HBV genotypes and antiviral-resistant variants in HBV infected subjects in Northern Italy

HBV genotypes were investigated in sera/plasma from 97 HBV positive subjects. Genotype D was revealed in 80.4% followed by E in 6.2%. Genotypes A, B, and C were also found, as well as for the first time a new combination of HBV D and G genotypes. In a cohort of subjects of this population, the relationship with lamivudine and/or famciclovir-resistant HBV mutants was also investigated. Among 12 untreated subjects, 25% carried HBV drug-resistant strains suggesting that drug-resistant variants naturally exist in untreated Italian HBV chronically infected subjects.     

乙型肝炎病毒外膜大蛋白和HBVDNA血清学诊断价值

目的探讨乙型肝炎病毒外膜大蛋白和HBV-DNA在乙肝患者中的血清学诊断价值。方法收集乙肝两对半(HBV-M)中HBsAg阳性血清标本260例作为乙肝研究组,乙肝两对半(HBV-M)阴性血清标本100例作为正常对照组;在不同乙肝模式中采用酶联免疫吸附试验(ELISA)检测血清HBV-LP和Pre-S1,荧光定量PCR检测HBV DNA;比较HBeAg血清中HBV-LP与HBV-DNA和不同HBV-DNA拷贝数的条件下HBV-LP与HBV-DNA剂量关系。结果HBsAg阳性血清中HBV-LP、HBV-DNA和Pre-S1阳性率分别为68.46%、63.08%和24.23%;HBeAg阳性标本中HBV-LP、HBV-DNA和Pre-S1阳性率分别为94.87%、94.87%和79.49%;HBeAg阴性标本中HBV-LP、HBV-DNA和Pre-S1阳性率分别为62.64%、49.45%和0.55%,HBV-LP和HBV-DNA二者检出一致率为67.03%[(50+72)/182];HBV-LP吸光度(A值)与HBV DNA呈正相关。结论HBV-LP与HBV-DNA在HBeAg阳性血清中代表病毒复制具有较高检出一致率;HBV-LP与HBV-DNA在HBeAg阴性血清中具有较大的差异性,HBV-DNA阴性血清中检测HBV-LP反应乙肝病毒复制对乙肝抗病毒治疗更有重要意义;HBV DNA拷贝数与HBV-LP含量呈正相关系。     

HBV Genotypic Variability in Cuba

The genetic diversity of HBV in human population is often a reflection of its genetic admixture. The aim of this study was to explore the genotypic diversity of HBV in Cuba. The S genomic region of Cuban HBV isolates was sequenced and for selected isolates the complete genome or precore-core sequence was analyzed. The most frequent genotype was A (167/250, 67%), mainly A2 (149, 60%) but also A1 and one A4. A total of 77 isolates were classified as genotype D (31%), with co-circulation of several subgenotypes (56 D4, 2 D1, 5 D2, 7 D3/6 and 7 D7). Three isolates belonged to genotype E, two to H and one to B3. Complete genome sequence analysis of selected isolates confirmed the phylogenetic analysis performed with the S region. Mutations or polymorphisms in precore region were more common among genotype D compared to genotype A isolates. The HBV genotypic distribution in this Caribbean island correlates with the Y lineage genetic background of the population, where a European and African origin prevails. HBV genotypes E, B3 and H isolates might represent more recent introductions.     

HBV感染免疫状态与HBV基因型关系研究思路

HBV感染免疫状态不同,临床意义不同;HBV基因型不同,导致病毒致病性、变异、抗病毒等临床疗效及预后不同.HBV感染临床意义的不同,是宿主与病毒共同作用的结果.将HBV感染免疫状态与HBV基因型结合在一起研究,探索广西桂北地区不同免疫状态下基因型的分布情况及HBV感染免疫状态与基因型的关系,并希期望能针对宿主免疫状态、病毒特性,为每一位HBV感染患者制订最好的治疗方案.     

Interaction between nucleophosmin and HBV core protein increases HBV capsid assembly

Host factors are involved in Hepatitis B virus (HBV) genome replication and capsid formation during the viral life cycle. A host factor, nucleophosmin (B23), was found to bind to HBV core protein dimers, but its functional role has not been studied. This interaction promoted HBV capsid assembly and decreased the degree of capsid dissociation when subjected to denaturant treatments in vitro. In addition, inhibition of B23 reduced intracellular capsid formation resulting in a decrease of HBV production in HepG2.2.15 cells. These results provide important evidence that B23 acts on core capsid assembly via its interaction with HBV core dimers.     

HBV Pre-S1与DNA及其他血清学标志物的相关性研究

目的研究乙型肝炎病毒血清前S1抗原、HBV-DNA与其他乙型肝炎血清标志物HBs-Ag、HBeAg的相关性。方法采用实时聚合酶链反应(Real-Time PCR)技术检测血清中HBV-DNA的含量,用酶联免疫法(ELISA)检测PreS1Ag、HBsAg和HBeAg。采用SPSS 13.0统计软件进行分析,成组设计资料,率比较采用配对的χ2检验,结果的关联性采用独立性的χ2检验。结果以HBV-DNA1.000E+03Copy/ml为阴性组;HBV-DNA≥1.000E+03Copy/ml为阳性组。600例HBsAg阳性的乙型肝炎患者中241例HBV-DNA阳性,283例Pre-S1阳性。其中241例HBV-DNA阳性患者中,Pre-S1阳性222例,阳性率为92.12%。显著高于HBV-DNA阴性组的Pre-S1阳性率(16.99%)。经配对的差异性检验P=0.000(确切概率)。经独立性检验,χ2=326.573,P=0.000。241例HBsAg、HBV-DNA阳性组,HBeAg阳性191例,Pre-S1阳性222例,其中191例HBeAg阳性患者中,Pre-S1Ag阳性185例,阳性率为96.86%。显著高于HBeAg阴性组的Pre-S1Ag阳性率(61.67%)。经配对的差异性检验P=0.000(确切概率)。经独立性检验,χ2=28.511,P=0.000。结论 Pre-S1Ag与HBV-DNA阳性高度相关,有好的一致性和互补性,较HBeAg更敏感。可作为乙肝病毒存在和复制的可靠标志,是反映HBV是否具有传染性的观察指标。     

Characterization of hepatitis B virus (HBV)-specific T-cell dysfunction in chronic HBV infection

Dysfunctional CD8+ T cells present in chronic virus infections can express programmed death 1 (PD-1) molecules, and the inhibition of the engagement of PD-1 with its ligand (PD-L1) has been reported to enhance the antiviral function of these T cells. We took advantage of the wide fluctuations in levels of viremia which are typical of chronic hepatitis B virus (HBV) infection to comprehensively analyze the impact of prolonged exposure to different virus quantities on virus-specific T-cell dysfunction and on its reversibility through the blocking of the PD-1/PD-L1 pathway. We confirm that chronic HBV infection has a profound effect on the HBV-specific T-cell repertoire. Despite the use of a comprehensive panel of peptides covering all HBV proteins, HBV-specific T cells were rarely observed directly ex vivo in samples from patients with chronic infection, in contrast to those from patients with acute HBV infection. In chronic HBV infection, virus-specific T cells were detected mainly in patients with lower levels of viremia. These HBV-specific CD8+ T cells expressed PD-1, and their function was improved by the blocking of PD-1/PD-L1 engagement. Thus, a broad spectrum of anti-HBV immunity is expressed by patients with chronic HBV infection and this spectrum is proportional to HBV replication levels and can be improved by blocking the PD-1/PD-L1 pathway. This information may be useful for the design of immunotherapeutic strategies to complement and optimize available antiviral therapies.     

HBV转基因小鼠--乙型肝炎研究的重要工具

HBV感染具有严格的种属特异性和组织亲嗜性,所以可用于研究的动物模型很少。随着转基因技术的出现和发展,人们通过研制转基因动物模型来研究病毒致病机理。把HBV的DNA或其片段转入小鼠受精卵建立起来的HBV转基因小鼠,已被广泛地应用于乙型肝炎的研究中,主要体现在以下3个方面：研究HBV的致病机制、与肝细胞癌的关系及寻找、评价治疗乙肝的方法。     

63例慢性乙肝e抗原阴性HBV基因多态性检测结果报告

用地高辛标记引物酶显色法,检测了63例e抗原阴性慢性肝炎HBV基因多态性。结果突变率为53.9%(34/63)。前C/C区1896位突变率最高为49.2%(31/63),1814位38.1%(24/63);BCP区1762位、1764位均为39.7%(25/63),552位突变率为14.3%(9/63)。该检测方法灵敏度高,简便易行。严格控制杂交温度及显色温度是检测操作的关键。     

The hepatitis B virus (HBV) precore protein inhibits HBV replication in transgenic mice.

In this study, we examined the ability of the hepatitis B virus (HBV) precore, envelope, and X gene products to modulate HBV replication in the livers of transgenic mice that replicate the virus. Hepatic HBV replication was not affected by overexpression of the envelope or X gene products when these animals were crossed with transgenic mice that express the corresponding viral genes in the hepatocyte. Overexpression of the precore protein, however, eliminated nucleocapsid particles from the cytoplasm of the hepatocytes and abolished HBV replication without affecting the hepatic steady-state content of pregenomic HBV RNA. These observations suggest that the precore protein can exert a dominant negative effect on HBV replication, presumably at the level of nucleocapsid particle maturation or stability, suggesting an important role for this enigmatic viral protein in the HBV life cycle.     

两种前S蛋白与HBV复制关系的初步研究

乙型肝炎病毒(HBV)前S基因及其产物的发现有助于认识HBV复制规律。一些研究提示:前S_1蛋白是完整病毒颗粒表面的必要成分,其存在与HBV复制密切相关,前S_1检测能敏感和特异地反映HBV复制状态。另一些研究则认为:前S_2蛋白含有人多聚白蛋白的结合位点,并提出前S_2蛋白为HBV复制的新标志。为探讨HBV复制与两种前S蛋白之间的联系,本研究应用原位分子杂交分析一组慢性肝炎患者肝细胞内HBV DNA,同时检测肝细胞内HBsAg、HBcAg与两种前S蛋白,综合分析两种前S蛋白在HBV复制中的地位和作用。     

乙型肝炎病毒基因亚型检测意义

乙型肝炎病毒基因亚型检测意义曹洪林张显忠陈禹保乙型肝炎是危害我国人民身体健康的重要疾病,患者和病毒携带者约占人群的１０％～１５％,感染人群约５０％～７０％。乙型肝炎病毒有四种重要的血清学亚型（ａｄｒ、ａｄｗ、ａｙｒ、ａｙｗ）,血清学亚型检测方法为蛋白质水平的检测技术,所观察的亚型属蛋白质水平的表型结果,不能反映决定其亚型的基因和其变异情况。乙型肝炎病毒血清学亚型的决定基因位于Ｓ基因区,该基因...     

Spinoculation Enhances HBV Infection in NTCP-Reconstituted Hepatocytes

Hepatitis B virus (HBV) infection and its sequelae remain a major public health burden, but both HBV basic research and the development of antiviral therapeutics have been hindered by the lack of an efficient in vitro infection system. Recently, sodium taurocholate cotransporting polypeptide (NTCP) has been identified as the HBV receptor. We herein report that we established a NTCP-complemented HepG2 cell line (HepG2-NTCP12) that supports HBV infection, albeit at a low infectivity level following the reported infection procedures. In our attempts to optimize the infection conditions, we found that the centrifugation of HepG2-NTCP12 cells during HBV inoculation (termed “spinoculation”) significantly enhanced the virus infectivity. Moreover, the infection level gradually increased with accelerated speed of spinoculation up to 1,000g tested. However, the enhancement of HBV infection was not significantly dependent upon the duration of centrifugation. Furthermore, covalently closed circular (ccc) DNA was detected in infected cells under optimized infection condition by conventional Southern blot, suggesting a successful establishment of HBV infection after spinoculation. Finally, the parental HepG2 cells remained uninfected under HBV spinoculation, and HBV entry inhibitors targeting NTCP blocked HBV infection when cells were spinoculated, suggesting the authentic virus entry mechanism is unaltered under centrifugal inoculation. Our data suggest that spinoculation could serve as a standard protocol for enhancing the efficiency of HBV infection in vitro.     

应用RNAi技术治疗HBV的研究进展

乙型肝炎病毒（hepatitis B virus,HBV）感染是一种全球性的健康问题。全球大约有4亿HBV慢性感染患者,尤其在中国,感染率高达9.8%。RNAi（RNA interference）技术具有特异性地抑制,甚至关闭基因表达的特点,在治疗HBV感染方面有很大的应用前景。近年来,研究者针对HBV基因设计或筛选有效siRNA靶点做了很多研究,最近还出现了针对与HBV代谢相关的宿主基因设计或筛选siRNA靶点治疗HBV的新策略。该文对RNAi技术在HBV治疗方面取得的研究进展作一综述。     

海口市人群乙型病毒性肝炎血清学调查分析

目的了解海口市人群乙型肝炎表面抗原(HBs Ag)和乙型肝炎表面抗体(抗-HBs)状况,评价乙型肝炎疫苗(乙肝疫苗)纳入儿童计划免疫后的效果。方法采用分层整群抽样方法,按接种率高、中、低分为3层,每层采取完全随机的方式将调查对象分为8个年龄组,并采集静脉血进行HBs Ag和抗-HBs检测分析。结果共筛选调查对象1 162人,乙肝疫苗接种率为74.18%,15岁以下者乙肝疫苗接种率(83.61%)明显高于15岁以上者(58.82%)。HBs Ag阳性率为5.94%,15岁以下者HBs Ag阳性率(4.16%)低于15岁以上者阳性率(8.82%)。抗-HBs阳性率为57.32%,15岁以下者与15岁以上者抗-HBs阳性率分别为60.69%和51.81%。接种率越高地区HBs Ag阳性率越低,抗-HBs阳性率越高。结论海口市乙肝疫苗纳入儿童计划免疫效果显著,明显降低了15岁以下儿童HBs Ag阳性率,抗-HBs阳性率上升幅度明显,乙型肝炎的控制成效显著。     

Suppression of HBV by Tenofovir in HBV/HIV Coinfected Patients: A Systematic Review and Meta-Analysis

Background

Hepatitis B coinfection is common in HIV-positive individuals and as antiretroviral therapy has made death due to AIDS less common, hepatitis has become increasingly important. Several drugs are available to treat hepatitis B. The most potent and the one with the lowest risk of resistance appears to be tenofovir (TDF). However there are several questions that remain unanswered regarding the use of TDF, including the proportion of patients that achieves suppression of HBV viral load and over what time, whether suppression is durable and whether prior treatment with other HBV-active drugs such as lamivudine, compromises the efficacy of TDF due to possible selection of resistant HBV strains.

Methods

A systematic review and meta-analysis following PRISMA guidelines and using multilevel mixed effects logistic regression, stratified by prior and/or concomitant use of lamivudine and/or emtricitabine.

Results

Data was available from 23 studies including 550 HBV/HIV coinfected patients treated with TDF. Follow up was for up to seven years but to ensure sufficient power the data analyses were limited to three years. The overall proportion achieving suppression of HBV replication was 57.4%, 79.0% and 85.6% at one, two and three years, respectively. No effect of prior or concomitant 3TC/FTC was shown. Virological rebound on TDF treatment was rare.

Interpretation

TDF suppresses HBV to undetectable levels in the majority of HBV/HIV coinfected patients with the proportion fully suppressed continuing to increase during continuous treatment. Prior treatment with 3TC/FTC does not compromise efficacy of TDF treatment. The use of combination treatment with 3TC/FTC offers no significant benefit over TDF alone.