Hepatitis B Virus Group Research Articles

Long-term outcomes of primary total knee arthroplasty in patients with hepatitis B virus infection.

AimsThe purpose of this study was to compare the clinical outcomes, mortalities, implant survival rates, and complications of total knee arthroplasty (TKA) in patients with or without hepatitis B virus (HBV) infection over at least ten years of follow-up.MethodsFrom January 2008 to December 2010, 266 TKAs were performed in 169 patients with HBV (HBV group). A total of 169 propensity score–matched patients without HBV were chosen for the control group in a one-to-one ratio. Then, the clinical outcomes, mortalities, implant survival rates, and complications of TKA in the two groups were compared. The mean follow-up periods were 11.7 years (10.5 to 13.4) in the HBV group and 11.8 years (11.5 to 12.4) in the control group.ResultsThe mean Knee Society scores in the HBV and control groups improved from 37.1 (SD 5.6) and 38.4 (SD 5.4) points preoperatively to 78.1 (SD 10.8) and 81.7 (SD 10.2) points at final follow-up (p = 0.314), while the mean function scores in the HBV and control groups improved from 36.2 and 37.3 points preoperatively to 77.8 and 83.2 points at final follow-up (p = 0.137). Nine knees in the HBV group required revision surgery, including seven due to septic loosening and two due to aseptic loosening. Four knees in the control group required revision surgery, including three due to septic loosening and one due to aseptic loosening. Kaplan–Meier survivorship analysis with the revision of either component as an endpoint in the HBV and control groups estimated 96.6% and 98.5% chances of survival for ten years, respectively (p = 0.160).ConclusionTKA in patients with HBV infection resulted in good clinical outcomes and survivorship. However, there was a higher revision rate over a minimum ten-year follow-up period compared to TKA in patients without HBV infection.Cite this article: Bone Jt Open 2022;3(6):470–474.

Evaluation of the genotoxicity and genomic instability in patients with HBV, HCV and HCC using micronucleus and comet assay

On somatic cells, the hepatitis B virus (HBV) and the hepatitis C virus (HCV) are mutagenic. HBV and HCV may be causing these mutagenesis effects via integrating into host DNA or by viral proteins. The purpose of this research was to investigate if HBV and HCV had a genotoxic effect on renal epithelial cells' DNA. A total of 145 samples were taken from participants between the periods of 5 \1 2020 and 15\9 2021. (40 healthy controls, HBV 38, 44 HCV, and HCC 23) were used to perform cytogenetic analysis in renal epithelial cells using the micronucleus (MNi) test and comet assay. For the comet experiment, 100 cells were examined for each participant. A total of 100 cells were examined, with MNi scores assigned to each participant. The frequency of MNi was found to be considerably greater in the HBV, HCV, and HCC patient groups than in the control group. There was no significant difference in MNi scores between the HBV, HCV, and HCC patient groups, however there was a significant difference between the study groups and healthy carriers. In conclusion: due to their levels of DNA damage and MNi, chronic HBV, HCV, and HCC patients are afflicted by genomic instability much like other patients.

Evaluation of the genotoxicity in patients with HBV, HCV, and HCC using micronucleus and comet assay in Mosul City\Iraq

Hepatitis B virus (HBV) and hepatitis C virus (HCV) have mutagenic effects on somatic cells. HBV and HCV may be showing these mutagenic effects through its viral proteins or through integrating into host DNA. The aim of this study was to determine whether HBV and HCV have a genotoxic effect on the DNA of oral epithelial cells. A cohort of 145 samples have been collected from participants from the date of 5 \ 1 \ 2020 to 15\9\ 2021. Among those samples are (40 healthy controls, HBV 38, 44 HCV, and HCC 23) to make cytogenetic evaluation by observing the micronucleus (MNi) test and comet assay. For each individual, 100 cells were analyzed for comet assay. Around 100 cells were observed and MNi were scored for each individual. Our results showed significantly higher frequencies of MNi in HBV, HCV, and HCC patients groups than in the control group. There was no difference in MNi scores among HBV, HCV, HCC patients groups, and showed a significantly difference of study groups compared to healthy carriers. In conclusion: chronic HBV, HCV, HCC patients have genomic instability as affected as patients because of their levels of DNA damage and MNi.

Immunogenicity and Safety of Childhood Combination Vaccines: A Systematic Review and Meta-Analysis.

Background: Vaccination is considered the most effective and economical measure for controlling infectious diseases. Although combination vaccines are widely used worldwide, whether any of the combination vaccines is superior to each separate vaccine has yet to be established. This systematic review and meta-analysis aimed to summarize the available evidence on the effectiveness and safety of combination vaccines in children. Methods: A systematic search was conducted from database inception to August 20, 2021, in MEDLINE, Embase, Cochrane, and Scopus. Published randomized clinical trials (RCTs) and open-label trials of immunogenicity and safety of combined vaccines were selected. The results of the studies were quantitatively synthesized. Results: Overall, 25 articles met the inclusion criteria and were included in the meta-analysis. The results indicated that the combined diptheria–tetanus–acellular pertussis (DTaP)–hepatitis B virus (HBV)–Haemophilus influenzae type B (Hib) vaccine group had lower levels of anti-tetanus antibodies than the combined DTaP–HBV and separate Hib vaccinations group (SMD = −0.23; 95% CI: −0.42, −0.05; p = 0.013). Meanwhile, the combined DTaP–HBV–inactivated polio virus (IPV)–Hib vaccine group had higher levels of anti-pertussis (PT) and anti-filamentous hemagglutinin (FHA) antibodies than the combined DTaP–IPV–Hib and separate HBV vaccinations group (anti-PT: SMD = 0.60; 95% CI: 0.45, 0.75; p < 0.0001; anti-FHA: SMD = 0.40; 95% CI: 0.01, 0.78; p = 0.042). The levels of anti-pertactin (PRN) antibodies were lower in the combined DTaP–IPV–Hib vaccine group than in the combined DTaP–IPV and separate Hib vaccinations group (SMD = −0.13; 95% CI: −0.27, −0.00; p = 0.047). The individuals injected with the DTaP–HBV–IPV–Hib vaccine had a lower risk of pain and swelling than those injected with the combined DTaP–HBV–IPV and separate Hib vaccines (pain: RR = 0.79; 95% CI: 0.69, 0.91; p = 0.001; swelling: RR = 0.87; 95% CI: 0.78, 0.98; p = 0.020). However, the group that received the DTaP–HBV–IPV–Hib vaccine had a higher risk of fever than the group that received DTaP–HBV–IPV and separate Hib vaccinations (RR = 1.13; 95% CI: 1.02, 1.26; p = 0.021). Conclusions: This meta-analysis suggests that the combined vaccines (DTaP–IPV–Hib, DTaP–HBV–Hib, DTaP–HBV–IPV–Hib) are safe, well-tolerated, and provide immunogenic alternatives to separate vaccines in children. The combined DTaP–HBV–IPV–Hib vaccine showed a higher incidence of fever, which was lower than the cumulative incidence of fever induced by all vaccines. Future studies should evaluate the cost-effectiveness of using combined vaccines and compare the potency of different formulations to improve routine local or national childhood immunization programs.

Transjugular intrahepatic portosystemic shunt in patients with autoimmune hepatitis-induced cirrhosis and variceal bleeding.

An increasing number of patients with autoimmune hepatitis (AIH)-induced cirrhosis and variceal bleeding are currently referred for transjugular intrahepatic portosystemic shunt (TIPS). The aim of this study was to evaluate the safety and efficacy of TIPS in such patients, and to compare these results with data from patients with hepatitis B virus (HBV)-induced cirrhosis. This retrospective study consisted of 211 patients between August 2016 and May 2021, and patients were allocated to AIH (n = 35) and HBV (n = 176) groups according to the etiology of the cirrhosis. The primary endpoint was mortality after TIPS use; the secondary endpoints were recurrent bleeding, overt hepatic encephalopathy (OHE), shunt dysfunction, and dynamic changes in liver function over time. During a median follow-up period of 27months, 23 (10.9%) patients died, 22 (10.4%) experienced recurrent bleeding, 50 (23.7%) experienced OHE, and 25 (11.8%) developed shunt dysfunction. Compared with the HBV group, the AIH group exhibited a similar mortality risk (adjusted hazard ratio, HR 1.199; 95% confidence interval, CI 0.367-3.917; p = 0.764), OHE (adjusted HR 1.023, 95% CI 0.483-2.167, p = 0.954), and shunt dysfunction (adjusted HR 0.862, 95% CI 0.285-2.610, p = 0.792); but a higher risk of recurrent bleeding (adjusted HR 2.731, 95% CI 1.112-6.708, p = 0.028). The dynamic changes in liver function manifested an initial trend toward deterioration, and then subsequent recovery in both the AIH and HBV groups. TIPS is a safe and effective treatment, and should be considered for those patients with AIH-induced cirrhosis and variceal bleeding.

Dual hepatitis B and C-associated hepatocellular carcinoma: clinical characteristics, outcome, and prognostic role of albumin-bilirubin grade.

Albumin-bilirubin (ALBI) grade is used to evaluate the outcome of patients with hepatocellular carcinoma (HCC) which is often associated with chronic hepatitis B virus (HBV) or hepatitis C virus (HCV) infection. This study aimed to investigate the clinical characteristics, outcome, and prognostic role of ALBI grade in dual HBV/HCV-related HCC. A total 3341 HCC patients with viral etiology were prospectively enrolled and retrospectively analyzed. Multivariate Cox proportional hazards model was used to identify independent prognostic predictors. Of all patients, 2083 (62%), 1068 (32%), and 190 (6%) patients had HBV, HCV, and dual HBV/HCV infection, respectively. The mean age of HBV, HCV, and dual virus group was 60, 68, and 64years (p < 0.001), respectively. There was no significant survival difference between HBV, HCV, and dual HBV/HCV-related HCC group (p = 0.712). Multivariate Cox analysis in dual HBV/HCV-related HCC showed that multiple tumors [hazard ratio (HR): 1.537, p = 0.044], tumor size >3cm (HR 2.014, p = 0.044), total tumor volume (TTV) >50 cm3 (HR 3.050, p < 0.001), vascular invasion (HR 3.258, p < 0.001), performance status 2-4 (HR 2.232, p < 0.001), ALBI grade 2-3 (HR 2.177, p < 0.001), and BCLC stage B-D (HR 2.479, p < 0.001) were independent predictors of poor survival. Dual viral infection does not accelerate the development of HCC in HBV carriers. Patient survival is similar between dual HBV/HCV-related HCC and single HBV- or HCV-related HCC group. The ALBI grade is a robust prognostic model in dual virus-related HCC to discriminate patient long-term survival.

Hepatitis B virus infection does not affect the clinical outcome of anti-programmed death receptor-1 therapy in advanced solid malignancies: Real-world evidence from a retrospective study using propensity score matching.

This study aimed to investigate the impact of hepatitis B virus (HBV) infection on the outcome of patients with advanced solid malignancies treated with programmed death receptor-1 (PD-1) inhibitors.We retrospectively included patients treated with PD-1 inhibitors between August 2018 and April 2020. Propensity score matching (PSM) was performed to match the characteristics of the HBV and non-HBV groups. Objective response rate (ORR) and disease control rate (DCR) were compared between HBV and non-HBV groups using χ2 or Fisher exact tests. Kaplan-Meier and log-rank tests were used to analyze overall survival (OS) and progression-free survival (PFS).A total of 120 patients, including 43 (35.8%) with HBV and 77 (64.2%) without HBV, were enrolled. Cases of HBV reactivation were not observed. In the entire study population, ORR and DCR did not significantly differ between both groups. After PSM, the study population comprised 39 patients, 15 with and 24 without HBV. The HBV group had an ORR of 55.6%, whereas the ORR in the non-HBV group was 36.8% (P = .35). Similarly, the DCR was 77.8% in the HBV group, as compared to 68.4% in the non-HBV group (P = .61). Additionally, HBV infection did not significantly affect OS (P = .54) and PFS (P = .64) in the unmatched cohort. Moreover, statistically significant differences regarding OS (P = .15) and PFS (P = .23) were also not detected after PSM.In conclusion, the HBV infection status did not impact the therapy response or prognosis of patients treated with PD-1 inhibitors. Further prospective studies are needed to corroborate these findings.

Novel Prognostic Indicators to reflect the grade of liver fibrosis in hepatic patients

Background: Liver fibrosis is the result of a sustained wound healing response to chronic liver injury. The main reasons include chronic hepatitis C virus (HCV), hepatitis B virus (HBV) infection, and Non-alcoholic fatty liver disease (NAFLD). Non-invasive methods of assessing fibrosis are often used in clinical practice as a safer, more accessible, and less costly way than liver biopsy to stratify individuals by risk. The current study early diagnosis of liver fibrosis in patients with hepatitis B, C, and NAFLD using indirect non-invasive biomarkers and evaluating the diagnostic impact of the Study applied on 250 patients divided into five equal groups: HBV Group, HCV Group, HBV + HCV Group, NAFLD Group and Control Group, for each with the same inclusion and exclusion criteria in order to monitor the prevalence of Apolipoprotein B (ApoB) (g/L), Lipoprotein A (mg/dL), Serum Amyloid A (SAA) (mg/L) and Insulin-like growth factor 1 (IGF1) (ng/ml) as biomarkers reflecting the grade of liver fibrosis in hepatic patients. Results: In the terms of Alanine aminotransferase ALT (p < 0.05), Gamma-glutamyltransferase GGT (p < 0.001), Glycosylated hemoglobin HbA1C (p < 0.001), and Apo B(p < 0.001), in the NAFLD group, had the highest value. Meanwhile, the terms of Aspartate aminotransferase AST (p < 0.001), Aspartate aminotransferase to platelet ratio index APRI (p < 0.001), total bilirubin (p < 0.05), and Serum Amyloid A SAA (p < 0.001)in the HCV group had the greatest value. In addition, the HBV+HCV group had the highest AST/ALT value (p < 0.001), α2 macroglobulin (p < 0.001) values. platelets (p < 0.001), haptoglobin (p < 0.001), lipoprotein A (p < 0.001), and Insulin-like growth factor 1 IGF1(p < 0.001) were all greatest in the control group. The biomarkers Lipoprotein (A) in HBV and NAFLD; Apolipoprotein B (ApoB) in HCV and HBV+ HCV group were found to be predictive of early fibrosis using Receiver Operator Characteristics (ROC) curves. Conclusion: The estimation of non-invasive biomarkers (ApoB), (IGF1), (SAA), and Lipoprotein A were the most predictive of early fibrosis in hepatic patients with significant accuracy. These biomarkers can be used as liver biopsy alternatives to support the early diagnosis of liver fibrosis.

Association Analysis of Genetic Variants of Sodium Taurocholate Co-Transporting Polypeptide NTCP Gene (SLC10A1) and HBV Infection Status in a Cohort of Egyptian Patients

Background: Single nucleotide polymorphisms (SNPs) in the SLC10A1 gene, coding for a functional receptor of hepatitis B virus (HBV), sodium taurocholate co-transporting polypeptide (NTCP), may influence the susceptibility, outcome, and disease course of HBV infection in some populations. Aim: to determine the prevalence of SNPs of the NTCP gene, rs2296651 and rs943277, and their relationship with chronic HBV infection in a group of Egyptian patients. Methods: One hundred and thirty seven patients with HBV and 65 healthy controls were enrolled, and the patients were divided into two groups; group I chronic HBV infection (68 patients with normal ALT and minimal or no liver necroinflammation or fibrosis) and group II chronic hepatitis B (69 patients with elevated ALT and moderate or severe liver necroinflammation). They were subjected to full history taking, clinical examination, laboratory investigations, abdominal ultrasound, and liver stiffness measurement using both Echosens® Fibroscan and acoustic radiation force impulse (ARFI). A real time PCR TaqMan 5′ allelic discrimination assay was applied to detect the SNPs in the NTCP gene, rs2296651 and rs943277. Results: On studying the rs2296651 variant, all controls and patients had genotype GG without any significant association with HBV infection or disease progression. However, the rs943277 variant in all controls and 98% of patients had genotype GA, except for two chronic HBV infection patients who had genotype AA, but no significant difference between patients and controls was found. The non-invasive methods for liver fibrosis assessment ARFI, AST/platelet’s ratio (APRI), and fibrosis-4 score (FIB-4) could predict the stages of fibrosis in agreement with Fibroscan with AUCOR 0.8, 0.79, and 0.76, respectively. Conclusion: These findings may suggest that there is no relation between these SNPs of the NTCP gene and the susceptibility or chronicity of HBV infection in the Egyptian population. We also suggest that the use of the non-invasive methods for liver fibrosis assessment, ARFI, FIB-4, and APRI, may decrease the need for liver biopsies in the prediction of significant hepatic fibrosis in chronic HBV patients.

Study on Behavioral Factors Affecting the Risk of New HBV Infection among Diabetic Patients

To analyze the behavioral factors influencing of new hepatitis B virus (HBV) infection in diabetic patients, so as to provide evidence for reducing the risk of new HBV infection in diabetic patients. A nested case-control study was conducted to follow up and observe 4 586 diabetic patients. The 114 diabetic patients who newly developed HBV infection during the follow-up period were selected as the case group, and 228 diabetic patients who did not develop HBV infection in the same period were selected as the control group from the cohort population at a matching ratio of 1∶2 according to the age ±2 years. Questionnaire surveys and laboratory examinations were conducted in the cohort. The contents of the questionnaire included family history of hepatitis B, history of trauma, history of receiving/donating blood, individual-related behavioral characteristics, diabetes severity, and behavior related to diabetes treatment and management. In addition, the blood samples of the cohort were tested for hepatitis B surface antigen (HBsAg) by enzyme-linked immunosorbent assay (ELISA). The conditional logistic regression model was used to analyze the related behavioral factors affecting new HBV infection in diabetic patients. The median ages of the HBV group and the control group were 64 years old and 66 years old, respectively. There was no statistically significant difference in the composition of sex, age, ethnicity, occupation and amount of formal education between the two groups ( P>0.05). Multivariate analysis showed that diabetic patients with a family history of hepatitis B ( OR=13.052, 95% CI: 3.799 to 44.847) had a higher risk of new HBV infection, while diabetic patients who used blood collection/injection devices in a standardized way ( OR=0.189, 95% CI: 0.082 to 0.436), safety locking blood glucose needles ( OR=0.142, 95% CI: 0.073 to 0.276) and venous blood collection needles ( OR=0.019, 95% CI: 0.001 to 0.262) and self-testing of blood sugar at home ( OR=0.466, 95% CI: 0.222 to 0.980) had a lower risk of new HBV infection. Family history of hepatitis B is an independent factor that increases the risk for new HBV infection in diabetic patients. During the process of long-term blood glucose management of diabetic patients, standardized use of blood collection/injection devices, use of safer types of blood sampling lancet, and self-testing of blood glucose help can reduce the risk of HBV infection.

Association of deleted in liver cancer-1 gene polymorphism with increased risk of chronicity of disease among Malaysian patients with hepatitis B infection.

The aim of this study is to examine the association between genetic variations in deleted in liver cancer 1 (DLC1) gene with progression of the hepatitis B virus (HBV) infection. A total of 623 subjects were included in this study, of whom, 423 were chronic hepatitis B (CHB) patients without liver cirrhosis or hepatocellular carcinoma (HCC), 103 CHB with either liver cirrhosis ± HCC and 97 individuals who had resolved HBV. Two single-nucleotide polymorphisms rs3739298 and rs532841 of DLC1 gene were genotyped using the Sequenom MassARRAY platform. Our results indicated significant differences between the chronic HBV and resolved HBV groups in genotype and allele frequencies of DLC1-rs3739298 [odds ratio (OR) = 2.23; 95% confidence interval (CI): 1.24-3.99; P = 0.007] and (OR = 1.54; 95% CI: 1.07-2.22; P = 0.021), respectively. Moreover, haplotype analysis revealed significant associations between chronicity of HBV with TG and GA haplotypes (P = 0.041 and P = 0.042), respectively. A significant association exists between the rs3739298 variant and susceptibility to CHB infection.

Pathological prognostic factors for post-resection survival in patients with hepatocellular carcinoma associated with non-alcoholic fatty liver disease.

BackgroundThe incidence of hepatocellular carcinoma (HCC) in patients with non-alcoholic fatty liver disease (NAFLD) is steadily increasing. However, little is known about the characteristics of these patients or the factors affecting their prognosis. Our aim was to evaluate the pathological prognostic factors associated with survival in NAFLD patients.MethodsThis was a retrospective cohort study of 575 patients who underwent resection of HCC between January 2004 and December 2018. HCC was associated purely with NAFLD or hepatitis B virus (HBV) based on the pathology and viral markers. The pathological markers of HCC were compared between patients with pure NAFLD and patients with pure HBV.ResultsThe pathological factors were similar between the two groups. There were no differences in overall survival (OS; P=0.283) or recurrence-free survival (RFS; P=0.990) between the pure NAFLD and pure HBV groups. The NAFLD group had a similar local RFS (P=0.785) but a better systemic RFS compared with the HBV group, (P=0.089). In multivariable analysis using bootstrapping with resampling and replacement of data, no single factor was significantly associated with RFS. However, the Ki-67 labeling index [P=0.022; bootstrap 95% confidence interval (CI): 0.000–0.919] was the only independent factor associated with systemic recurrence in the NAFLD group.ConclusionsIn patients with HCC associated with NAFLD, the Ki-67 labeling index determined by immunohistochemistry may predict the risk of systemic recurrence following resection, allowing for stricter monitoring protocols for such patients.

Ceruloplasmin Activity and Ferritin in Patients with Chronic Liver Disease

Background: Ceruloplasmin (CP) is a copper-containing glycoprotein found in the globulin portion of human blood serum 2. CP, a glycoprotein secreted by hepatocytes, carries more than 90% of copper in the bloodstream of healthy people. CP is an effective antioxidant that prevents lipid peroxidation by removing oxygen. CP inhibits lipid peroxidation initiation. CP has function also known as an extracellular superoxide dismutase species (SOD) that neutralizes radicals of superoxide anions. Aims: The aim of this study is to understand the status of CP in chronic liver disease (CLD) patients, which could yield important information regarding the overall oxidative stress and iron storage. Out of the total 86 samples, 50 samples were patients who have been diagnosed with CLD, especially chronic hepatitis B virus (HBV) and hepatitis C virus (HCV), collected from the Center of Internal Medicine and Cardiology in Marjan Teaching Hospital in Hillah city, Babylon Province, Iraq and other samples were healthy controls. Materials and Methods: The CP oxidase activity test was processed by PPD buffer oxidation. Ferritin concentration was tested by enzyme-linked immunosorbent assay. Results: There were no significant differences in levels of ferritin between HBV and HCV patient groups, but there are slight increases in the mean of CP activity in the HCV patients. A positive significant correlation was observed between CP activity and ferritin. Conclusion: 1. CP activity increases in CLD patient and in HCV more than HBV. 2. CP activity is affected by viral load so it increases in positive viral load patients compared with negative viral load patients. 3. There was a positive correlation between CP activity and ferritin. 4. Serum ferritin is not affected by CLD.

Comorbidities in patients with chronic hepatitis C and hepatitis B on hemodialysis.

Hemodialysis patients are at increased risk of hepatitis B virus (HBV) and hepatitis C virus (HCV) infection. Both HBV and HCV infections lead to risks of end-stage liver diseases and extrahepatic manifestations. This study aimed to investigate hepatic and extrahepatic comorbidities in hemodialysis patients with HBV or HCV infections compared with those without viral hepatitis. A total of 1910 hemodialysis patients, including 159 HCV viremic patients (HCV group), 217 seropositive for HBV surface antigen (HBsAg, HBV group) and 1534 seronegative for both anti-HCV and HBsAg (non-B and non-C [NBNC] group), from 23 hemodialysis centers were enrolled. Comorbidities were classified into 10 categories by the International Classification of Diseases-10th Revision. Among the 1910 patients, the mean age was 64.6years, and 52.7% were male patients. A total of 1834 (96%) patients had at least one comorbidity, and the mean number of comorbidities was 2.9±1.5 per person. The three most common comorbidities were hypertension, diabetes, and ischemic heart diseases. The mean number of comorbidities per person was significantly higher in the HCV group (3.3±1.7) than in the HBV (2.7±1.5, P<0.001) and NBNC groups (2.9±1.5, P=0.004), mainly due to the higher prevalence of ischemic heart disease, respiratory disorders, and mental/behavioral disorders. The HBV and NBNC groups exhibited comparable burdens of comorbidities. Hemodialysis patients had a high prevalence of multiple comorbidities. Hemodialysis patients with HCV exhibited a higher burden of comorbidities, especially ischemic heart diseases, respiratory disorders, and mental/behavioral disorders, than HBV and NBNC patients did.

Hepatotoxicity of iodine-131 ablation for post-surgical differentiated thyroid cancer patients with hepatitis B virus infection

ObjectiveRadioiodine (Iodine-131, 131I) ablation is a standard treatment for differentiated thyroid cancer (DTC) after thyroidectomy. Hepatotoxicity is a rare side effect of 131I, and little information is available on the hepatotoxicity of 131I ablation for post-surgical DTC patients with hepatitis B virus (HBV) infection. MethodsWe performed a retrospective study of 94 post-surgical DTC patients between November 2012 and August 2015 in our hospital. All the patients had been screened for HBV infection and divided into HBV group and non-HBV group. Clinical data were compared between the two groups. Results14 patients with HBV infection and 80 patients without HBV infection were analyzed. The baseline characteristics of the two groups had no statistical differences. Incidence of hepatotoxicity was higher in HBV group than in non-HBV group and HBV infection was confirmed as a risk factor of hepatotoxicity by univariate and multivariate regression analysis. ConclusionPost-surgical DTC patients with HBV infection were prone to hepatotoxicity by 131I ablation treatment. Physicians should pay more attention to the liver function of patients at risk.

Mortality in relation to hepatitis B virus (HBV) infection status among HIV-HBV co-infected patients in sub-Saharan Africa after immediate initiation of antiretroviral therapy.

It is unknown how past and active hepatitis B virus (HBV) infection affect immunorecovery and mortality in people with HIV who initiate tenofovir-based antiretroviral therapy (ART). Using data collected between 2008 and 2015, we studied people with HIV in sub-Saharan Africa initiating immediate ART in the Temprano randomized control trial. We classified participants into HBV groups at ART initiation: hepatitis B surface antigen (HBsAg)-positive with HBV DNA≥2,000IU/ml; HBsAg-positive with HBV DNA<2,000IU/ml; isolated HBcAb-positive; resolved infection (HBsAb-positive/HBcAb-positive); and HBV non-immune/vaccinated (HBcAb-negative). We compared square-root CD4-cell count increases using mixed-effect, non-linear regression adjusted for age, sex, baseline CD4 cell count, and HIV RNA. We compared all-cause mortality using Bayesian parametric survival regression. Among 879 participants, 24 (2.7%) had HBsAg with high HBV DNA, 76 (8.6%) HBsAg with low HBV DNA, 325 (37.0%) isolated anti-HBcAb, 226 (25.7%) resolved HBV infection and 228 (25.9%) HBV non-immune/vaccinated. We found no significant difference in CD4 cell increases between HBV-infection groups after adjustment (p=0.16). Participants with HBsAg and high HBV DNA had the highest incidence of all-cause mortality (1.9/100 person-years, 95% Credibile Interval [CrI]=1.0-3.4). By comparison, incidence rates of mortality were reduced by 57% (95%CrI=-79%, -13%), 60% (95%CrI=-82%, -12%) and 66% (95%CrI=-84%, -23%) in those who had isolated anti-HBcAb-positive, resolved HBV infection and HBV non-immune/vaccinated, respectively. In conclusion, individuals with HIV and past HBV infection or isolated anti-HBcAb-positive serology, much like HBV non-immune/vaccinated, experience lower mortality than those with HBsAg and high HBV DNA. Additional HBV-related management would not be necessary for these individuals.

Issues des transferts cumulés d’embryons frais et congelés en fécondation in vitro chez les femmes infectées par le virus de l’hépatite B

ObjectiveTo assess the impact of hepatitis B virus (HBV) infection in women on in vitro fertilization (IVF) outcomes. MethodsAn observational monocentric case-control cohort study conducted between 2012 and 2019 compared the outcomes of the first cycle of IVF between 64 woman infected with HBV and 128 seronegative controls. Frozen embryos transfers made within 18 months of the puncture were included. The exclusion criteria were severe infections, viral co-infection in women, any viral infection in their spouse, or lack of fresh embryo transfer. The matching was performed according to age, primary infertility or secondary, conventional or intracytoplasmic injection IVF technique and date of attempt. The main analysis focused on cumulative live births rates (LBR). ResultsThe clinical and ovarian stimulation characteristics were comparable except for a longer period of infertility in the HBV group. The LBR in the HBV group, when compared to controls, was not different after transfer of fresh (14.06 vs. 25.00% P=0.08) or frozen embryos (4.17 vs. 18.92% P=0.08), but significantly decreased in cumulative analysis (15.63 vs. 35.94% P=0.003). HBV infection was negatively associated with LBR in multivariate analysis OR=0.38 (95% CI 0.14–0.92) P<0.05. The implantation rate was lower in the HBV group versus controls, in fresh (14.89 vs. 27.72% P=0.02) and frozen (3.03 vs. 21.65% P=0.01) embryo transfers. ConclusionThis study suggests a negative impact of HBV infection in women on the cumulative LBR after IVF.

COVID-19 Among Patients With Hepatitis B or Hepatitis C: A Systematic Review

Context: Hepatic manifestations of Coronavirus Disease 2019 (COVID-19) are common among people living with Hepatitis B Virus (HBV) and Hepatitis C Virus (HCV). Objectives: This systematic review aimed to summarize the evidence on COVID-19 patients living with HBV or HCV co-infections. Data Sources: We searched multiple electronic databases and preprint servers from December 1, 2019, to August 9, 2020. Study Selection: Studies were included if they reported quantitative empirical data on COVID-19 patients living with HBV or HCV co-infections. Data Extraction: Descriptive analyses were reported, and data were synthesized narratively. The quality assessment was completed using the Joanna Briggs Institute critical appraisal tools. Results: Out of the 941 uniquely identified records, 27 studies were included. Of the eligible studies, 232 COVID-19 patients were living with HBV and 22 were living with HCV. Most patients were male, and the mean age was 49.8 and 62.8 years in patients living with HBV and HCV, respectively. Among the reported cases of SARS-CoV-2-HBV co-infection, the proportions of death were 4.7% and 15% in cross-sectional and case series/report studies, respectively. The death proportion was 8.3% among the reported cases of SARS-CoV-2-HCV co-infection. Among COVID-19 patients, 34.1% and 76.2% reported at least one comorbidity besides HBV and HCV infections, mainly hypertension and type 2 diabetes mellitus. The most common COVID-19-related symptoms in both HBV and HCV groups were fever, cough, dyspnea, fatigue, and gastrointestinal symptoms. Conclusions: While understanding the pathogenesis of SARS-CoV-2 requires further investigations, the careful assessment of hepatic manifestations and chronic infections, such as HBV and HCV upon the admission of COVID-19 patients could help reduce multimorbidity among HBV or HCV patients and lead to more favorable health outcomes among them.

Impact of Insulin Treatment on Prognosis of non-B non-C Hepatocellular Carcinoma After Hepatectomy.

Several studies have reported that DM is closely associated with an increased incidence of hepatocellular carcinoma (HCC). To clarify the effects of diabetes mellitus (DM) and antidiabetic medications on the prognosis of patients with non-B non-C (NBNC) HCC following curative initial hepatectomy. HCC patients (n=156) were divided into three groups according to the presence or absence of chronic viral hepatitis: hepatitis B virus (HBV) group, hepatitis C virus (HCV) group, and NBNC group. The clinical characteristics and survival outcomes were compared. In the NBNC group, univariate and multivariate analyses were conducted to determine prognostic factors. The NBNC group had a higher incidence of DM, ethanol intake, and large nodules than the other groups. Disease-free survival (DFS) was significantly worse in the NBNC group than in the HBV group. In the NBNC group, insulin treatment was an independent prognostic factor for DFS and overall survival (OS). Medications for DM that affect insulin resistance might be appropriate prognostic factors for NBNC-HCC.

Longitudinal changes of liver function and hepatitis B reactivation in COVID‐19 patients with pre‐existing chronic hepatitis B virus infection

AimWith the current coronavirus disease (COVID‐19) pandemic and high endemic levels of chronic hepatitis B virus (HBV) infection worldwide, it is urgent to investigate liver function changes of COVID‐19 patients with chronic HBV infection, and how severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2) infection in turn affects the course of chronic HBV infection.MethodWe undertook a retrospective study based on 347 COVID‐19 patients (21 vs. 326 with vs. without chronic HBV infection). With the propensity score matching (PSM) method, we yielded 20 and 51 matched patients for the HBV group and the non‐HBV group, respectively.ResultsAt the end of follow‐up, all of these 71 patients achieved SARS‐CoV‐2 clearance (P = 0.1). During the follow‐up, 30% versus 31.4% in the HBV group versus non‐HBV group progressed to severe COVID‐19 (P = 0.97). After PSM, the longitudinal changes of median values for liver biochemistries were not significantly different between the two groups. In the HBV group versus non‐HBV group, 35% (7/20) versus 37.25% (19/51) (P = 0.86) had abnormal alanine aminotransferase at least once during hospitalization, 30% (6/20) versus 31.37% (16/51) had abnormal aspartate aminotransferase (P = 0.91), 40% (8/20) versus 37.25% (19/51) had abnormal γ‐glutamyltransferase (P = 0.83), and 45% (9/20) versus 39.22% (20/51) had abnormal total bilirubin levels (P = 0.91). Moreover, three patients in the HBV group had hepatitis B reactivation.ConclusionsLiver dysfunction presented in COVID‐19 patients with/without chronic HBV. Moreover, those COVID‐19 patients co‐infected with chronic HBV could have a risk of hepatitis B reactivation. It is necessary to monitor liver function of COVID‐19 patients, as well as HBV‐DNA levels for those co‐infected with HBV during the whole disease course.