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本帖最后由 StephenW 于 2012-11-30 16:44 编辑
Vaccination May Not Protect Against HBV with Surface Antigen Mutation
接种疫苗可能无法防止表面抗原突变的乙肝病毒
In a disturbing development, researchers have documented the first case of infection with a mutated hepatitis B virus (HBV) that was able to infect a vaccinated man.
“The possibility of an infection with HBV despite an effective vaccination may pose a major health issue, requiring a change in routine diagnostic and screening programs,” German researchers wrote in the Journal of the International AIDS Society 2012.
The hepatitis B vaccine contains only the hepatitis B surface antigen (HBsAg) in order to trigger the immune system to create surface antibodies that are primed to attack if there was exposure to the real virus.
Recently, researchers have found patients with mutated HBsAg that are able to avoid the vaccine-induced or antiviral treatment-induced surface antibodies. They call these mutated viral proteins “vaccine escape” surface antigens because they can survive despite immunization.
However, this is the first documented case where “vaccine escape” HBV infected a previously-vaccinated person. According to the report, a young man who had sex with men was treated for a newly-diagnosed HIV infection. Because his alanine aminotransferase (ALT) levels were above normal–indicating liver damage–he was tested for hepatitis B. He tested negative for HBsAg and was found to have high levels of surface antibodies, probably due to his immunization.
But three months later, he was retested and this time he tested positive for HBsAg; his surface antibodies had vanished, and his HBV DNA load was high. When his HBV was analyzed, he was found to have HBV genotype F with the "vaccine escape" mutation in the surface antigen.
“Despite a fairly high CD4 count (indicating a strong immune system), the transmission may have been promoted by a loss of immunity through an acute HIV infection,” researchers noted. “Clinicians need to be aware of the possibility of HBV infections with mutant viruses.”
一个令人不安的发展，研究人员记录了首例感染与变异的乙肝病毒（HBV）感染接种疫苗的人。
“一个有效的疫苗接种的乙肝病毒感染的可能性，尽管可能会造成重大的健康问题，需要改变常规诊断和筛查项目”，杂志的国际艾滋病协会2012年德国研究人员写道。
B型肝炎疫苗，包含仅在B型肝炎表面抗原（HBsAg），以触发的免疫系统来创建表面都准备的抗体，该抗体攻击是否有暴露的真正的病毒。
最近，研究人员发现乙肝表面抗原突变的患者是能够避免的引起的疫苗或抗病毒药物治疗引起的表面抗体。他们称这些突变的病毒蛋白疫苗逃避“表面抗原，因为他们可以生存，尽管免疫接种。
然而，这是首次有记载的情况下，“疫苗逃避HBV感染了以前接种疫苗的人”。根据报告，一名年轻男子发生过性关系的男人被一个新确诊的HIV感染治疗。因为他的谷丙转氨酶（ALT）水平高于正常显示肝功能损害，他进行了测试他的测试结果为乙肝表面抗原阴性B型肝炎，被发现有高浓度的表面抗体，可能是由于他的免疫。
但3个月后，他被重新测试，这一次，他为乙肝表面抗原检测呈阳性，他的表面抗体已经消失了，和他的HBV DNA载量高。当他的HBV进行了分析，他发现有HBV基因型F“疫苗越狱”表面抗原突变。
“尽管有相当高的CD4细胞计数显示出强大的免疫系统，可能已经被提拔的传输通过一个急性HIV感染的免疫力下降，研究人员指出。” “临床医生需要意识到的突变病毒HBV感染的可能性。”
HBV-Infected Fathers Appear Not to Pose Infection Risk to Fetuses
HBV感染的父亲似乎不构成感染胎儿的风险
Men infected with HBV can safely have sex with their pregnant partners without posing an infection risk to the fetus, according to a report in the November issue of the International Journal of Infectious Diseases.
Chinese researchers followed 164 couples where the father was the only one infected with HBV. In all cases the wives had been immunized against hepatitis B. The doctors sampled the amniotic and cord fluid for HBV, and screened all infants for infection for one year after birth. All babies had been treated with hepatitis B immune globulin and immunized at birth.
None of the offspring of the HBV-infected fathers became infected. “The infection of fetuses with HBV from the spermatozoa of carrier fathers seems unlikely, especially in an area where pre-conception hepatitis B vaccination is routinely provided,” researchers concluded.
男性感染乙肝病毒可以安全地与他们怀孕的合作伙伴发生性关系，不构成对胎儿的感染风险，根据问题的国际传染病杂志在11月的一份报告。
中国研究人员随后164的父亲是唯一一个感染乙肝病毒的夫妇。在所有情况下，妻子已经接种了B型肝炎，医生的羊水和脊髓液取样和筛选HBV，所有感染的婴儿出生后一年。所有的婴儿在出生时经治疗后已与乙肝免疫球蛋白和免疫。
HBV感染的父亲的后代没有受到感染。 “感染HBV从载体的父亲的精子的胎儿似乎不太可能，尤其是在受孕前接种乙肝疫苗常规，研究人员得出结论。”
Genotype B Prone to Chronic Infection, and Genotype D Prone to Liver Cancer Despite Treatment
B型易发生慢性感染，D型易发生肝癌，尽管治疗
HBV genotypes or strains developed and evolved over thousands of years in specific regions of the world. Today, researchers are discovering that each genotype may be unique when it comes to disease progression and severity.
Two recent reports from the 2012 American Association for the Study of Liver Diseases (AASLD) suggest:
HBV genotype B, found in Asia and Oceania, may be more prone to cause chronic hepatitis B infection–lasting for more than six months–than genotypes A or C.
And genotype D, found in the Middle East, Mediterranean Basin and Central Asia, can lead to liver cancer despite treatment with antivirals.
Japanese researchers followed 215 Japanese adult patients who were newly infected with HBV–52.5% had genotype A, 12% had genotype B, and 34% had genotype C. Only six (2.8%) patients–five of whom had genotype B–failed to clear the infection within 12 months.
The second study from Italy found that many patients with hepatitis B "e" antigen-negative hepatitis B still developed liver cancer, despite treatment with antivirals. In other genotypes, antivirals have been found to lower the risk of liver cancer.
Researchers measured liver cancer rates in 235 antiviral-treated patients, all with genotype D, who had been treated for about 18 months. Over a seven-year observation period, cancer developed in:
15 of 120 patients treated with entecavir (Baraclude) (12.5%)
7 of 27 treated with tenofovir (Viread) (13.4%)
6 of 7 treated with lamivudine (Epivir-HBV) (85.7%)
4 of 18 (22.2%) treated with adefovir (Hepsera) plus lamivudine
And in no patients treated with telbivudine (Tyzeka) (2 patients).
As might be expected, liver cancer was higher in patients with cirrhosis than in those without the severe liver scarring (35% vs. 2.5%). What surprised researchers was the high rate of liver cancer, despite the long-term antiviral treatment, suggesting genotype D carries a higher risk of cancer.
HBV基因型或品系的开发和发展了千百年来在世界上的特定区域。如今，研究人员发现，各基因型可能是唯一的，当它涉及到疾病进展和严重程度。
从2012年美国肝病研究协会（AASLD）最近的两份报告建议：
HBV基因型B，在亚洲和大洋洲，可能会更容易引起慢性B型肝炎感染持久的为6个月以上，比基因型A或C。
基因型和D，在中东，地中海盆地和中亚，可导致肝癌，尽管使用抗病毒药物治疗。
日本研究人员随后215日本新感染的成人患者HBV-52.5％，基因型A，12％的基因型B，C基因型34％的只有6例（2.8％）患者，其中五人的基因型B-没有内清除感染12个月。
来自意大利的第二项研究中发现，许多乙肝患者的“e”抗原阴性B型肝炎肝癌，尽管使用抗病毒药物治疗。在其他基因型，抗病毒药物已被发现降低肝癌的风险。
研究人员测量肝脏的癌症发病率在235抗病毒治疗的患者中，基因型D，已经接受了18个月。超过7年的观察期，癌症的发展：
15恩替卡韦（博路定）治疗120例（12.5％）
7处理27与替诺福韦（VIREAD的）（13.4％）
6 7处理与拉米夫定（拉米HBV）（85.7％）
4阿德福韦（阿德福韦酯）联合拉米夫定治疗18例（22.2％）
而在没有治疗的患者替比夫定（Tyzeka）（2例）。
正如所预期的，肝癌，肝硬化患者比那些没有严重的肝脏疤痕（35％比2.5％）。吃惊的研究人员是肝癌的高利率，尽管长期抗病毒治疗，基因型D较高的患癌症的风险。
Lamivudine Results Raising Concern Among Researchers
拉米夫定研究结果引起人们的关注
As noted in the previous report, lamivudine failed to prevent liver cancer in six of seven cirrhotic patients with genotype D treated with the antiviral. Other reports presented at AASLD also raised concerns about this antiviral, which was the first antiviral approved to treat hepatitis B, but later found to have a high rate of drug resistance.
Increased cancer risk in older men: In a unique study, researchers compared liver cancer risk in patients who had been successfully treated with antivirals and achieved low viral loads. Despite the low viral loads, which should have lowered cancer risk, a small group of older, male patients developed liver cancer. Seventy-seven percent of those developing liver cancer had been treated with lamivudine.
"The association with lamivudine exposure raises the possibility of drug-induced mutations associated with an increased risk of liver cancer development–this possibility is currently under investigation," researchers noted.
Avoid lamivudine when treating cancer patients: To prevent reactivation of hepatitis B in patients treated with chemotherapy, doctors often use lamivudine to prevent reactivation in patients with inactive or resolved hepatitis B.
Chemotherapy weakens the immune system and can contribute to life-threatening reactivation of hepatitis B. Because of this, physicians often prescribe antivirals to prevent reactivation during chemotherapy treatment for other cancers.
One study described two men, both HBeAg-negative, who were treated with chemotherapy for lymphoma. They were both given lamivudine during treatment to suppress any viral resurgence. However, several months after chemotherapy ended, both men died from liver failure despite their continued lamivudine treatment.
"Lamivudine should not be used for prophylaxis of patients with chronic hepatitis B with detectable HBV DNA undergoing chemotherapy with R-CHOP, even if they have never had exposure to lamivudine in the past," researchers wrote. "In this setting, lamivudine failure due to resistance can develop quickly leading to liver failure that cannot be salvaged with (the antiviral) tenofovir."
In another study, researchers compared the effectiveness of the antivirals lamivudine, telbivudine and entecavir in preventing HBV reactivation after chemotherapy for a variety of cancers. They found lamivudine to be the least effective.
正如在以前的报告中指出，拉米夫定六D型肝硬化患者的抗病毒治疗，预防肝癌。在美国肝病学会提出的其他报告也提出了担心这种抗病毒，这是批准的第一个抗病毒治疗乙肝，但后来发现，具有较高的耐药率。
中老年男性患癌症的风险增加：在一个独特的研究中，研究人员已成功使用抗病毒药物治疗，取得了低病毒载量的患者相比，肝癌风险。尽管低病毒载量，降低患癌症的风险，一小群的老年人，男性患者发展为肝癌。百分之七十七的那些肝癌已与拉米夫定治疗。
“与拉米夫定曝光引起了药物引起的基因突变与发展，这可能是目前正在调查中，研究人员指出，肝癌的风险增加的可能性。
避免拉米夫定在治疗癌症患者时，为了防止激活的B型肝炎治疗与化疗的患者，医生经常使用拉米夫定，防止不活动或解决B型肝炎患者恢复“
化疗会削弱免疫系统，并可能危及生命的激活B型肝炎正因为如此，医生往往开抗病毒药物，以防止重新在化疗期间治疗其他癌症。
一项研究描述了两个男人，无论是HBeAg阴性，化疗治疗淋巴瘤的治疗。他们均给予拉米夫定治疗期间，禁止任何病毒死灰复燃。然而，数个月后化疗结束，两人死于肝功能衰竭，尽管他们继续拉米夫定治疗。
“不应该被用于拉米夫定预防慢性乙型肝炎患者检测到HBV DNA，接受R-CHOP化疗，即使他们从未有过在过去曝光拉米夫定，”研究人员写道。 “在此设置中，拉米夫定电阻引起的故障可以发展迅速导致肝功能衰竭，无法打捞抗病毒药物替诺福韦。”
在另一项研究中，研究人员比较了抗病毒药物拉米夫定，替比夫定和恩替卡韦在预防多种癌症化疗后HBV再激活。他们发现拉米夫定是最有效的。
HBeAg Seroconversion Rate Lower with Entecavir Than Earlier Reported
HBeAg恩替卡韦血清转换率较低,比以前的报道
Is entecavir as good as early studies touted, resulting in HBeAg serconversion (loss of HBeAg and development of "e" antibodies) within 12 months in 21% of those treated? Newer studies found lower seroconversion rates, so Stanford University researchers followed 136 HBeAg-positive patients treated with 0.5 mg of entecavir daily for three years to assess the accurate HBeAg seroconversion rate. About 61% of patients were male and average age was 39.
According to their report published in the November issue of the European Journal of Gastroenterology and Hepatology, at months 12, 24, and 36, undetectable HBV DNA was achieved in 41%, 66%, and 85% of those treated.
However, the HBeAg seroconversion rates were much lower than early reports indicated–4.8% at 12 months, 20% at 24 months, and 30% at 36 months.
"In clinical settings, entecavir is highly tolerable and potent at suppressing hepatitis B viremia," researchers wrote, "however, the rates of HBeAg seroconversion appear to be much lower than those reported, highlighting the importance of appropriate counseling and planning for long-term therapy."
恩替卡韦好，早期的研究吹捧，导致在的e抗原serconversion（亏损HBeAg和发展的“e”抗体）治疗者中，21％的12个月内吗？新的研究发现血清转换率较低，所以斯坦福大学的研究人员随访了136例HBeAg阳性患者，恩替卡韦每天0.5毫克三年，以评估准确的HBeAg血清学转换率。约61％的患者为男性，平均年龄为39岁。
根据他们的报告发表在11月发行的欧洲胃肠病学和肝病学杂志，12，24，和36个月时，检测不到HBV DNA达到了41％，66％，85％接受这种治疗的。
然而，HBeAg血清学转换率明显低于早期的报告显示在12个月的4.8％，20％，24个月，36个月和30％。
“在临床上，恩替卡韦抑制B型肝炎病毒血症高度容忍的和有效的，”研究人员写道，“但是，出现HBeAg血清学转换率要远远低于那些报道，强调适当的咨询和规划的重要性，长期治疗“。
Environmental Toxin Dramatically Increases Liver Cancer in Asia and Africa在亚洲和非洲环境毒素显着提高肝癌
According to a report in Hepatology Monthly, aflatoxin is partially to blame for the high rate of liver cancer in Asia and sub-Saharan Africa, where hepatitis B is prevalent.
Aflatoxin is a toxic poison produced by a fungus found in soil and decaying plant matter. It contaminates more than 25% of maize and groundnut crops produced in some African countries and also affects rice. Aflatoxin causes liver cancer, suppresses the immune system, and slows the growth and development of children.
U.S. researchers evaluated various studies of aflatoxins and reported, "... the data suggest that dietary exposure to aflatoxins is an important contributor to the high incidence of liver cancer in Asia and sub-Saharan Africa, where almost 82% of the cases occur."
据肝病月刊的一份报告中，黄曲霉毒素是部分地归咎于肝癌在亚洲和撒哈拉以南的非洲地区，其中乙肝是流行率很高。
黄曲霉毒素是一种有毒的土壤和腐烂的植物中发现的有毒物质由一种真菌。污染超过25％的玉米和花生作物在一些非洲国家，也影响了大米。黄曲霉毒素会导致肝癌，抑制免疫系统，减缓儿童的成长和发展。
美国研究人员评估的黄曲霉毒素及各种研究报告，“数据表明，食物中摄取黄曲霉毒素是一个重要因素，在亚洲和撒哈拉以南的非洲地区，几乎有82％的病例发生肝癌的高发期。 “
Antivirals Reduce Liver Cancer Risk in Some–But Not All抗病毒药物降低肝癌风险在一些，但不是所有的患者
A number of studies unveiled at the AASLD conference and published this month in the Journal of the American Medical Association (JAMA) find that antivirals are effective in some cases in lowering liver cancer rates in some hepatitis B patients.
But some patients–including those with cirrhosis–appear to remain at high risk of cancer despite treatment.
A Taiwanese study published in JAMA revealed that people treated with antivirals after a liver transplant had lower rates of cancer recurrence than those not treated with antivirals after surgery (20.5% vs. 43.6%) and lower death rates (10.6% vs. 28.3%). This was true even in transplant patients who had cirrhosis.
However several AASLD studies found that antiviral treatment did not substantially decrease liver cancer risk. A Danish review of numerous studies found, "In patients with chronic hepatitis B, antiviral treatment decreases the incidence of liver cancer in a subgroup of patients with established cirrhosis, but not in patients without cirrhosis. The absolute risk reduction is modest and especially in cirrhosis, liver cancer (monitoring) surveillance is still essential."
Contradicting this finding, a Chinese study found cirrhosis to increase liver cancer risk despite antiviral treatment. The researchers followed 531 patients treated with antivirals and found 22 to have developed liver cancer–all of whom had cirrhosis when treatment began.
"Cirrhosis status before antiviral treatment (begins) is an independent risk factor of liver cancer....And in the first or second years after antiviral therapy, even (when patients' viral load decrease and liver damage diminishes), the risk of liver cancer was not significantly reduced," they wrote.
许多在美国肝病学会会议上公布了研究，并发表在本月的美国医学会杂志“（JAMA）发现，抗病毒药物，降低肝脏的癌症发病率在一些乙肝患者在某些情况下是有效的。
但是，一些患者，包括肝硬化出现保持在较高的患癌症的风险，尽管治疗。
一位台湾研究发表在JAMA显示了肝脏移植手术后使用抗病毒药物治疗的人有较低的癌症复发率比那些不及时治疗手术后使用抗病毒药物（20.5％比43.6％），死亡率较低（10.6％对28.3％） 。这是真实的，即使在移植的患者有肝硬化的人。
但是，几个AASLD的研究发现，抗病毒治疗没有显着降低肝癌的风险。许多研究发现，丹麦的审查“与慢性B型肝炎患者，抗病毒治疗降低肝癌的发病率，建立肝硬化患者的一个子群，而不是在无肝硬化患者的绝对风险是适度的降低，尤其是在肝硬化，肝癌（监测）监督仍然是必要的。“
这一发现矛盾，中国的研究发现，肝硬化，肝癌的危险增加，尽管抗病毒治疗。研究人员随后531抗病毒药物治疗的患者，发现22已经开发出肝癌，所有的人有肝硬化治疗开始时。
“肝硬化抗病毒治疗前的状态（开始）是肝癌的独立危险因素。......在第一或第二年后的抗病毒治疗，甚至（当病人的病毒载量下降和肝脏的损害减少），肝的风险癌症并没有显着减少，“他们写道。
Because It Can Be Reversed, New Terminology Needed to Describe Cirrhosis
因为它是可以逆转的，新术语用来描述肝硬化
As recently as five to 10 years ago, cirrhosis was considered the final swan song of liver disease–usually terminal and never reversible.
But recent discoveries show that antiviral treatment can stop and even reverse cirrhosis. Because of this, experts writing in the journal Alimentary Pharmacology & Therapeutics, are calling for different terms and vocabulary in how doctors diagnose and treat cirrhosis.
Recent developments in the understanding of how the liver responds to HBV infection–including the evolution of fibrosis and development of severe scarring or cirrhosis–"...have revealed that the process is a dynamic one and a capacity for recovery from any degree of fibrosis including those associated with cirrhosis is plausible," they wrote.
They reviewed recent studies that show the remarkable ability of livers–even cirrhotic ones–to recover and create healthy liver tissue with treatment.
"There is abundant clinical evidence in support of the idea of the reversibility of cirrhosis in patients with ... advanced hepatic disease including viral, autoimmune and metabolic/infiltrative liver disease," they noted. "The concept of cirrhosis has changed from being a form of static and irreversible entity to a dynamic and reversible disease stage."
Instead of describing livers as having either fibrosis or cirrhosis, the writers call for a more nuanced approach that utilize several stages to identify fibrosis or cirrhosis that can still be reversed through treatment.
在最近的5到10年前，肝硬化被认为是最后的绝唱的肝脏疾病，通常终端，从来不可逆的。
但是，最近的研究表明，抗病毒治疗可以阻止甚至逆转肝硬化。正因为如此，不同的术语和词汇写在杂志上消化道药理学与治疗学，专家们呼吁，在医生的诊断和治疗肝硬化。
最近的事态发展在了解肝响应，HBV感染，包括纤维化和严重疤痕或肝硬化“的演变人士透露，这个过程是一个动态的从任何程度的纤维化和恢复能力包括那些伴有肝硬化是合理的，“他们写道。
他们回顾了近年来的研究表现出显着的肝甚至肝硬化的恢复能力，创造健康的肝组织处理。
“有丰富的临床证据支持先进的肝脏疾病，包括病毒，自身免疫性疾病和代谢/浸润的肝脏疾病的患者肝硬化的可逆性的想法，”他们指出。肝硬化的概念已经从静态的和不可逆的实体的一种形式是一个动态的，可逆的疾病阶段。“
相反的描述可以有肝纤维化或肝硬化的肝脏，作家要求更加细致入微的方法，利用几个阶段来识别仍然可以通过治疗逆转肝纤维化或肝硬化。
Depression During Interferon More Severe in Hepatitis C Than Hepatitis B Patients
在丙肝比乙肝患者干扰素更严重的抑郁症
A study of 73 hepatitis B and 85 hepatitis C Asian patients treated with interferon found that those with hepatitis C and/or prior depression experienced more depression during treatment than those with hepatitis B, according to the report in the journal of Antiviral Therapy.
Historically, there have been more reports of depression in white males with hepatitis C treated with interferon than among Asians with hepatitis B treated with the same dose of interferon. This has led some to speculate that race, gender and/or type of viral infection could play a role in dictating the severity of depressive side effects during interferon treatment.
Taiwanese researchers screened for depression before treatment began and then biweekly until treatment ended. They found depression was heightened for all patients between treatment weeks 2-10 and between weeks 16-36.
They found, however, that hepatitis C patients and those with pre-existing depression had more severe symptoms. "Depression ... should be early and actively assessed especially in patients with chronic hepatitis C or pre-existing depression," they recommended.
73 B型肝炎和C型肝炎85亚洲干扰素治疗的患者的研究发现，C型肝炎和/或之前的抑郁症经历了抑郁症在治疗过程中比B型肝炎，抗病毒治疗在杂志上的报告。
在历史上，有过抑郁症的白人男性相比，亚洲人与相同剂量的干扰素治疗乙肝干扰素治疗C型肝炎的报告。这导致一些人猜测，种族，性别和/或类型的病毒感染可以发挥的作用，注定了在干扰素治疗严重抑郁症的副作用。
台湾研究人员筛选了抑郁症的治疗开始前，然后每两周一次，直到治疗结束。他们发现，抑郁症加剧对所有患者治疗2-10周之间16-36周之间。
然而，他们发现，C型肝炎患者和那些与预先存在的抑郁症有较严重的症状。 “抑郁症应早期和积极的评估，尤其是在慢性丙型肝炎或预先存在的抑郁症患者，他们建议。”
Nearly Half of HBV-Infected Children Eventually Lose HBeAg–With or Without Treatment
将近一半的HBV感染的儿童最终会失去大三阳有或没有治疗
A team of Canadian researchers followed 252 HBeAg-positive children for 25 years into adulthood to see how the infection progressed, how many lost HBeAg and how many achieved inactive infection without liver damage.
Among the children in the study, 59.9% had HBV-infected mothers, 77% were of Asian descent, and 33 (13%) had been treated with interferon.
About 41.7% lost HBeAg over an average 19 years of follow-up. HBeAg seroconversion was not affected by how the children became infected, their gender, or whether they were treated. By age 19, about half of the children had achieved "inactive" hepatitis B, with no apparent liver damage and low viral load, according to the report in the Journal of Viral Hepatitis.
Those who were not Asian and who had moderate liver damage during childhood had higher rates of HBeAg serconversion and inactive disease later in life.
一组加拿大研究人员随后252例HBeAg阳性的儿童，25岁进入成年期感染的进展，看看，多少失去了HBeAg和多少不活动的感染无肝功能损害。
在这些孩子在学习中，59.9％的人感染乙肝病毒的母亲，77％是亚洲裔，33（13％）已与干扰素治疗。
在平均19年的后续失去了HBeAg的约41.7％。 HBeAg血清转换率并没有受到影响如何受到感染的孩子，他们的性别，或他们是否接受治疗。 19岁，大约有一半的儿童已达到“不活跃”的B型肝炎，没有明显的肝功能损害和病毒载量低，根据杂志病毒性肝炎的报告。
谁是亚洲和谁在童年时有中度肝功能损害的发生率较高的HBeAg serconversion和非活动性疾病以后的生活中。
Researchers Identify the Protein Doorway That Allows HBV to Infect Liver Cells
研究人员确定，允许乙肝病毒感染肝细胞的蛋白质门口
Chinese researchers have found the protein "receptor" or doorway that allows HBV to attach itself to and infect liver cells. They scoured thousands of proteins and RNA in tree shrew cells (the only mammal in addition to humans and chimpanzees that can be infected with HBV), to find sodium taurocholate cotransporting polypeptide or NTCP–the protein that HBV target to infect liver cells.
According to the report published in eLife, both hepatitis B and D viruses target this receptor. After researchers tried silencing the gene that controls NTCP, they found that HBV had difficulty attaching to and replicating in liver cells without the NTCP.
This discovery means researchers can use this gene to develop treatments that might shut down this receptor and halt HBV replication in liver cells.
中国的研究人员发现，“受体”的蛋白质或门口，允许乙肝病毒将其自身附加到感染的肝细胞。他们搜遍了数以千计的蛋白质和RNA在树鼩细胞（哺乳动物中除了人类和黑猩猩可以感染HBV），牛磺胆酸钠cotransporting多肽或NTCP的蛋白质，感染肝细胞内的HBV目标。
根据该报告发表在e生活，B型肝炎和D病毒针对这种受体。研究者尝试后沉默的基因，该基因控制NTCP，他们发现，乙型肝炎病毒有困难附带和未经NTCP在肝细胞中复制。
这一发现意味着研究人员可以利用这种基因的治疗方法，可能会关闭这一受体，并停止在肝细胞内的HBV复制。
Tenofovir Used to Treat Many Newly-Infected with Multi-Drug Resistant HBV替诺福韦用于治疗许多新的多药耐药HBV感染
Italian doctors treated a man who contracted a severe hepatitis B infection with HBV that was reportedly already resistant to lamivudine and telbivudine. Doctors quickly treated him successfully with tenofovir, which proved to be effective against the drug-resistant HBV.
The patient, according to the report in the November issue of the Journal of Medical Virology, cleared the infection, and developed surface antibodies. He had contracted the infection with the drug-resistant HBV in Thailand.
Researchers stressed that in cases of life-threatening acute hepatitis B cases, doctors should screen for drug resistance so the most effective antiviral–in most cases broad spectrum tenofovir–can be used to suppress the infection.
意大利医生治疗一个人染上了严重的B型肝炎感染乙肝病毒，据称已经耐拉米夫定和替比夫定。医生迅速处理他成功地替诺福韦，这被证明是有效对抗耐药的HBV。
病人，根据医学病毒学杂志十一月号的报告中，清除了感染，并制定了表面抗体。他患的感染与耐药的HBV在泰国。
研究人员强调，在危及生命的急性乙肝病例的情况下，应在医生筛选耐药性，因此最有效的抗病毒药物，在大多数情况下，广谱替诺福韦可以用来抑制感染。
Another Study Links Hepatitis B and Diabetes
另一项研究链接B型肝炎和糖尿病
A study of nearly 8,000 Korean men and women (average age 49) confirmed earlier studies that show adults with hepatitis B are one and a-half times more likely to also have diabetes or some kind of insulin sensitivity, according to a study published in the World Journal of Gastroenterology.
"For subjects identified with insulin resistance, the odds ratio of an accompanying diagnosis of chronic hepatitis B was 1.534 after adjustment for age, gender, body mass index and amount of alcohol consumption," they reported. They suggested that all adults with chronic hepatitis B also be monitored for insulin resistance and/or diabetes.
近8000名韩国男性和女性（平均49岁）的研究证实了早先的研究显示成人B型肝炎是一个半倍更有可能同时有糖尿病或某种对胰岛素的敏感性，根据公布的一项研究中世界胃肠病学杂志。
“的主题确定与胰岛素抵抗，随后的诊断慢性B型肝炎的比值比为1.534，在调整了年龄，性别，身体质量指数，饮酒量，”他们的报告。他们认为，所有成年慢性乙型肝炎进行监控，胰岛素抵抗和/或糖尿病。
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发表于 2012-11-30 16:42
