Persistent Infection Group Research Articles

Study on the Clinical Characteristics, Persistent Infection Ability and Viral Load of Human Papillomavirus Type 73 Single Infection.

Human papillomavirus (HPV) infection is a main cause of cervical cancer. Different HPV types exhibit significant differences in pathogenicity. Clinical data on HPV73 single infection is limited, this study aimed to analyze the clinical characteristics of HPV73 single infections. We collected cervical exfoliated cells to examine the infection rate and the clinical characteristics of patients with single HPV73 infection, and to investigate the association of viral load, persistent infection, and pathogenicity. The positive rate of HPV73 among women tested was approximately 0.14% (609/435 072). Among 214 HPV73 single infection cases, the number of patients with normal cytology, cervical intraepithelial neoplasia (CIN)1, CIN2, CIN3, and cervical cancer were 182, 24, 5, 1, and 1, respectively. Follow-up data showed that 14.29% (3/21) of CIN1 patients developed to higher-grade lesions, with 3.73% (5/134) of normal patients progressed to CIN. The viral load in the CIN group was significantly higher than that in the normal group (p = 0.001), and the viral load in the persistent infection group was significantly higher than that of the viral-clearance group (p < 0.001). HPV73 single infection can lead to cervical cancer, with relatively low pathogenicity. And high viral load is a crucial factor in its persistent infection and pathogenicity.

Study on the clinical characteristics, persistent infection capability and viral load of human papillomavirus type 26 single infection

BackgroundHuman papillomavirus (HPV) infection is the main cause of cervical cancer. Different types of HPV have varying carcinogenic capabilities, and viral load is one of the key indicators of pathogenicity. Currently, there is a lack of clinical data on HPV26. This study analyzed the clinical characteristics of patients with HPV26 single infection.MethodsExfoliated cervical cells were collected for HPV genotyping from women who attended gynecological outpatient clinics or physical examinations. The clinical characteristics of HPV26 single infections in both cross-sectional and follow-up studies were examined, and the association of viral load with HPV26 persistent infection and pathogenicity was investigated.ResultsThe HPV26 positive rate among women visiting hospitals for gynecological medical consultation or physical examination was approximately 0.09% (379/435,072). Among the HPV types tested, the detection rate of HPV26 was 0.37% (379/103,608). In the cross-sectional histopathological study of 101 patients with HPV26 single infection, 62.37% (63/101) presented lesion-free. The numbers of patients with cervical intraepithelial neoplasia (CIN) 1, CIN2, and CIN3 were 25, eight, and five, respectively. Cervical cancer was not detected in any patient. 71 patients attended follow-up examinations as well as HPV26 retesting up to two years, during which, 28.57% (6/21) of CIN1 patients have developed into high-grade lesions, and 9.61% (5/52) of lesion-free patients have progressed to CIN stage. The viral load in the CIN group was significantly higher than that in the lesion-free group (p = 0.012). Similarly, the viral load in the persistent infection group was significantly higher than that in the viral-clearance group (p < 0.001).ConclusionsThe pathogenicity of single HPV26 infections is moderate among high-risk types, warranting the inclusion of HPV26 in expanded screening for HPV. High viral load is an important factor in the persistent infection and pathogenicity of HPV26. Viral load is expected to serve as a screening risk factor for persistent infection and disease progression associated with HPV26.

Long-term Helicobacter pylori infection is associated with an increased risk of carotid plaque formation: a retrospective cohort study.

Cardiovascular disease significantly impacts human health. The development of carotid plaques elevates the risk of cardiovascular disease, while the influence of Helicobacter pylori (H. pylori) on carotid plaques remains a subject of debate. This study aimed to investigate the association between H. pylori infection and carotid plaque using a cohort study. The study included individuals who underwent multiple physical examinations at the Health Examination Center of Taizhou Hospital. The relationship between H. pylori and carotid plaque was explored using multifactorial logistic regression analysis. Participants were categorized into groups based on their H. pylori infection status at the initial and final examinations, comprising persistent infection, persistent negative, new infection, and eradication infection, to analyze variations in carotid plaque prevalence among these groups. In both univariate and multifactorial regression analyses, H. pylori was identified as a risk factor for carotid plaque development. Moreover, when compared to the persistent negative group, both the new infection and persistent infection groups showed a notable increase in the risk of carotid plaque. Additionally, individuals in the persistent infection group exhibited higher blood pressure and blood glucose levels than those in the persistent negative group. Likewise, there was a discrepancy in the impact of insulin resistance on carotid plaque between the H. pylori positive and negative groups. H. pylori is a risk factor for carotid plaque, with a long-term infection associated with an increased risk of carotid plaque formation. In addition, H. pylori promoting carotid plaque formation may be related to blood pressure, blood glucose, and insulin resistance.

Persistent Helicobacter pylori infection leads to elevated fasting plasma glucose level: A retrospective cohort study based on a nondiabetes Chinese population.

The relationship between Helicobacter pylori (H. pylori) and fast plasma glucose (FPG) on nondiabetes populations is still inconclusive. Nowadays, not only the high infection rate of H. pylori but also the high FPG level is threatening the Chinese people. A retrospective cohort study has been established to analyze the relationship between H. pylori infection and FPG level, 18164 individuals performed healthy examination in Taizhou Hospital Health Examination Center from 2017 to 2022 were included, and hematological indicators, body parameters, and H. pylori detection by 13 C-urea breath test were collected from patients. The follow-up intervals were greater than 12months. H. pylori infection was regarded as an independent risk factor for elevated FPG after multivariate logistic regression. Additionally, the average interval time were 33.6±13.3months. Mean changed FPG values in the persistent infection group were higher than in the subgroup of persistent negative (P=0.029) as well as eradication infection (P=0.007). The aforementioned changes began to appear after 2years of follow-up. Similarly, when compared with the subgroup of persistent infection, mean changed triglyceride/high density lipoprotein (TG/HDL) values were much lower in the subgroup of persistent negative (P=0.008) and eradication infection (P=0.018), but the differences appeared after 3years of follow-up. H. pylori infection is an independent risk factor for elevated FPG in non-diabetes mellitus (DM) individuals. Persistent H. pylori infection causes an increase in FPG level and TG/HDL, which may be a risk factor for diabetes mellitus.

Early and Late Outcomes of Endovascular Aneurysm Repair for Infected Abdominal Aortic and/or Iliac Aneurysms

Infected abdominal aortic and/or iliac aneurysm (AAIA) is a rare condition with a high mortality rate when treated with open surgery. In the past decade, the condition has increasingly been treated with endovascular aneurysm repair (EVAR). However, early and late outcomes, including the continued need for antibiotic treatments and predictors of persistent infection, are poorly understood. We evaluated the outcomes of patients who underwent EVAR for infected AAIA from January 2010 to October 2017. We collected data including patient age, gender, clinical presentation, aneurysm location, culture results, intraoperative details, postoperative complications, 30-day mortality, in-hospital mortality, persistent infection, reintervention, and survival. Among 792 patients diagnosed with AAIA, 64 were diagnosed with primary infected aneurysm, underwent EVAR, and were included in this study (81.3% male; median age, 72years; range, 18-94years). The most commonly isolated organisms were Salmonella species (34%), followed by Streptococcus (21%), and Staphylococcus species (21%). Aneurysms were intact in 48 patients (75%) and were ruptured in 16 (25%). The perioperative mortality was 4.7% (3 patients) of whom one was diagnosed with ruptured infected AAIA. Six (9.4%) patients died during hospitalization, 5 of severe sepsis with multiorgan failure and one of myocardial infarction. Among the 58 surviving patients, 34 (58.6%) had persistent infection, of whom 13 (22.4%) required early and late reintervention, including 2 with endograft infection, 8 with primary and secondary aortoenteric fistula, 2 with recurrent new aortic infection, and one with graft limb occlusion. The remaining 24 patients were able to discontinue antibiotics and had no recurrence or need for reintervention. Overall survival rates at 1, 3, and 5years in the antibiotic-discontinuation group were 91.7%, 87.5%, and 68.0%, respectively, and 82.4%, 52.6%, and 32.9%, respectively, in the persistent-infection group (P=0.009). In multivariable analysis, primary aortoenteric fistula (Adjusted OR [aOR], 20.469; 95% confidence interval (CI), 1.265-331.320; P=0.034) and preoperative serum albumin level <3g/dL (aOR, 7.399; 95% CI, 1.176-46.558; P=0.033) were preoperative parameter that predicted persistent infection. AC-reactive protein level more than 5mg/L (aOR, 34.378; 95% CI, 4.888-241.788; P<0.001) was observed in patients with persistent infection. EVAR is a feasible treatment with acceptable perioperative mortality for infected AAIA. Patients able to discontinue antibiotics have better survival and lower reintervention rates than those with persistent infection. A preoperative albumin level below 3g/dL and primary aortoenteric fistula predicted persistent infection in this population.

Effect of Helicobacter pylori eradication on hyperplastic gastric polyps: A systematic review and meta-analysis.

There is increasing evidence that the eradication of Helicobacter pylori leads to the regression of gastric hyperplastic polyps (GHPs). We performed a systematic review with a meta-analysis of randomized controlled trials and observational studies that assessed the effects of eradication. We searched the PubMed, Embase, and Cochrane Central Register of Controlled Trials databases for relevant studies with a combination of the terms "Helicobacter pylori" and "polyps." The risk ratio was used to compare the effect of H. pylori eradication/treatment on GHP. We also calculated the pooled disappearance rate of GHP in the H. pylori eradication/treatment group and persistent infection group. We analyzed data from 6studies, including 3 RCTs. A total of 58/394 patients were included in the H. pylori treatment/successful eradication group, and 57/302 patients were included in the H. pylori untreated/persistent infection group. The pooled rate of GHP elimination after H. pylori treatment/successful eradication was 59% (95% CI, 43%-75%)/79% (95% CI, 72%-86%). H. pylori treatment/successful eradication significantly increased the GHP elimination rate [ITT: (pooled rate: 58% vs. 0%, RR =22.24, 95% CI, 4.51- 109.78, p = 0.0001), PP: (pooled rate: 65% vs. 0%, RR =22.25, 95% CI, 4.52- 109.37, p = 0.0001)/(pooled rate: 79% vs. 9%, RR =26.87, 95% CI, 1.34-540.5, p = 0.03)]. Our meta-analysis showed that after the eradication of H. pylori, most GHPs are eliminated. Moreover, the treatment/successful eradication of H. pylori increased the GHP elimination rate by more than 20 times that in the control group.

Cervicovaginal microbiota dysbiosis correlates with HPV persistent infection

HPV persistent infection is a main event leading to the development of cervical intraepithelial neoplasia and cervical cancer. Earlier to distinguish HPV persistent and transient infection is meaningful but the methods are limited. This study used 16S rDNA sequencing to determine the cervicovaginal microbiota of HPV persistent infection, transient infection and health women. Sequences analysis was performed and according to subsequent statistical analysis, the structure of cervicovaginal microbiota of healthy and transient infection individuals is relatively single, Firmicutes occupy the main composition. However, that of the HPV persistent infection presented a complicated trend and the abundance of Proteobacteria, Actinobacteria, Bacteroidetes and Fusobacteria was higher. The significance p-values of the average species abundance of Firmicutes, Proteobacteria and Bacteroides between HPV persistent and transient infection groups were 0.003, 0.018 and 0.005, respectively. The study also found 36 biomarkers of cervicovaginal microbiota dysbiosis for LDA score>4 among different groups. At genus level, Prevotella, Sphingomonas and Anaerococcus correlated with HPV persistent infection. At species level, Lactobacillus iners correlated with HPV transient infection. Besides, local immune microenvironment was changed with cervicovaginal microbiota dysbiosis. Interleukin-6 and TNF-α were significantly upregulated in cervical secretions from HPV persistent infection compared with those from transient infection and healthy women. Peripheral blood Regulatory T cells and myeloid-derived suppressor cells in patients with HPV persistent infection were also significantly increased. In conclusion, this study identified cervicovaginal microbiota dysbiosis closely related to HPV persistent infection, which provided a new idea and method for the prevention of cervical cancer.

Effect of Helicobacter pylori infection and its eradication on gastric regenerating atypia in 22133 subjects.

The aim of this study was to identify factors affecting persistent gastric regenerating atypia and determine the effect of Helicobacter pylori eradication on the course of this lesion. In cross-sectional setting, comprehensive health check-up subjects who underwent both endoscopy and H.pylori test from 2001 to 2009 were included. The association between H.pylori and gastric regenerating atypia was evaluated. In cohort setting, patients with regenerating atypia who underwent H.pylori test from 2001 to 2013 were included. Factors affecting positive pathology (persistent regenerating atypia or new development of neoplasm) in patients with regenerating atypia at baseline were investigated. In cross-sectional setting, regenerating atypia was observed in 1.1% (241/22133). H.pylori infection was associated with gastric regenerating atypia (adjusted odds ratio, 1.47; 95% confidence interval [CI], 1.12-1.91). In cohort setting, 310 patients with regenerating atypia were finally eligible. Positive pathology rate during follow up was 16.1% (15/93) in the persistent infection group, 2.8% (3/106) in successful eradication group, and 4.5% (5/111) in baseline H.pylori-negative group. Persistent H.pylori infection increased the risk of positive pathology (adjusted risk ratio [RR], 7.18; 95% CI, 1.95-26.48) compared to H.pylori eradication group. Persistent H.pylori infection increased the risk of regenerative atypia (adjusted RR, 5.70; 95% CI, 1.46-22.17) and new neoplasm (adjusted RR, 10.74; 95% CI, 1.10-105.17) compared to baseline negative H.pylori. H.pylori infection is an independent risk factor for gastric regenerating atypia. Eradication of H.pylori seems helpful for regression of regenerating atypia.

480 The characteristics of patients with persistent HHV-6 infection after drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS)

Background: Drug-induced hypersensitivity syndrome/drug reaction with eosinophilia and systemic symptoms (DIHS/DRESS) is characterized by fever, cutaneous eruptions, hematological abnormalities, organ disorder, and reactivation of human herpesvirus 6 (HHV-6). In addition, autoimmune diseases such as type 1 diabetes and thyroiditis may develop long-term after resolution of DIHS. Reactivation of HHV-6 has been reported to be involved in clinical condition of DIHS. We found that quite a few patients harbor high levels (> 1000 copies / 106 PBMC) of HHV-6 DNA in PBMC over 4 months after onset of DIHS. However, it is unclear what effects persistent HHV-6 infection has on DIHS patients in chronic phase. Methods: We analyzed clinical symptoms, blood test findings, reactivation of herpes virus, expression of serum cytokines (IL-4, IL-5, IL-10, IFN-γ) and soluble IL-2 receptor for 8 DIHS patients with persistent HHV-6 infection and 10 patients with transient HHV-6 infection. Results: Compared to the transient HHV-6 infection group, persistent HHV-6 infection group showed 1) more severe acute phase cutaneous and mucosal eruptions, 2) higher levels of HHV-6 DNA in acute phase, 3) higher rate of cytomegalovirus reactivation, 4) higher levels of IL-4 in acute phase and higher levels of soluble IL-2 receptor in late phase, 5) higher rate of long-term complications (ie, interstitial nephritis, arthritis, thyroiditis). Conclusion: Persistent HHV-6 infection may have some influence on the pathological and immunological conditions of DIHS and may be involved in the clinical course and prognosis.

Diagnostic Utility of HPV16 E6 mRNA or E7 mRNA Quantitative Expression for Cervical Cells of Patients with Dysplasia and Carcinoma

Current human papillomavirus (HPV)16 DNA testing has high sensitivity but low specificity, while mRNA testing (qualitative) improves the specificity. However, both techniques are not able to discriminate between transient and persistent infections. To overcome the disadvantages, we quantitatively detected E6 and E7 mRNAs by quantitative real-time polymerase chain reaction (qRT-PCR) in cervical brushing cells from 87 HPV16+ and 31 HPV16− patients. Our results showed that the expression levels of E6 mRNA or E7 mRNA were significantly increased in HPV16-positive cases than that in the negative cases. Furthermore, in HPV16+ cases, the expression levels of E6 mRNA were significantly increased in invasive cancer compared with high-grade squamous intraepithelial lesion (HSIL; p < 0.01), and HSIL compared with low-grade squamous intraepithelial lesion (LSIL; p < 0.01). There were no significant changes between LSIL and benign lesions. The expression levels of E7 mRNA presented no significant difference among the above-mentioned four groups. To test whether qRT-PCR can discriminate between transient and persistent infections, 57 HPV16+ patients were followed up for 1 year, and our results demonstrated that the expression levels of both E6 mRNA and E7 mRNA in the persistent infection group were significantly increased relative to the transient infection group (p < 0.01 or 0.05). Thus, a quantitative detection of the expression levels of E6 mRNA in cervical brushing cells may not only be used as an ancillary tool to cytological diagnosis of cervical neoplasia, but may also help to determine the severity of the lesions and the triage of transient infection.

The genetic polymorphism of CYP7A1 in Fujian Han HBV infected patients

Objective The study aims to investigate the associationbetweencholesterol 7α-hydroxylase (CYP7A1) gene polymorphism and different clinical outcomes after Hepatitis B virus (HBV) infection in Fujian Han population and lay a foundation for understanding the mechanisms of genesis and development of HBV-related diseases. Methods Case-control study was conducted.586 patients of HBV persistent infection without antiviral therapy and 225 HBV rehabilitation patients(35-55 years old) were collected from May 2015 to June 2016 in the Liverish Center of First Clinical College of Fujian Medical University.The group of HBV persistent infection without antiviral therapy included 246 patients with chronic hepatitis B, 177 patients with hepatitis B-related cirrhosis, and 163 patients with hepatitis B-related liver cancer.The rs3824260, rs4738687and rs8192871 loci of CYP7A1 gene were detected by improved multiple ligase detection reaction (iMLDR). Logistic regression analysis and chi-square test were used to analyze the genotyping results. Results Three SNPs (single nucleotide polymorphisms) of CYP7A1 gene were selected and compared between HBV persistent infection group and HBV rehabilitation group and between chronic hepatitis B subgroup, liver cirrhosis subgroup and liver cancer subgroup. After adjustment for factors including age andgender, there was no significant difference in the distribution of rs3824260 genotype among the groups(χ2=1.565, P=0.459), however, the frequency of allele C in HBV rehabilitation group was significantly higher than in HBV persistent in fectiongroup for men(χ2=4.365, P=0.037), whereas the frequency of rs3824260 CC and CT was more likely to be observed in liver cancer group than in non-liver cancer group (chronic hepatitis B subgroup and liver cirrhosis subgroup) for women (χ2=5.768, P=0.012; χ2=10.130, P=0.001). The frequency of rs4738687 GG genotype was more likely to be observed in non-liver cancer group than in liver cancer group (χ2=4.403, P=0.041; χ2=6.940, P=0.009). The results of gender stratification showed that there were significant differences in the distribution of rs4738687 among the HBV persistent infection groups for men(χ2=10.697, P=0.030), however, there was no significant difference in the distribution of rs4738687 among the HBV persistent infection groups for women(χ2=4.627, P=0.329), and there was no significant difference in the distribution of genotype frequency and allele frequency among all groups(χ2=0.489, P=0.792). There was no significant difference after sex stratification either(χ2=1.282, P=0.526; χ2=1.565, P=0.465). Conclusions These findings suggested that CYP7A1 gene polymorphism was related todifferent clinical outcomes in Fujian Han population. The rs3824260 mutation had a certain gender preference and the mutation allele was detected in a higher proportion in male patients. Male HBV patients with rs3824260 C allele had more chance of switching to rehabilitation. The rs4738687 was likely to be related to the occurrence of liver cancer in Fujian Han population, and GG genotype may delay the occurrence and development of liver cancer especially in the male group. The rs8192871 was not found to be related to the different clinical outcomes of HBV infection.(Chin J Lab Med, 2018, 41: 155-164) Key words: Hepatitis B virus; Polymorphism single nucleotide; Cholesterol 7-alpha-Hydroxylase

Simplified Method of Detection of Dialister invisus and Olsenella uli in Oral Cavity Samples by Polymerase Chain Reaction

Aims and Objectives: The oral microbial flora is highly complex and diverse with obligate anaerobic bacteria as the predominant component. Most of these are not yet cultivated/difficult to cultivate due to technical limitations. In this study, we aim to detect two novel oral bacterial species Dialister invisus and Olsenella uli by simplified and economical procedure of polymerase chain reaction (PCR) and study their association with primary and persistent endodontic infections. Material and Methods: The study involved 60 patients that included 30 patients of primary endodontic infections and 30 with persistent endodontic infections. The sample collection from the root canal was performed by universally accepted protocol by using sterile paper points. The deoxyribonucleic acid (DNA) extraction was done, followed by PCR with species specific primers. We made several changes to the protocol mentioned by original authors. We adopted a one-step protocol for amplification of bacterial DNA, omitting the 16SrDNA amplification step with universal primers. Results: It was seen that 7 (23.3 %) samples in primary endodontic infection group and 24 (80 %) samples in persistent endodontic infection group were positive for D. invisus. On the other hand, 11 (36.6 %) patients of primary endodontic infection showed positivity for O. uli in comparison to 9 (30 %) of persistent endodontic infection. Conclusion: The results from the present study showed efficient amplification of both O. uli and D. invisus in a single-step PCR. Hence, we conclude that the modified protocol used here with taq polymerase enzyme offers a faster and cheaper alternative to nested PCR without compromising the quality of amplification process.

Differences in Rab protein expressions in McCoy cells with acute versus persistent Chlamydia trachomatis infection

Objective To investigate differences in Rab protein expressions in McCoy cells with acute versus persistent Chlamydia trachomatis (Ct)infection. Methods Cultured McCoy cells were infected with different amounts(400, 500, 550 μl/well)of Ct strain D suspensions , then cultured with the medium containing 100 U/ml penicillin G(persistent Ct infection groups)or that without penicillin G (acute Ct infection groups). Ctuninfected McCoy cells receiving no penicillin G treatment served as the blank control group, and those receiving penicillin G treatment as the penicillin group. After 48-hour culture, McCoy cells were lysed, proteins were collected, and total RNA was extracted from the cells. Enzyme-linked immunosorbent assay (ELISA)was conducted to measure protein levels of Rab4A, Rab6A, Rab10, Rab11A and Rab14, and fluorescence-based quantitative PCR to quantify mRNA expressions of Rab4A and Rab14 (expressed as 2-ΔΔCt). Results Protein levels of Rab4A, Rab6A, Rab10, Rab11A and Rab14 were all significantly lower in the acute than in the persistent Ct infection groups (all Z = 3.621, P 0.05). In addition, the expressions of Rab4A and Rab14 mRNAs were consistent with those of their proteins in these groups. Conclusion The transcriptional and expression levels of Rab proteins are higher in McCoy cells persistently infected with Ct than in those acutely infected with Ct. Key words: Chlamydia trachomatis; Chlamydia infections; rab GTP-binding proteins; Acute infection; Persistent infection; McCoy cells

Recurrent Urinary Tract Infections Due to Bacterial Persistence or Reinfection in Women—Does This Factor Impact Upper Tract Imaging Findings?

We compared the rates of upper tract imaging abnormalities of recurrent urinary tract infections due to bacterial persistence or reinfection. Following institutional review board approval we reviewed a prospectively maintained database of women with documented recurrent urinary tract infections (3 or more per year) and trigonitis. We searched for demographic data, urine culture findings and findings on radiology interpreted upper tract imaging, including renal ultrasound, computerized tomography or excretory urogram. Patients with irretrievable images, absent or incomplete urine culture results for review, no imaging performed, an obvious source of recurrent urinary tract infections or a history of pyelonephritis were excluded from analysis. Of 289 women from 2006 to 2014 with symptomatic recurrent urinarytract infections 116 met study inclusion criteria. Mean ± SD age was 65.0 ± 14.4 years. Of the women 95% were white and 81% were postmenopausal. Almost a third were sexually active and none had prolapse stage 2or greater. Of the 116 women 48 (41%) had persistent and 68 (59%) had reinfection recurrent urinary tract infection. Imaging included ultrasound in 52 patients, computerized tomography in 26, ultrasound and computerized tomography in 31, and excretory urogram with ultrasound/computerized tomography in 7. Of the total of 58 imaging findings in 55 women 57 (98%) were noncontributory. One case (0.9%) of mild hydronephrosis was noted in the persistent recurrent urinary tract infection group but it was not related to any clinical parameters. Escherichia coli was the dominant bacteria in 71% of persistent and 47% of reinfection recurrent urinary tract infections in the most recently reported urine culture. This study reaffirms that upper tract imaging is not indicated for bacterial reinfection, recurrent urinary tract infections. However, the same conclusion can be extended to recurrent urinary tract infections secondary to bacterial persistence, thus, questioning the routine practice of upper tract studies in white postmenopausal women with recurrent urinary tract infections and trigonitis.

HLA-DPB1 Variant Effect on Hepatitis B Virus Clearance and Liver Cirrhosis Development Among Southwest Chinese Population.

Background:Previous studies have shown that genetic variants in HLA-DP genes affect disease progression in hepatitis B virus (HBV) infection.Objectives:We aimed to evaluate possible association between HLA-DPB1 rs9277534 polymorphism and different clinical complications of hepatitis B virus (HBV) infection.Materials and Methods:Snapshot assay was used to investigate the association of rs9277534 polymorphism in 342 patients with persistent HBV infection and 342 age and gender-matched HBV spontaneous clearance controls. Patients were categorized into asymptomatic HBV carriers (AsC, n = 104), chronic hepatitis B (CHB, n = 116), and liver cirrhosis (LC, n = 122) subgroups.Results:There was a significantly higher proportion of the rs9277534 minor allele A in HBV spontaneous clearance control than that in HBV persistent infection group (OR = 0.58, 95%CI = 0.46-0.73, P < 0.0001). Genotypic analysis showed that GA and AA genotypes were associated with HBV spontaneous clearance (GA: OR = 0.56, 95%CI = 0.40-0.79, P = 0.019; AA: OR = 0.24, 95%CI = 0.14-0.44, P < 0.0001). A significant difference was found between AsC and LC groups in the distribution of AA genotype (OR = 9.32, 95%CI = 1.293-67.14, P = 0.027).Conclusions:Variant at rs9277534 could affect both the spontaneous clearance of HBV infection and progression from asymptomatic HBV carriers to HBV-related liver cirrhosis in Southwest Han Chinese population.

Polymorphisms in CISH gene are associated with persistent hepatitis B virus infection in Han Chinese population.

Background and AimCytokine-inducible SRC homology 2 domain protein (CISH) is the first member of the suppressors of cytokine signaling (SOCS) protein family. An association between multiple CISH polymorphisms and susceptibility to infectious diseases has been reported. This study aimed to investigate the possible association of these single nucleotide polymorphisms (SNPs) in CISH gene with different outcomes of Hepatitis B virus (HBV) infection.Methods1019 unrelated Chinese Han subjects, including 240 persistent asymptomatic HBV carriers, 217 chronic hepatitis B patients, 137 HBV-related liver cirrhosis patients, and 425 cases of spontaneously recovered HBV as controls, were studied. Four SNPs (rs622502, rs2239751, rs414171 and rs6768300) in CISH gene were genotyped with the snapshot technique. Transcriptional activity of the CISH promoter was assayed in vitro using the dual-luciferase reporter assay system.ResultsAt position rs414171, A allele and AA genotype frequencies were significantly higher in the HBV-resolved group as compared to the persistent HBV infection group. At position rs2239751, TT genotype was further observed in the HBV-resolved group. Using asymptomatic HBV carriers as controls, our results indicated that the rs414171 and rs2239751 polymorphisms were unrelated to HBV progression. The other two SNPs (rs622502 and rs6768300) showed no association with persistent HBV infection. Haplotype analysis revealed that the GGCA haplotype was associated with spontaneous clearance of HBV in this population. Moreover, luciferase activity was significantly higher in the PGL3-Basic-rs414171T construct as compared to the PGL3-Basic-rs414171A construct (p<0.001).ConclusionTwo SNPs (rs414171 and rs2239751) in the CISH gene were associated with persistent HBV infection in Han Chinese population, but not with HBV progression.

CD4+/CD25+ T cells suppress autologous CD4+/CD25- lymphocytes and secrete granzyme B during acute and chronic hepatitis C

We aimed to verify whether CD4(+)/CD25(+) T cells suppress CD4(+) T cells and secrete Granzyme B (GZB) during acute and chronic hepatitis C (CHC) infection. We enrolled 50 subjects: 20 patients with CHC (Group A), 15 healthy individuals (Group B), 10 patients with acute hepatitis C later evolved to persistent infection (Group C) and five patients who resolved hepatitis C virus infection during acute phase (Group D). We analysed, on enrolled subjects CD4(+)/CD25(+) T cells and related GZB production as well as Annexin V activity. Patients from Groups A and C had higher frequency and function of peripheral Treg cells than healthy individuals. Groups A and C showed an increase in spot-forming colonies (SFCs) of GZB compared with Group B (P < 0.01, Mann-Whitney U-test). CD4(+)/CD25(+) T cells in Group D had a lower number of GZB SFCs compared with Groups A and C but higher number than Group B (P < 0.01 Mann-Whitney U-test). Annexin V production was higher in Groups A and C than B or D. Patients having acute and chronic hepatitis C have a higher Treg frequency and function in peripheral blood than healthy controls or those resolving the infection in acute phase secreting GZB, probably inducing apoptosis.

Failure of Helicobacter pylori eradication and age are independent risk factors for recurrent neoplasia after endoscopic resection of early gastric cancer in 283 patients

Whether the incidence of metachronous gastric dysplasia and cancer could be decreased by eradication of Helicobacter pylori after endoscopic submucosal dissection (ESD) for early gastric cancer (EGC). To compare the incidence of metachronous gastric lesion in the eradicated group and the persistent group. Second end point is to evaluate the risk factors for metachronous gastric lesions after ESD for EGC. In a single centre, between May 2007 and May 2010, the patients who had evidence of H. pylori infection at the time of ESD for EGC were included, and the follow-up data were analysed retrospectively. We enrolled 283 patients who have shown H. pylori infection at the time of ESD for EGC. Successful eradication was achieved for 214 patients (75.6%) (Eradicated group), and 69 patients (24.4%) showed persistent H. pylori infection (Persistent group). Metachronous gastric lesions developed in 13 (18.8%) in the persistent group and 18 (8.4%) in the eradicated group (P=0.016). In the ≥60-year-old group, the cumulative incidence of metachronous gastric cancer showed a significant increase (P=0.012). Cumulative hazard ratio of subsequent gastric metachronous lesions differed between the eradication group and the persistent infection group (OR=2.322, 95% CI=1.136-4.744, P=0.021), and ≥60 age at the time of endoscopic resection (OR=2.803, 95% CI=1.207-6.509, P=0.016). Both persistent H. pylori infection and old age (≥60) are independent risk factors for the increased incidence of metachronous gastric cancer.

Association of Human Leukocyte Antigen Class I Polymorphism with Spontaneous Clearance of Hepatitis B Surface Antigen in Qidong Han Population

Aim. To investigate whether HLA class I polymorphisms could influence the clearance of hepatitis B surface antigen (HBsAg) in Qidong Han population. Methods. We genotyped HLA-A, -B, and -C loci of 448 individuals with HBV persistent infection and 140 persons with spontaneous clearance of HBsAg by polymerase chain reaction with sequencing based typing (PCR/SBT). All the individuals were unrelated males enrolled from Qidong Han population and were followed up for 10 years. Results. The frequency of HLA-A∗33:03:01G was increased in persistent HBV infection group (P value is 0.028), while frequency of HLA-B∗13:01:01G was increased in HBsAg clearance group (P value is 0.0004). Conclusion. These findings suggested that the host HLA class I polymorphism is an important factor in determining the outcomes of HBV infection.

The Relationship between Tumor Necrosis Factor-α Polymorphisms and Hepatitis C Virus Infection: A Systematic Review and Meta-Analysis

Background and aims: Hepatitis C virus (HCV) is now recognized as one of the major causes of chronic liver disease. It is also one of the most common complications in maintenance hemodialysis (HD) patients. Tumor necrosis factor (TNF)-α promoter polymorphisms are observed to modulate TNF-α levels and thought to have an effect on susceptibility to HCV infection and the virus clearance, but the results are inconsistent. In this study, a systematic review and meta-analysis of the published data was performed to evaluate the relationship between the TNF-α-238, -308 polymorphisms and HCV infection. Methods: A total of 15 studies published were analyzed, which were indexed from PubMed, Embase, and CNKI databases (up to December 2010). All the data were analyzed using RevMan 4.2 software. Odds ratios (OR) and confidence intervals (95% CI) were calculated by fixed or random-effects models. Heterogeneity and publication bias across the studies were also explored. Results: The data showed no significant association between TNF-α-308, -238 gene polymorphisms and the susceptibility to HCV infection in the global group (p = 0.28, p = 0.38, respectively) and the sub-groups (European, American, African, and Asian). Besides, the distributions of TNF-α-308, -238 A/G alleles were also not significantly different between the persistent infection group and the spontaneous clearance group (p = 0.64, p = 0.75, respectively). Conclusion: TNF-α-238, -308 gene polymorphisms might have no effect on susceptibility to HCV infection and the virus clearance. The findings of this meta-analysis have implications in the optimal prevention of HCV in HD patients and in the guidance of future research.