Christine Kukka:HBV杂志回顾 2012年11月1号，第9卷，第11号

StephenW

HBV杂志回顾
2012年11月1号，第9卷，第11号
Hepatitis B Accompanied Humans Out of Africa 33,600 Years Ago

How old is the hepatitis B virus? When did it first infect humans? Where did it originate?

University of Athens researchers compared the timeline of human migration out of Africa with the evolution and dispersal of the hepatitis B virus (HBV) and its various strains (genotypes) and concluded that the virus first infected humans about 33,600 years ago in Africa and followed them on their migration around the globe.

"Our study provides, for the first time, an estimated timescale for the HBV epidemic that closely coincides with dates of human dispersals, supporting the hypothesis that HBV has been co-expanding and co-migrating with human populations for the last 40,000 years," researchers concluded in the October issue of Hepatology.

Each HBV genotype is found in a distinct region of the world, and its subgenotypes are also found in specific geographic areas. Researchers sampled HBV in indigenous populations around the world, in hopes of documenting HBV that may have migrated out of Africa and then evolved in place over thousands of years.

They studied the genotypes and subgenotypes of Australian Aborigines (who have genotype C), Amerindians in South America (genotype F), Amerindians in Central and North America (genotype H). These suggest, "...an ancient introduction of the (genotype) G/H ancestral strains to the Americas, certainly occurring before the recent European colonization."

HBV from isolated people, including Canadian arctic First Nations people (genotype B6), and those in Papua Indonesia and the Pacific islands (a variety of C subgenotypes), form distinct strains resulting from different waves of human migration.

Genotype C, researchers suggest, shows up in the earliest migrating groups out of Africa, including the Aborigines. To test this hypothesis of slow viral evolution, researchers examined the molecular make-up of HBV DNA recovered from a Korean mummy dating back to the 16th century.

The mummy's genotype was C, which may have originated in Australia and worked its way up through Asia with migrating humans, "confirming that HBV is a slow evolving pathogen and that its genotypes and subgenotypes were shaped long before the 16th century."

Genotype A, which originated early in Africa (and can be found among Haitians whose ancestors were transported there as slaves from Africa more than 300 years ago), also journeyed with humans north to Europe about 5,000 years ago, as evidenced by the various HBV genotype A subtypes in Europe.

The researchers suggest the humanoids who migrated out of Africa, carrying the virus, left behind Homo sapiens who died out or were replaced by more recent population expansions, which is why only one HBV genotype A subgroup is now found in Africa.

If HBV has been infecting humans for so long, why has its liver-damaging symptoms remained unnoticed and largely undocumented for centuries?

Because, scientists wrote, it takes about 40 to 60 years for the virus to cause noticeable liver damage and death in humans. Until about 150 years ago, the average human lifespan was less than 40 years.
B型肝炎伴随着人类33600年前走出非洲

B型肝炎病毒有多大年纪？它是什么时候第一次感染人类？它是在哪里起源的？

雅典大学研究人员比较了人类迁徙的时间表非洲的演变和传播的乙肝病毒（HBV）和它的各种株（基因型），并得出结论，病毒首先感染人类33600年前在非洲和跟在他们后面他们在全球各地的移民。

“我们的研究，第一次，提供紧密人类疏散与日期相一致，支持这一假设的HBV一直合作扩大和合作与人群最后40000年，迁移为HBV流行病的估计时间刻度”研究人员得出结论，在10月号的杂志。

每个HBV基因型在不同地区的世界，它的的亚型还发现，在特定的地理区域。研究人员采样HBV在世界各地的土著人群，希望能记录HBV可能迁移出非洲，然后在几千年的地方发展。

他们研究的澳洲原住民的基因型和基因亚型（有C基因型的人），在南美洲的印第安人（基因型F），美洲印第安人在中美洲和北美洲（基因型H）。这些建议，“......一个古老的（基因型）G / H祖株美洲引进的，肯定是发生在最近的欧洲殖民”。

HBV孤立的人，包括加拿大北极地区第一个国家人（基因型B6），并在巴布亚印度尼西亚和太平洋岛屿（各种规格的C亚型），形成不同的菌株产生不同的人类迁徙浪潮。

C基因型，研究人员建议，在最早的迁移组的非洲，包括原住民。为了验证这一假说的慢病毒的进化，研究人员检查，使HBV DNA分子从韩国木乃伊可以追溯到16世纪的恢复。

这具木乃伊的基因型为C，可能起源于澳大利亚和工作的方式，从亚洲迁移人类“，确认乙肝病毒是一个缓慢的演变中的病原体和其基因型和亚型被塑造16世纪的前。”

基因型A，它起源早在非洲（可以发现其中海地人的祖先有超过300年前从非洲的奴隶被运），也与人类北同行的欧洲大约在5000年前，就证明了不同的HBV基因型在欧洲的一个亚型。

研究人员建议迁移出非洲，携带的病毒，留下智人谁死了或者被替换了近期的种群扩张，这是为什么只有一个HBV基因型的亚组，现在在非洲发现的类人型机器人。

如果HBV感染人类了这么久，为什么有其肝损害的症状仍然被忽视，主要是无证几个世纪呢？

因为，科学家们写道，需时约40至60岁的病毒在人类引起明显的肝损伤和死亡。直到大约150年前，人类的平均寿命不到40岁。


Surprise Discovery: Diabetes Drug Prevents Liver Cancer

Two separate studies presented at the 2012 Digestive Disease Week convocation show that the common diabetes drug metformin has an unexpected quality—it prevents liver cancer.

Previous studies have suggested that metformin, which helps cells absorb insulin, may prevent several cancers and in one study it slowed liver tumor development in mice with chemically-induced liver tumors.

People with diabetes have a 2.5-fold higher risk of developing liver cancer. The Taiwanese study presented at the conference compared liver cancer rates in diabetics who took metformin and those who did not take the drug. Those who did not take metformin were at far higher risk of liver cancer than those who took it regularly.

For every year of metformin use, patients with diabetes had a 7% decrease in liver cancer. A second study from Mayo Clinic that compared diabetic patients who took metformin against those who did not, found the drug reduced liver cancer risk by an astonishing 60%.

The findings are preliminary and will not result in immediate prescribing of metformin for hepatitis B patients with cirrhosis who are at risk of cancer, but larger studies are underway to verify the findings.
惊喜的发现：糖尿病药物预防肝癌

两个独立的研究发表在2012年消化疾病周召开秀，常见的糖尿病治疗药物二甲双胍有一个意想不到的品质，它可以防止肝癌。

以前的研究表明，二甲双胍，这有助于细胞吸收胰岛素，可能防止几种癌症，在一项研究中，它减缓化学诱导的肝肿瘤的小鼠中肝脏肿瘤的发展。

患有糖尿病的人有一个高2.5倍，罹患肝癌的风险。台湾在会议上提出的研究相比，肝脏的癌症发病率在糖尿病患者中，二甲双胍和那些谁没有服用此药。这些谁没有采取二甲双胍远远高于肝癌的风险比那些经常把它。

每年的使用二甲双胍，糖尿病患者减少了7％，在肝癌。第二项研究中，梅奥诊所的糖尿病患者相比，二甲双胍对那些谁没有，发现了惊人的60％的药物降低肝癌的风险。

结果是初步的，并不会造成直接的处方二甲双胍治疗乙肝肝硬化患者，在患癌症的风险，但更大规模的研究正在进行中，以验证结果。
Statins Also Appear to Prevent Liver Cancer

Statins, used to lower cholesterol levels, appear also able to prevent or lower the risk of liver cancer, especially in people with Asian ethnicity, according to a report published in the October issue of Gastroenterology.

Statins lower cholesterol by blocking a chemical in the liver that is needed to generate cholesterol. Mayo Clinic researchers examined numerous studies that compared liver cancer in people who used statins and those who did not. Ten studies involving 4,298 cases of liver cancer in 1.5 million patients were analyzed.

Statin users were less likely to develop liver cancer than non-users in all patient populations, but especially among Asian patients with hepatitis B.

Researchers called for additional studies to see if statins could one day be prescribed to prevent cancer in people with viral hepatitis.
此外，他汀类药物预防肝癌

他汀类药物，用于降低胆固醇水平，似乎也能防止或降低肝癌的风险，尤其是在亚洲人种的人，根据一份报告发表在10月消化问题。

他汀类药物降低胆固醇的生成所需要的胆固醇在肝脏中，通过阻断一种化学品。梅奥诊所的研究人员研究了大量的研究，肝癌的人使用他汀类药物和那些谁没有。十项研究，涉及150万患者在肝癌4298案件进行了分析。

他汀类药物的用户比非患者人群中所有用户不太可能发展为肝癌，但特别是在亚洲与B型肝炎患者

研究人员呼吁更多的研究，看看他汀类药物可能有一天会规定，以防止癌症的人病毒性肝炎。
Researchers Uncover New Ways to Prevent Viral Replication

Two collaborating research groups from the University of Colorado Boulder and the Xiamen University in China may have uncovered an "Achilles heel" in the hepatitis B tumor-promoting protein called HBx that could allow new drugs to stop HBV replication.

The two studies, published in the October Proceedings of the National Academy of Sciences, identified two prime targets in liver cells that the HBx needs to enable viral replication.

The "host targets" of HBx in human liver cells, which are used for viral replication, are two small cell proteins known as Bcl-2 and Bcl-xL that help inhibit cell death.

HBx uses a "motif"--a strand of protein building blocks known as amino acids that resemble those seen in some cell death-causing proteins—to interact with the Bcl-2 and Bcl-xL to generate an increase in calcium in the host cell. The calcium elevation triggers both viral HBV replication and cell death.

When the researchers introduced gene mutations into the motif, HBx could not bind to the Bcl-2 and Bcl-xL proteins, nor could it reproduce in the liver cells and damage them. Also, when either Bcl-2 or Bcl-xL proteins in the liver cells were weakened, HBx was less able to finesse an increase in calcium and viral replication in the infected liver cell.

Now that researchers have identified the motif and the two HBx targets, scientists can start developing drugs that target the motif and two proteins to prevent HBV replication.

In one of the studies, researchers used a tiny roundworm known as C. elegans, a widely used animal model in biomedical research, to identify HBx host targets within the cell. This roundworm has never been used in hepatitis research and scientists hope this new model will "galvanize" hepatitis B research into identifying host "targets" in liver cells that HBV must bind to in order to replicate.
研究人员发现新的方法来防止病毒复制

两个从美国科罗拉多州博尔德大学和中国厦门大学合作研究组发现B型肝炎肿瘤，促进蛋白质HBx蛋白，可以让新的药物来阻止HBV复制的“阿喀琉斯之踵”。

这两项研究，发表在10月的美国国家科学院论文集，确定了两国总理在肝细胞内的目标，HBx的需要，使病毒的复制。

“主机目标”的HBx蛋白在人类肝细胞，用于病毒复制，被称为Bcl-2和Bcl-xL的两个小细胞的蛋白质，，帮助抑制细胞死亡。

HBx蛋白采用的是“主题” - 一个被称为氨基酸，类似于那些在一些细胞死亡的蛋白质积木链导致蛋白与Bcl-2和Bcl-xL的相互作用产生增加钙在主机细胞。钙的升高触发了病毒HBV复制和细胞死亡。

当研究人员介绍了基因突变的主题，HBX不能绑定到Bcl-2和Bcl-xL的蛋白，也可能在肝细胞内复制和破坏。此外，被削弱时，无论在肝细胞内的Bcl-2或Bcl-xL的蛋白，HBx蛋白是不太能够精细度的增加钙和在受感染的肝细胞的病毒复制。

现在，研究人员已经确定的主题和HBx的目标，科学家们可以开始发展为目标的主题和两种蛋白质以防止乙肝病毒复制的药物。

在其中一项研究中，研究人员利用一种微小的蛔虫，线虫，一种广泛使用的生物医学研究的动物模型，HBx蛋白的宿主细胞内的目标识别。蛔虫从未使用过肝炎的研究和科学家希望这种新的模式将“促成”B型肝炎研究确定主机的“目标”，乙肝病毒在肝细胞内必须绑定到以复制。

HBV Genotype D Associated with “Spontaneous” Viral Mutations

What role do genotypes play in viral mutations and loss of the hepatitis B e antigen (HBeAg)? A group of University of Miami researchers examined the HBV DNA of 213 southern Florida, multi-ethnic residents who had a mix of HBV genotypes to see how genotype influenced disease progression.

Patients were predominantly male (67%); 61 (31%) were African-American, 60 (28%) were Hispanic, 37 (17%) were Haitian, 27 (19%) were white, and 14 (6.6%) were of Asian ethnicity.

Genotype A was found in 101 (69%), D in 25 (17%), F in 9 (6%), G in 7 (5%), C and E in 6 (4%) each, B in 4 (3%), and H in 2 (1%) patients. Interestingly, a mix of genotypes were found in 11 patients.

Genotype A was more prevalent in all ethnicities except among Asians. Among HBeAg-negative patients (59%), basal core mutations, precore, and a combination of the two mutations were found in 30 (37.5%), 13 (16.3%), and 14 (17.5%), respectively. Genotype D was associated with higher rate of HBeAg- negative status and mutations.

PC mutations were more common in genotype D than genotype A. Researchers, reporting in the October issue of the Journal of Clinical Gastroenterology, found that 100% and 79% of Asians and Haitians had spontaneous mutations, with no drug resistance-related mutations. All Haitians with genotype D had precore mutations.
HBV基因型D与“自燃”的病毒突变

什么样的作用的基因型发挥在B型肝炎e抗原（HBeAg）病毒变异和损失？ A组的迈阿密大学研究人员研究的HBV DNA 213佛罗里达州南部，居民的多民族混合的HBV基因型，基因型如何影响疾病的进展。

患者以男性为主（67％），61例（31％）是非裔美国人，60（28％）是西班牙裔美国人中，有37例（17％）是海地，27（19％）是白人，和14（6.6％），亚洲人种。

A基因型，发现在101个（69％），D 25（17％），9（6％），F，G的7（5％），C和E，6（4％）各4个，B（ 3％），和H 2（1％）的患者。有趣的是，混合型11例。

A基因型以外的所有种族在亚洲人中更为普遍。在HBeAg阴性患者（59％），基本核心突变，前C区，并结合两个突变被发现在30（37.5％），13例（16.3％），14（17.5％），分别。 D基因型与HBeAg阴性的状态和突变率较高。

PC突变多见于D基因型比A基因型的研究人员，在临床胃肠病学杂志十月号的报告发现，100％和79％的亚洲人和海地人自发突变，无耐药性相关的突变。所有海地人与D基因型前C区突变。

Antivirals Safe in Patients with Severe Cirrhosis

Researchers are studying whether antivirals are safe to treat vulnerable patients with severe hepatitis B-related liver damage. They reviewed eight studies involving 511 patients with decompensated cirrhosis--when the liver is extensively scarred and unable to function properly, which can lead to life-threatening complications.

According to their report published in the journal Digestive Diseases and Sciences, lamivudine (Epivir-HBV) and telbivudine (Tyzeka) significantly decreased patients' death rate, improved liver health, and promoted HBeAg seroconversion (loss of the "e" antigen and development of the "e" antibody).

In an unrelated article published in the journal Clinical Gastroenterology and Hepatology, researchers evaluated the effectiveness of lamivudine, entecavir (Baraclude) and tenofovir (Viread) in patients with moderate and cirrhosis. They followed 227 patients, 104 of whom had decompensated cirrhosis (severe). Seventy-two received tenofovir, 77 received entecavir, and 74 received lamivudine for two or more years.

Undetectable HBV DNA (less than 400 copies/mL) were achieved in 91.5%, 92.5%, and 77% of patients receiving tenofovir, entecavir, or lamivudine respectively, with 86.8%, 92.1%, and 71.8% achieving normal ALT levels with tenofovir, entecavir, and lamivudine respectively.

Liver biopsies showed improved liver health in 8.5% receiving tenofovir, 15.6% receiving entecavir, and 27.4% received lamivudine.

Lamivudine had to be changed to another drug in 32.4% of the patients because of drug resistance. Researchers recommend tenofovir and entecavir for long-term use in patients with either compensated or decompensated cirrhosis.
合并重度肝硬化的抗病毒药物安全

研究人员正在研究是否抗病毒药物治疗严重的B型肝炎相关的肝损害脆弱的病人是安全的。他们审查了八个研究涉及511例肝硬化失代偿期 - 当肝脏是广泛伤痕累累，无法正常工作，这可能会导致危及生命的并发症。

根据他们的报告发表在杂志上消化道疾病和科学，贺普丁（拉米HBV）和替比夫定（Tyzeka）能显着降低患者的死亡率，改善肝脏的健康，促进HBeAg血清学转换（亏损的“e”抗原与发展的“e”抗体）。

在无关的杂志临床胃肠病学和肝病学杂志发表的一篇文章中，研究人员评估在中度和肝硬化的患者，拉米夫定，恩替卡韦（博路定）和替诺福韦（VIREAD的）。他们遵循了227名患者，其中104人已经失代偿期肝硬化（重度）。 77收到72个替诺福韦，恩替卡韦，74位接受拉米夫定治疗两年或两年以上。

检测不到HBV DNA（小于400拷贝/毫升）达到91.5％，92.5％，77％的患者接受替诺福韦，恩替卡韦和拉米夫定，86.8％，92.1％和71.8％，实现正常的ALT水平与替诺福韦，恩替卡韦和拉米夫定。

8.5％，接受替诺福韦，肝活检显示改善肝脏的健康，接受恩替卡韦15.6％，27.4％接受拉米夫定。

拉米夫定，就必须改变另一种药物，32.4％的患者由于耐药性。研究人员建议任何补偿或代偿期肝硬化患者长期使用恩替卡韦和替诺福韦。
Elevated ALTs and Body Mass Index Increases Diabetes Risk

People infected with HBV who have a higher body mass index (BMI) and elevated alanine aminotransferase (ALT) levels are at higher risk of diabetes (insulin resistance) according to a study published in a recent Chinese medical journal (PubMed 23044237).

Researchers compared 68 hepatitis B patients with and without diabetes with a group of uninfected people who had normal ALT levels.

Compared to the healthy people in the study, people infected with HBV with elevated ALT levels had higher rates of diabetes.

Diabetes was detected in 44.12% (30 of the 68) hepatitis B patients. The levels of ALT and BMI were significantly different between the hepatitis B patients with diabetes and without diabetes.

Researchers concluded that elevated ALT and high BMI in hepatitis B patients also increased their risk of diabetes.
升高的低价竞标和身体质量指数增加患糖尿病的风险

根据（医学23044237）在最近的一次中国现代医学杂志发表的一项研究显示，人感染乙肝病毒的人有较高的身体质量指数（BMI）和谷丙转氨酶升高（ALT）水平是在高风险的糖尿病（胰岛素抵抗）。

研究人员比较了68乙型肝炎患者和无糖尿病的一组ALT水平正常的未感染的人。

在研究健康人相比，人感染乙肝病毒的ALT水平升高的糖尿病的发生率较高。

44.12％（30对68），B型肝炎患者中检测到糖尿病。 B型肝炎，糖尿病患者和无糖尿病的ALT水平和BMI显着差异。

研究人员得出结论乙型肝炎患者ALT升高和高BMI也增加了他们患糖尿病的风险。

Mutations in Surface Antigen Increase Liver Cancer Risk in Older Patients

A team of Korean researchers followed 195 patients (average age 44, 72.3% male, 56% HBeAg-positive, all genotype C, and 40.5% with cirrhosis) for seven years to see which patients developed liver cancer.

They found that those who had a pre-S mutation (a mutation in the hepatitis B surface antigen (HBsAg) that enables it to avoid detection by most lab tests) were at higher risk of liver cancer.

They reported in the journal Digestive Diseases and Sciences that 22.6% of the 195 patients had the surface antigen mutation. Patients with the surface mutation had significantly higher liver cancer diagnoses at five years than those without the mutation (26.5% vs. 5.7 %).

Patients older than 50 with the mutation were at notably higher risk of liver cancer (58.3 %) compared to those without the surface antigen mutation (16.1%).

Researchers called for heightened cancer surveillance in older patients with the surface mutation, also called “occult” hepatitis B.
老年患者表面抗原突变增加肝癌的风险

一组韩国研究人员随后七年例患者肝癌195例患者（平均年龄44岁，72.3％为男性，56％的HBeAg阳性，所有C基因型，肝硬化和40.5％）。

他们发现，那些谁了前-S基因突变（突变，使其能够避免大多数实验室测试检测乙肝表面抗原（HBsAg））在肝癌的风险较高。

他们的报告在杂志上消化道疾病与科学学院的195名患者中有22.6％的表面抗原突变。表面突变的患者在五年比那些无变异（26.5％对5.7％）有显着较高的肝癌诊断。

特别是肝癌的风险较高（58.3％）比那些没有表面抗原突变（16.1％），50岁以上患者的突变。

研究人员呼吁提高癌症监测在老年患者中的表面突变，也被称为“隐匿”B型肝炎


Many with HIV Also Infected with “Occult” Hepatitis B

A study of 298 HIV-infected South Africans found most who were coinfected with hepatitis B tested negative for the surface antigens and had “occult” hepatitis B. Only a sensitive lab test that screened for HBV DNA was able to identify their HBV infection.

Increasingly, physicians and researchers are discovering that mutations in HBV and other dynamics make it difficult to identify hepatitis B infections in HIV- and hepatitis C-infected people, unless a highly sensitive HBV DNA test is used.

In this study published in PLoS One, researchers stressed the need to test people at risk of hepatitis B using sensitive nucleic acid testing, so the infection can be identified and appropriately treated.
许多艾滋病毒感染者也感染了“隐匿”B型肝炎

298艾滋病毒感染南非的研究发现，大多数合并感染B型肝炎表面抗原检测结果呈阴性，并有“隐匿”B型肝炎敏感的实验室试验，筛选出HBV DNA能够识别其HBV感染。

越来越多的医生和研究人员都发现，在HBV的突变和其他动态很难确定B型肝炎感染艾滋病毒和丙型肝炎病毒感染者，除非一个高度敏感的HBV DNA测试是用来。

发表在PLoS ONE在这项研究中，研究人员强调，需要测试的人在使用敏感的核酸检测B型肝炎的风险，因此可以识别和适当处理的感染。

Patients with Genotype A, and Past Interferon Treatment, More Likely to Clear HBsAg During Antiviral Treatment

Japanese researchers followed 442 HBeAg-positive patients and 349 HBeAg-negative patients who were treated with antivirals over nine years to see which ones were able to clear the virus.

Eighteen (4.1%) of HBeAg-positive patients and 20 (5.7 %) of the HBeAg-negative patients cleared surface antigen over the nine years.

Among HBeAg-positive patients who cleared the virus were patients who:

    Had been previously treated with interferon

    Had genotype A

    Experienced a 0.5 log IU/mL decline or more of HBsAg levels within six months of starting treatment

    And lost HBeAg after six months of treatment.

Among HBeAg-negative patients, those most likely to clear the virus during antiviral treatment:

    Had also been treated with interferon

    Had genotype A

    Had experienced a significant decline in HBsAg during the first six months of treatment

    And had low HBsAg levels, less than 730 IU/mL, when they started treatment, according to the report in the Journal of Gastroenterology.
A基因型病人，和过去的干扰素治疗，在抗病毒治疗中更容易清除乙肝表面抗原

日本研究人员随访了442例HBeAg阳性患者和349例HBeAg阴性患者使用抗病毒药物治疗，九年来看看哪些是能够清除病毒。

十八（4.1％）的HBeAg阳性患者和HBeAg阴性患者中有20（5.7％）清除表面抗原九年。

在清除病毒的HBeAg阳性患者，患者谁：

    以前曾用干扰素治疗

    有A基因型

    开始治疗后的6个月内经历了0.5日志IU / mL的HBsAg水平下降或以上

    失去了6个月的治疗后HBeAg。

HBeAg阴性患者中，那些最有可能清除病毒的抗病毒治疗过程中：

    也已干扰素治疗

    有A基因型

    在第一个6个月的治疗经历了显着下降，乙肝表面抗原

    HBsAg水平低，小于730 IU / mL时，当他们开始接受治疗时，根据在胃肠病学杂志的报告。


Electronic Reminders Spur Physicians to Test Asian-Americans for HBV

Studies repeatedly have found that primary care physicians fail to adequately screen Asian-American patients for hepatitis B--because doctors don't know they should or they forget Asian-Americans are at high risk of hepatitis B.

A new study by the University of California Davis School of Medicine found that building in hepatitis B screening reminders into electronic medical record systems improves hepatitis B screening.

According to the report published in the journal of Digestives Diseases and Sciences, the record system was primed to remind providers to screen for HBV when patients had Chinese or Vietnamese surnames and there was no history of HBV testing in the patient's records.

The study revealed that when prompted by the electronic record, physicians tested 41% of at-risk patients for hepatitis B, while physicians who did not receive electronic reminders only checked 1% if their patients for hepatitis B.

As a result of these prompts, four (13.3 %) of patients tested were found to be HBsAg-positive, 14 (46.7 %) were immune, and 12 (40 %) were vulnerable to HBV and required immunization.

"(Electronic) provider prompts significantly increased HBV testing in Chinese and Vietnamese patients when compared to 'usual care,'" researchers wrote. "(Electronic) prompts are a promising intervention that could significantly increase screening for HBV."
电子提醒支线，医生要测试亚裔美国人HBV

研究一再发现，初级保健医生没有充分筛选亚洲和美国的B型肝炎患者 - 因为医生不知道他们或他们忘记了亚裔美国人是在高风险的B型肝炎

大学，加州大学戴维斯分校医学院的一项新研究发现，B型肝炎筛检催进电子病历系统的建设，改善B型肝炎筛检。

的消化疾病与科学“杂志发表的报告，备案制度底漆提醒HBV患者有中国或越南的姓氏和HBV测试病人的记录，也没有历史的屏幕供应商。

该研究显示，当提示的电子记录，医生测试，41％的B型肝炎的高危患者，而医生谁没有收到电子提示只检查了1％，如果他们的B型肝炎患者

这些结果提示，4（13.3％）的患者进行测试，发现HBsAg阳性，14例（46.7％）是免疫的，和12（40％），HBV和所需的免疫是脆弱的。

“（电子版）提供提示显着增加HBV测试时，在中国和越南的患者相比，”常规护理“，”研究人员写道。 “（电子版）的提示，可以显着提高筛查HBV是一种很有前途的干预。”

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