AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross...AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.展开更多
Tenofovir disoproxil fumarate(TDF)is a potent nucleotide analogue with high barrier to resistance,which is recommended for multi-drug resistant hepatitis B virus(HBV)infection.However,nephrotoxicity has been reported ...Tenofovir disoproxil fumarate(TDF)is a potent nucleotide analogue with high barrier to resistance,which is recommended for multi-drug resistant hepatitis B virus(HBV)infection.However,nephrotoxicity has been reported during TDF treatment,and tenofovir alafenamide(TAF),which has comparable efficacy to TDF and improves bone and renal safety,can be used as a replacement strategy.Herein,we describe a clinical case concerning a 60-year-old individual suffering liver cirrhosis and renal dysfunction,and being infected with multidrug-resistant HBV.When failing treatment with TDF,he received TAF as a rescue therapy.TAF effectively inhibited HBV replication without worsening renal function or serum phosphorus abnormality.Furthermore,hepatocellular carcinoma(HCC)occurred during TAF treatment despite controlling the viral load.The risk of HCC could not be eliminated and should be monitored during TAF treatment.展开更多
BACKGROUND Correlation between Triglyceride(TG)and estimated glomerular filtration rate(eGFR)remains largely unknown in overweight and non-overweight patients.AIM To investigated the dynamic changes of eGFR and lipid ...BACKGROUND Correlation between Triglyceride(TG)and estimated glomerular filtration rate(eGFR)remains largely unknown in overweight and non-overweight patients.AIM To investigated the dynamic changes of eGFR and lipid profiles during 3-year tenofovir disoproxil fumarate(TDF)treatment in patients with chronic hepatitis B(CHB)and overweight.METHODS A total of 202 CHB patients who received TDF treatment at the Third People's Hospital of Changzhou(Changzhou,China)and Nanjing Drum Tower Hospital(Nanjing,China)between January 2016 and May 2018 were retrospectively enrolled.According to the body mass index(BMI)at the initiation of TDF treatment,CHB patients were divided into overweight(BMI≥25 kg/m^(2))and nonoverweight(BMI<25 kg/m^(2))groups.Logistic regression was applied for the analysis of risk factors for eGFR<90 mL/(min·1.73 m^(2)).RESULTS There is no significant difference in hepatitis B virus DNA(HBV DNA)negativity and hepatitis Be antigen(HBeAg)loss between patients with overweight and nonoverweight(both P>0.05).More patients in non-overweight group achieved alanine aminotransferase normalization compared with those in overweight group(χ^(2)=11.036,P<0.01).In non-overweight patients,the eGFR significantly declined in the 1^(st) year(P<0.01),then remained at a relatively lower level.TG significantly declined in the 2^(nd) year(P=0.02)and increased in the 3^(rd) year.Moreover,TG was negatively correlated with GFR at the four-time points(P=0.002,0.030,0.007,0.008,respectively).In overweight patients,eGFR and TG remained relatively stable during the 3-year treatment,and eGFR showed no significant relationship with TG.Moreover,multivariate analysis showed that age[P<0.01,95%CI(0.97-1.005)]and baseline eGFR[P<0.01,95%CI(5.056-33.668)]were independent risk factors for eGFR<90 mL/(min·1.73 m^(2))at the 3^(rd) year.CONCLUSION Dynamic changes in renal function were conversely related to TG during TDF treatment in patients with CHB and normal BMI,but not with overweight.展开更多
基金Supported by the Preventive Medicine research projects of Jiangsu Province,No.Y2012016the Social Development Project of Zhenjiang City,No.SH2014060
文摘AIM To understand the prevalence of hepatitis C virus(HCV) infection in blood donors over a nearly 27-year interval and to explore the factors that affect the outcome of HCV infection.METHODS A retrospective and cross-sectional study was conducted.The participants,mostly plasma donors,were selected from three administrative villages in the Jiangsu province in Eastern China.A questionnaire was administered among the villagers who had a history of blood donation from the late 1980 s to the early 1990 s.All participants underwent physical examination,liver B-ultrasonography,and liver stiffness measurement.In addition,10 m L of blood was collected from each participant to measure simple liver function parameters(albumin,alanine aminotransferase,aspirate aminotransferase),blood factors(platelet),and for hepatitis B surface antigen,anti HCV,and antihuman immunodeficiency virus detection.HCV RNA detection,HCV genotyping,and other tests were carried out in anti HCV-positive patients.RESULTS After a median of 27 years(25-31 years) from the last blood donation to the time of survey,a total of 1694 participants were investigated,and the anti HCVpositive individuals were categorized into three groups:blood donors(n = 12,3.3%),plasma donors(n = 534,68.5%),and mixed donors(n = 324,58.8%).A total of 592(68.05%) patients had detectable HCV RNA,and 91.9% had genotype 1 b.A total of 161(27.2%,161/592) patients with chronic HCV were considered to have cirrhosis with a liver stiffness measurement level higher than 12 k Pa.Multiple logistic(binary) regression analysis results showed that platelet and Ig G levels were associated with cirrhosis.CONCLUSION The nearly 27-year interval investigation revealed that chronic hepatitis C infection is a very serious public health problem in Eastern China.Plasma donation and subsequent return of blood cells to the donor are the main causes of hepatitis C infection.The main HCV genotype is 1 b.Nearly 28% of cases progressed to cirrhosis.Age,especially over 60 years,and regular drinking habits were risk factors associated with cirrhosis.
基金Supported by the Chinese Foundation for Hepatitis Prevention and Control-WBE Liver Fibrosis Foundation,No.WBE20161013the Science and Technology project of Changzhou,No.CJ20160024 and No.CJ20179030
文摘Tenofovir disoproxil fumarate(TDF)is a potent nucleotide analogue with high barrier to resistance,which is recommended for multi-drug resistant hepatitis B virus(HBV)infection.However,nephrotoxicity has been reported during TDF treatment,and tenofovir alafenamide(TAF),which has comparable efficacy to TDF and improves bone and renal safety,can be used as a replacement strategy.Herein,we describe a clinical case concerning a 60-year-old individual suffering liver cirrhosis and renal dysfunction,and being infected with multidrug-resistant HBV.When failing treatment with TDF,he received TAF as a rescue therapy.TAF effectively inhibited HBV replication without worsening renal function or serum phosphorus abnormality.Furthermore,hepatocellular carcinoma(HCC)occurred during TAF treatment despite controlling the viral load.The risk of HCC could not be eliminated and should be monitored during TAF treatment.
基金Supported by the 333 High-Level Talents Project of Jiangsu Province,No.LGY2020032the Science and Technology Project of Changzhou,No.CJ20200057Qingmiao Talents Cultivation Project of Changzhou Health Commission,No.CZQM2020089.
文摘BACKGROUND Correlation between Triglyceride(TG)and estimated glomerular filtration rate(eGFR)remains largely unknown in overweight and non-overweight patients.AIM To investigated the dynamic changes of eGFR and lipid profiles during 3-year tenofovir disoproxil fumarate(TDF)treatment in patients with chronic hepatitis B(CHB)and overweight.METHODS A total of 202 CHB patients who received TDF treatment at the Third People's Hospital of Changzhou(Changzhou,China)and Nanjing Drum Tower Hospital(Nanjing,China)between January 2016 and May 2018 were retrospectively enrolled.According to the body mass index(BMI)at the initiation of TDF treatment,CHB patients were divided into overweight(BMI≥25 kg/m^(2))and nonoverweight(BMI<25 kg/m^(2))groups.Logistic regression was applied for the analysis of risk factors for eGFR<90 mL/(min·1.73 m^(2)).RESULTS There is no significant difference in hepatitis B virus DNA(HBV DNA)negativity and hepatitis Be antigen(HBeAg)loss between patients with overweight and nonoverweight(both P>0.05).More patients in non-overweight group achieved alanine aminotransferase normalization compared with those in overweight group(χ^(2)=11.036,P<0.01).In non-overweight patients,the eGFR significantly declined in the 1^(st) year(P<0.01),then remained at a relatively lower level.TG significantly declined in the 2^(nd) year(P=0.02)and increased in the 3^(rd) year.Moreover,TG was negatively correlated with GFR at the four-time points(P=0.002,0.030,0.007,0.008,respectively).In overweight patients,eGFR and TG remained relatively stable during the 3-year treatment,and eGFR showed no significant relationship with TG.Moreover,multivariate analysis showed that age[P<0.01,95%CI(0.97-1.005)]and baseline eGFR[P<0.01,95%CI(5.056-33.668)]were independent risk factors for eGFR<90 mL/(min·1.73 m^(2))at the 3^(rd) year.CONCLUSION Dynamic changes in renal function were conversely related to TG during TDF treatment in patients with CHB and normal BMI,but not with overweight.
