摘要:

Summary.Accumulated evidence in recent years has shown that the variation of hepatitis B virus (HBV) genomes may have profound implications for our understanding of hepatitis B pathogenesis and prevention. Attention has focused on areas of the outer envelope coded by the S gene which are involved in the induction of a protective neutralising antibody response, and mutations which directly affect the production of C gene products, one of which is considered as a target for immune T cells involved in virus clearance. This review highlights recent experimental data which emphasizes the role of such mutations in the establishment and maintenance of chronic HBV infections and focuses attention on the significance of HBV variants with respect to the expanding use of HBV vaccines for mass immunization.

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00024.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.Variations in the serum levels of hepatitis C virus (HCV) RNA, IgM antibody against the HCV ‘core’ structural protein (c22) and alanine aminotransferase (ALT) were measured in 23 patients with chronic hepatitis C who underwent therapy with interferon‐α2a (IFNα2a). Low pretreatment levels of viraemia and undetectable IgM anti‐core were significantly associated with a long‐term response to treatment. In patients with hepatitis relapses after the end of treatment, HCV RNA levels increased before or at the same time as ALT in 29 out of 34 cases (85%). ALT flares occurred before or simultaneously with IgM anti‐core elevations in 18 out of 20 cases (90%). Therefore, post‐treatment hepatitis C exacerbations show the same sequence of events seen as in hepatitis B exacerbations (increases of viraemia followed by those of ALT and IgM anti‐‘core’). These findings underscore the diagnostic and prognostic usefulness of monitoring anti‐HCV‐positive patients with quantitati

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00025.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.Several studies from Europe have observed a relationship between hepatitis C virus infection and anti‐liver/kidney microsome‐1 (anti‐LKM‐1) positive chronic hepatitis. It has been suggested that hepatitis C may induce an autoimmune phenomenon that leads to the development of a specific type (type II anti‐LKM‐1 positive) autoimmune chronic hepatitis. We evaluated 204 sera from patients with well‐documented hepatitis C infection from two centres in the United States of America and compared them with sera from 428 French patients from three centres. We evaluated the serological prevalence of anti‐smooth muscle antibodies, anti‐nuclear antibodies, anti‐liver cytosol antibodies, and anti‐mitochondrial antibodies subtype anti‐M2in patients with chronic hepatitis C. The two groups were matched in their ages, gender, mode of transmission of hepatitis C infection and severity of liver disease. Anti‐LKM‐1 was not observed in the patients from the USA at a time when it was noted in 3.7% of French patients. There were no differences, however, in the expression of other auto‐antibodies, which were often in low titres. Absence of anti‐LKM‐1 in USA sera in comparison with French sera suggests that there may be differences in induction of anti‐LKM‐1 related to environmental and/or host genetic factors, and/or genom

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00026.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.Ninety consecutive patients with chronic hepatitis C were included in a randomized, uncontrolled trial to compare the efficacy of two treatment regimens, 10 MU (group A)vs5 MU (group B), of lymphoblastoid interferon, in a step‐down schedule for 24 weeks. All of the patients had antibodies against the hepatitis C virus, and all but one were HCV RNA positive in serum. The origin of the infection was attributed to blood transfusion in 30 patients and classified as sporadic in 60 patients. During treatment reduction in the ALT levels as well as the elimination of viraemia was observed in both treated groups, although these changes did not correlate significantly with the interferon dose. Nine months after the end of therapy, a sustained response was achieved in 13.6% (12/88) of the patients. Relapse in group B (87.5%) was significantly higher than in group A (59.1%). The percentage of cases which remained with undetectable HCV RNA was significantly higher for the sustained responders (66.7%) than for the non‐responders (11.8%) and relapser patients (2.4%). Repeated liver biopsies showed an overall significant reduction of all the subindices of histological activity from patients with sustained response, except for fibrosis. In short: the 10 MU dosing regimen of lymphoblastoid interferon was as efficient as the 5 MU dose as it brought about a similar improvement in ALT levels, histological activity and elimination of viraemia, albeit 10 MU proved significantly more effective in the prevention of a relapse among the responders after 24 weeks ther

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00027.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.During 1990, 38 patients with fulminant non‐A, non‐B hepatitis (NANB) died in Government Medical College Hospital, Aurangabad. Serum samples from these patients were tested for antibodies to hepatitis C virus (anti‐HCV) and IgM antibodies to hepatitis E virus (IgM‐anti‐HEV). All samples were also subjected to polymerase chain reaction (PCR) for the detection of HBV DNA, HCV RNA and HEV RNA. None of the patients had circulating anti‐HCV antibodies; three had HCV RNA. Based on anti‐HEV‐IgM positivity 14 patients (37%) could be diagnosed as suffering from hepatitis E. None was positive for HEV RNA. In the absence of serological markers, HBV DNA was present in three cases. None of the HBV DNA positive patients had anti‐δ antibodies. Dual infections (HBV with HEV, and HBV with HCV) were seen in two cases. The aetiology of half of the NANB cases could not be assigned to the known hepatitis viruses using

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00028.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.To investigate the contribution of hepatitis C virus (HCV) to chronic liver disease and hepatocellular carcinoma (HCC) in Korea, antibodies to HCV (anti‐HCV) were tested by enzyme immunoassay in 1759 patients with chronic liver disease and HCC, and in 808 healthy adults. The prevalence of anti‐HCV was 1.6% in 808 controls. Anti‐HCV was present in 32 (7.7%) of 418 hepatitis B surface antigen (HBsAg)‐positive and 128 (53.1%) of 241 HBsAg‐negative patients with chronic hepatitis, 16 (6.0%) of 265 HBsAg‐positive and 90 (30.5%) of 295 HBsAg‐negative patients with liver cirrhosis, and 16 (4.8%) of 330 HBsAg‐positive and 61 (29.0%) of 210 HBsAg‐negative patients with HCC. Antibodies to hepatitis B core antigen (anti‐HBc) were present in 80–88% of patients who were seropositive for anti‐HCV and seronegative for HBsAg. Among the sera from 114 patients with HBsAg‐negative and anti‐HCV‐positive chronic liver diseases, HBV DNA and HCV RNA were detected by polymerase chain reaction (PCR) in 54 (47.4%) and 61 (53.3%), respectively. Both HBV DNA and HCV RNA were detected in 4 (4.4%) samples. The mean age of the patients with both HBsAg and anti‐HCV was not different from that of patients who were seropositive for HBsAg alone. These findings indicate that current and/or past HBV infection is still the main cause of chronic liver disease in Korea. Although multivariate analysis showed that anti‐HCV is a risk factor for chronic hepatitis, cirrhosis of the liver and HCC, PCR data for HBV DNA and HCV RNA indicate that HCV infection plays only a minor role in HBsAg‐positive as well as in HBsAg‐negative liver disease and does not accelerate t

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00029.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.5″ untranslated and partial core (C) region sequence of hepatitis C virus (HCV) in 21 Singaporean and 1 5 Indonesian isolates were amplified by reverse‐transcription polymerase chain reaction and sequenced with the use of conserved primer sequences deduced from HCV genomes identified in other geographical regions. The HCV genotypes are predominantly that of Simmonds type 1 and less of type 2 and 3 with the latter genotype currently not detected in Indonesia. The 5″ untranslated sequences are related to HCV‐1, DK‐7 (Denmark), US‐11 (United States of America), HCV‐J4, SA‐10 (South Africa), T‐3 (Taiwan), HCV‐J6, HCV‐J8, Eb‐1 and Eb‐8. When compared with the prototype HCV‐1, insertions are found within the 5″ untranslated region of Singaporean isolates and not in the Indonesians. There are Singaporean and Indonesian isolates that have sequences within the 5″ untranslated region that differ slightly from each other. Microheterogeneity is observed in the core region of two Singaporeans and one Indonesian isolate. Finally, not all HCV isolates can be amplified with the conserved core sequence primers when compared with the ease with which these isolates can be amplified with 5″ untr

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00030.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.It has recently been proposed that a depletion of glutathione (GSH) may be a contributing factor to viral persistence and resistance to interferon‐α (IFN‐α) therapy in chronic hepatitis C virus (HCV) infection. The aim of this study was: (1) to compare plasma GSH levels in patients with chronic HCV infection and normal healthy controls; and (2) to correlate GSH levels with liver histology and serum HCV RNA levels. Twenty‐four patients with compensated chronic hepatitis C and 2 7 healthy subjects were studied. Serum and heparinized plasma were prospectively prepared and frozen within 1 h of collection. Plasma glutathione and glutathione peroxidase (GP) levels were measured spectrophotometrically. The serum HCV RNA level was quantitated by the branched chain DNA signal‐amplification assay. Plasma GSH levels were not decreased in patients with chronic HCV infection but were actually greater than in controls (control 1.2 7 ± 0.12 μg ml‐1, HCV 1.62 ± 0.11 μg ml‐1,P<0.05). There was also no difference in plasma GP activity between these two groups (control 0.233 ± 0.007 U ml‐1, HCV 0.230 ± 0.007 U ml‐1). Among the patients with chronic HCV infection, there was no correlation between either plasma GSH or GP levels and the serum alanine aminotransferase (ALT) or aspartate aminotransferase (AST), serum HCV RNA level, or liver histology. This study demonstrates that chronic HCV infection does not decrease the p

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00031.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY

摘要:

Summary.To determine if chemiluminescence can be used in an enzyme immunoassay (EIA) format to test for hepatitis C virus (HCV) antibody and to compare sensitivity and specificity of chemiluminescence to a licensed anti‐HCV EIA method, random volunteer donor samples were evaluated. One thousand and seventy‐four random volunteer donor samples were collected during a 2‐week period. Two aliquots of each sample were tested for anti‐HCV. One aliquot was tested using a licensed anti‐HCV 2.0 EIA test. The second aliquot was tested using the research anti‐HCV chemiluminescence assay. Confirmatory testing was done using Recombinant Immuno Blot Assay (RIBA) 2.0 HCV and HCV RNA. Of the 1074 samples, eight were found to be reactive for anti‐HCV. Seven were positive by the anti‐HCV 2.0 EIA and the chemiluminescence system. The eighth sample was chemiluminescence reactive, but EIA negative; when tested by an unlicensed EIA 3.0 HCV test, RIBA 3.0 HCV test and an HCV‐RNA assay, the sample was still negative. The same sample was also tested by RIBA 2.0 HCV and showed a reactive band to SOD. The chemiluminescence assay has a 100% sensitivity and 99.9% specificity compared to EIA and can be used as an alternative to EIA for detecting

ISSN:1352-0504    

DOI:10.1111/j.1365-2893.1995.tb00032.x

出版商:Blackwell Publishing Ltd    

年代:1995

数据来源: WILEY