patient survival.The combination therapy consisting of high-dose HBIG and lamivudine is highly efficacious for preventing the recurrence of HBV infection after LT and became the standard prophylaxis for HBV recurrence.However,mainly due to the high cost of HBIG treatment,an alternative protocol for reducing the dose and duration of HBIG has been evaluated.Currently,combination therapy using low-dose HBIG and NAs is considered as the most efficacious and cost-effective prophylaxis for post-LT HBV reinfection.Recently,NA monotherapy and withdrawal of HBIG from combination therapy,along with the development of new,potent high genetic barrier NAs,have provided promising efficacy,especially for low-risk recipients.This review summarizes the prophylactic protocol and their efficacy including prophylaxis of de novo HBV infection from anti-HBc antibody-positive donors.In addition,challenging approaches such as discontinuation of all prophylaxis and active immunity through hepatitis B vaccination are discussed.展开更多
A number of disease-associated genetic markers for common liver diseases have been identified using genome-wide association studies (GWASs). The GWAS strategy is based on genome-wide single-nucleotide polymorphism typ...A number of disease-associated genetic markers for common liver diseases have been identified using genome-wide association studies (GWASs). The GWAS strategy is based on genome-wide single-nucleotide polymorphism typing technologies, which are now commercially available, accom-panied by statistical methods to identify host genetic factors that are associated with target diseases or complex genetic traits. One of the most striking features of the GWAS strategy is the ability to identify unexpected disease-associated genetic markers across the entire human genome. Here, we describe the technological aspects of the GWAS strategy with examples from actual GWAS reports related to hepatitis research, including drug response for patients with chronic hepatitis C, susceptibility to primary biliary cirrhosis, and hepatitis-B-related hepatocellular carcinoma.展开更多
Background: specialized studies on hepatitis B virus (HBV) infection and B-NHL (B-cell Non-Hodgkin’s Lymphoma) are limited, as well as prophylactic antiviral therapy for B-NHL patients with HBV infection who are rece...Background: specialized studies on hepatitis B virus (HBV) infection and B-NHL (B-cell Non-Hodgkin’s Lymphoma) are limited, as well as prophylactic antiviral therapy for B-NHL patients with HBV infection who are receiving anticancer chemotherapy. This study aims to investigate the association between HBV infection and B-NHL, and to evaluate the effect of prophylactic antiviral therapy for HBV-infected B-NHL patients. Study design: A retrospective, case-control study was performed. The study group included 420 patients with B-NHL who were consecutively diagnosed from May 2003 to October 2013 (age range, 14 - 71 years), and the control group included 1280 Chinese residents in Guangxi who participated in the Health Survey (age range, 18 - 74 years). We compared the prevalence rate of HBV infection and clinic-pathologic characteristics between the two groups. The prevalence rate of HBV infection in our study was 34.7% (146/420), higher than the prevalence rate of 13.9% (178/1280) in the general population (P < 0.001). Among 146 B-NHL patients who received anticancer chemotherapy, 104 patients (71.2%) received prophylactic antiviral therapy. Conclusion: This study provides evidence that HBV may play an important role in development of B-NHL. Entecavir maybe the better antiviral drugs than Lamivudine, and antiviral therapy is maintained more than 6 months that maybe the optimal duration of prophylactic antiviral therapy. But further investigation should be conducted for determination of optimal duration and monitoring of antiviral therapy.展开更多
BACKGROUND:Controversy remains over whether the middle hepatic vein should be included in the liver graft in right liver living donor liver transplantation.Congestion in the anterior sector of a right liver graft can ...BACKGROUND:Controversy remains over whether the middle hepatic vein should be included in the liver graft in right liver living donor liver transplantation.Congestion in the anterior sector of a right liver graft can cause graft malfunction,which is especially devastating in the case of a graft with marginal size in relation to recipient body size on top of poor pre-transplant recipient status.The case we report here highlighted the importance of the middle hepatic vein in right liver living donor liver transplantation.METHODS:We illustrated the rectification of outflow obstruction of the middle hepatic vein in the anterior sector of right liver graft caused by technical error during transplantation.The rectification was performed with emergency re-routing using an artificial conduit.RESULT:Congestion in the anterior sector of the graft improved immediately and the patient’s postoperative liver function test results improved gradually.CONCLUSIONS:The middle hepatic vein is important for effective drainage of the anterior sector of a right liver graft.The re-routing technique described in the report can also be applied to cases in which the middle hepatic vein is injured during hepatectomy requiring immediate reconstruction.展开更多
Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors...Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors associated with HBV infection in these children. Patients and Methods: Retrospective-crosssectional study (January 5th, 2006 through December 31st, 2012). Studied parameters: biological and clinical characteristics of index subjects;Prevalence of HBsAg and Hepatitis B core antibody (HBcAb) in their children. Search for the HBV infection associated factors in the children (univariate analyses through Chi-square or Fisher’s exact test;multivariate analysis through a backward logistic regression). Results: Our 44 subjects’ median age was 43.1 ± 7.49 years and 88.6% of them lived with a spouse. Average number of children per index subjects was 2.3 ± 1.1. Our 92 children’s median age was 9.3 ± 4.55 (ranging from 1 to 15 years), and 43 (44.8%) were vaccinated against HBV. HBV infection prevalence was 24% (23/96 of which, 4 were HBsAg positive and 19 HBcAb positive subjects without HBsAg). Independent factors associated with HBV infection in children of index subjects were HBV DNA for index subjects >2000 IU/ml (OR = 11.5;p = 0.001), existence of HBV in two parents (OR = 7.9;p = 0.03) and absence of HBV vaccination in the children (OR = 30.9;p = 0.003). Conclusion: Immunization coverage for children of index subjects was insufficient, especially before the introduction of HBV vaccine into the enlarged vaccination program. Outside vertical transmission, those children were more exposed to HBV intrafamilial transmission risk when they were not immunized against HBV, when both parents were infected and when HBV viremia in index subjects was higher than 2000 IU/ml.展开更多
基金Supported by A Grant-in-Aid for the Research of Hepatitis and BSE from the Japanese Ministry of Health,Labour and Welfare
文摘Liver transplantation(LT)is a considerably effective treatment for patients with end-stage hepatitis B virus(HBV)-related liver disease.However,HBV infection often recurs after LT without prophylaxis.Since the1990s,the treatment for preventing HBV reinfection after LT has greatly progressed with the introduction of hepatitis B immunoglobulin(HBIG)and nucleos(t)ide analogues(NAs),resulting in improved patient survival.The combination therapy consisting of high-dose HBIG and lamivudine is highly efficacious for preventing the recurrence of HBV infection after LT and became the standard prophylaxis for HBV recurrence.However,mainly due to the high cost of HBIG treatment,an alternative protocol for reducing the dose and duration of HBIG has been evaluated.Currently,combination therapy using low-dose HBIG and NAs is considered as the most efficacious and cost-effective prophylaxis for post-LT HBV reinfection.Recently,NA monotherapy and withdrawal of HBIG from combination therapy,along with the development of new,potent high genetic barrier NAs,have provided promising efficacy,especially for low-risk recipients.This review summarizes the prophylactic protocol and their efficacy including prophylaxis of de novo HBV infection from anti-HBc antibody-positive donors.In addition,challenging approaches such as discontinuation of all prophylaxis and active immunity through hepatitis B vaccination are discussed.
文摘A number of disease-associated genetic markers for common liver diseases have been identified using genome-wide association studies (GWASs). The GWAS strategy is based on genome-wide single-nucleotide polymorphism typing technologies, which are now commercially available, accom-panied by statistical methods to identify host genetic factors that are associated with target diseases or complex genetic traits. One of the most striking features of the GWAS strategy is the ability to identify unexpected disease-associated genetic markers across the entire human genome. Here, we describe the technological aspects of the GWAS strategy with examples from actual GWAS reports related to hepatitis research, including drug response for patients with chronic hepatitis C, susceptibility to primary biliary cirrhosis, and hepatitis-B-related hepatocellular carcinoma.
文摘Background: specialized studies on hepatitis B virus (HBV) infection and B-NHL (B-cell Non-Hodgkin’s Lymphoma) are limited, as well as prophylactic antiviral therapy for B-NHL patients with HBV infection who are receiving anticancer chemotherapy. This study aims to investigate the association between HBV infection and B-NHL, and to evaluate the effect of prophylactic antiviral therapy for HBV-infected B-NHL patients. Study design: A retrospective, case-control study was performed. The study group included 420 patients with B-NHL who were consecutively diagnosed from May 2003 to October 2013 (age range, 14 - 71 years), and the control group included 1280 Chinese residents in Guangxi who participated in the Health Survey (age range, 18 - 74 years). We compared the prevalence rate of HBV infection and clinic-pathologic characteristics between the two groups. The prevalence rate of HBV infection in our study was 34.7% (146/420), higher than the prevalence rate of 13.9% (178/1280) in the general population (P < 0.001). Among 146 B-NHL patients who received anticancer chemotherapy, 104 patients (71.2%) received prophylactic antiviral therapy. Conclusion: This study provides evidence that HBV may play an important role in development of B-NHL. Entecavir maybe the better antiviral drugs than Lamivudine, and antiviral therapy is maintained more than 6 months that maybe the optimal duration of prophylactic antiviral therapy. But further investigation should be conducted for determination of optimal duration and monitoring of antiviral therapy.
文摘BACKGROUND:Controversy remains over whether the middle hepatic vein should be included in the liver graft in right liver living donor liver transplantation.Congestion in the anterior sector of a right liver graft can cause graft malfunction,which is especially devastating in the case of a graft with marginal size in relation to recipient body size on top of poor pre-transplant recipient status.The case we report here highlighted the importance of the middle hepatic vein in right liver living donor liver transplantation.METHODS:We illustrated the rectification of outflow obstruction of the middle hepatic vein in the anterior sector of right liver graft caused by technical error during transplantation.The rectification was performed with emergency re-routing using an artificial conduit.RESULT:Congestion in the anterior sector of the graft improved immediately and the patient’s postoperative liver function test results improved gradually.CONCLUSIONS:The middle hepatic vein is important for effective drainage of the anterior sector of a right liver graft.The re-routing technique described in the report can also be applied to cases in which the middle hepatic vein is injured during hepatectomy requiring immediate reconstruction.
文摘Aims of the Study: 1) Determine the Prevalence of Hepatitis B virus (HBV) infection in children (contact subjects) of chronic Hepatitis B surface antigen (HBsAg) carrier subjects (index subjects);2) Search for factors associated with HBV infection in these children. Patients and Methods: Retrospective-crosssectional study (January 5th, 2006 through December 31st, 2012). Studied parameters: biological and clinical characteristics of index subjects;Prevalence of HBsAg and Hepatitis B core antibody (HBcAb) in their children. Search for the HBV infection associated factors in the children (univariate analyses through Chi-square or Fisher’s exact test;multivariate analysis through a backward logistic regression). Results: Our 44 subjects’ median age was 43.1 ± 7.49 years and 88.6% of them lived with a spouse. Average number of children per index subjects was 2.3 ± 1.1. Our 92 children’s median age was 9.3 ± 4.55 (ranging from 1 to 15 years), and 43 (44.8%) were vaccinated against HBV. HBV infection prevalence was 24% (23/96 of which, 4 were HBsAg positive and 19 HBcAb positive subjects without HBsAg). Independent factors associated with HBV infection in children of index subjects were HBV DNA for index subjects >2000 IU/ml (OR = 11.5;p = 0.001), existence of HBV in two parents (OR = 7.9;p = 0.03) and absence of HBV vaccination in the children (OR = 30.9;p = 0.003). Conclusion: Immunization coverage for children of index subjects was insufficient, especially before the introduction of HBV vaccine into the enlarged vaccination program. Outside vertical transmission, those children were more exposed to HBV intrafamilial transmission risk when they were not immunized against HBV, when both parents were infected and when HBV viremia in index subjects was higher than 2000 IU/ml.
