乙肝杂志回顾 4 -研究揭示乙型肝炎重要信息在女性

StephenW

Studies Reveal Important Information about Hepatitis B in Women
Because men appear to suffer more liver damage from hepatitis B infection, and are therefore more frequently treated, enrolled in clinical trials and studied, there has been scant information on how HBV infection progresses in women and what role ethnicity or HBV strain or genotype play. This information is vital, considering that many new infections occur when infected mothers transmit the virus to their newborns.

Asian women with genotypes B or C remain HBeAg-positive longer: An international research team, led by Cedars-Sinai Medical Center doctors, assessed 355 HBV-infected women for race (Asian vs. non-Asian), age, alanine aminotransferase (ALT), and HBeAg status.

The average age was 41, most had moderately elevated ALT levels (indicating some liver damage), high HBV DNA levels, and 44.4% were HBeAg-positive. About 40% were Asian and 49.6% were Caucasian. HBV genotypes were available for about half of the study participants.

Researchers at the 64th annual American Association for the Study of Liver Diseases (AASLD) conference in Washington D.C. in November reported:

    Asian women 35 and younger were more likely to be HBeAg-positive and to have high viral load.

    Women with HBV genotypes B and C were more likely to be HBeAg-positive than women with genotypes A or D.

"In this large cohort of HBV patients, women under 35 had a significantly higher likelihood of HBeAg positivity and high HBV viral load," they wrote. "Asian women and those with genotypes B/C are also more likely to be HBeAg-positive... These results suggest higher risk of HBV perinatal (mother-to-child) transmission in these groups."

One-fifth of women experience ALT flares after giving birth: Australian researchers followed 126 HBV-infected women after they gave birth and discovered that 21% experienced an ALT flare (indicating liver damage) in the weeks after giving birth. Those who had flares were more likely to be younger, HBeAg-positive, and in their first pregnancy.

"Clinicians need to be aware of this phenomenon so women at the highest risk can be appropriately identified for close monitoring in the post-natal period," they wrote.

Source 1. AASLD Control ID: 1735475. HBeAg status, race and DNA levels in women with chronic hepatitis B infection.

Source 2: AASLD Control ID: 1732687. Clinical and virological factors that predict post partum flares in pregnant women with chronic HBV

研究揭示乙型肝炎重要信息在女性
因为男人似乎患有乙肝感染更多的肝损害，因此更频繁地处理，纳入临床试验和研究，出现了关于如何HBV感染的进展妇女和缺乏信息，什么样的角色种族或乙肝病毒株或基因型的发挥。这些信息是至关重要的，考虑到许多新的感染时，感染的母亲将病毒传染给她们的新生儿发生。

亚洲女性与基因型B或C保持HBeAg阳性再：一个国际研究小组，由雪松 - 西奈医疗中心的医生，评估355乙肝病毒感染的妇女进行比赛（亚洲与非亚洲） ，年龄，丙氨酸转氨酶（ALT ）和HBeAg状态。

平均年龄为41 ，最有中度升高的ALT水平（表明某些肝功能损害），高HBV DNA水平，而44.4 ％为HBeAg阳性。约40 ％为亚洲人和49.6 ％是白种人。 HBV基因型可供大约一半的研究参与者。

研究人员在肝病的研究第64届美国协会（ AASLD ）在华盛顿十一月份会议报道：

    亚洲女性35及以下更可能是HBeAg阳性和具有高的病毒载量。

    妇女与HBV基因型B和C更可能是HBeAg阳性的妇女比基因型A或D。

“在乙肝患者的这一大型队列，在35岁以下的妇女有e抗原阳性和乙肝高病毒载量的显著更高的可能性， ”他们写道。 “亚洲女性和那些与基因型B / C ，也更可能是HBeAg阳性......这些结果提示HBV母婴（母亲对孩子）在这些群体传播的风险较高。 ”

五分之一的女性体验ALT升高生完孩子后：澳大利亚研究人员随后126乙肝病毒感染的妇女后，他们生下，发现21 ％经历了ALT耀斑（说明肝损害）在周产后。那些谁了耀斑更可能是年轻， HBeAg阳性，并在他们的第一次怀孕。

“临床医生需要知道这种现象所以女性在最高风险可以适当确定在产后期间密切监测， ”他们写道。

来源1 。美国肝病学会控制编号： 1735475 。 HBeAg状态，种族和DNA水平在女性慢性乙肝感染。

来源2 ：美国肝病学会控制编号： 1732687 。可以预测产后耀斑孕妇患有慢性乙肝的临床和病毒学因素

Hepatitis B Risk in African Immigrants and African-Americans Studied
While Africans who have recently emigrated to the U.S. have high rates of hepatitis B, there has been little research into how their disease with its various genotypes progress. Two studies from Minnesota, presented at the AASLD conference, explore hepatitis B in east and west African immigrant communities.

In one study, University of Minnesota researchers followed 400 Asian and African immigrant adults who were treated for hepatitis B at outpatient clinics between 2007 and 2010—the average age was 41, 58% were males and 42% were female.

About 26% were Southeast Asian, 38% East African, 13% East Asian, 12% US-born, and 7% West African. Patients from Asia had higher rates of HBeAg-positivity, while only 8% of East Africans and 4% of West African were HBeAg-positive. Patients from Africa tended to have lower viral loads than those from Asia, and lower (healthier) ALT levels, indicating less liver damage.

"From this retrospective study, we found that ... (patients) from Southeast Asia were more likely to have active hepatitis B, more advanced liver disease at presentation, and an increased risk of developing liver cancer, while patients from East Africa were less likely to receive adequate screening and follow up," researchers reported.

Study compares hepatitis B in African-Americans and African immigrants: A second study, led by the Mayo Clinic College of Medicine, compared hepatitis B progression in 56 African-Americans and 163 African immigrants. While genotype A was most common in both groups, a substantial proportion of African immigrants had genotypes E or D, neither of which were found in African-Americans.

West Africans were more likely to have abnormal ALT levels, indicating current liver damage, and high viral loads than East Africans. The predominant genotype among West Africans was E (60%), whereas genotypes A (67%) and D (23%) were common in East Africans.

African-Americans were more likely to be HBeAg-positive and have higher HBV DNA levels compared to African immigrants, who were more likely to be "inactive carriers."

"Significant clinical and virological differences were found between (African immigrants and African-Americans)..., which may be attributable to differences in HBV epidemiology as well as genotype," researchers noted. They urged more studies to be done so those at higher risk of liver damage (African-Americans and West Africans) could be monitored and treated adequately.

Source 1. AASLD Control ID: 1730673. Comparison of demographic, virologic, and outcome characteristics of people with chronic hepatitis B in a major US urban center.

Source 2. AASLD Control ID 1731291. Differences in epidemiological and clinical characteristics in US- versus foreign-born Americans of African descent with chronic hepatitis B Enrolled in the HBRN Cohort.

乙肝的风险在非洲移民和非裔美国人就读
虽然谁最近移民到美国的非洲人有乙肝率高，很少有研究他们的疾病与不同基因型如何进步。来自明尼苏达州的两项研究，在AASLD会议上提出，探索在东部和西部非洲移民社区B型肝炎。

在一项研究中，美国明尼苏达大学的研究人员跟踪调查谁是治疗B型肝炎在门诊2007年和2010年的平均年龄之间41 ， 58 ％为男性， 42 ％为女性400亚洲和非洲移民的成年人。

约26 ％为东南亚， 38 ％的东非， 13 ％的东亚， 12 ％在美国出生，7％西非。来自亚洲患者的HBeAg阳性率较高，而只有8％的东非和西非的4％为HBeAg阳性。来自非洲的病人倾向于有较低的病毒载量高于来自亚洲，和较低的（健康） ALT水平，说明少肝损害。

“从这个回顾性研究中，我们发现， ...来自东南亚（患者）更可能有活动性乙型肝炎，更先进的肝病在演示文稿，患肝癌的风险增加，而来自东非的患者较少有可能获得足够的筛选和跟进， “研究人员报告。

研究比较了乙肝在非裔美国人和非洲移民：第二个研究，导致由医学梅奥诊所医学院，相比乙肝进展的56非裔美国人和163非洲移民。而A基因型是最常见的在两个组，非洲移民有相当比例的有基因型E或D ，两者都不被发现在非裔美国人。

西非人更可能有异常ALT水平，表明目前的肝功能损害和高病毒载量高于东非。中西非的主要基因型为E（ 60 ％ ） ，而基因型A（ 67 ％ ）和D （ 23 ％ ）在东非洲人很普遍。

非裔美国人更可能是HBeAg阳性，并具有较高的HBV DNA水平相比，非洲移民，谁更可能是“非活动性携带者。 ”

“与（非洲移民和非裔美国人）被发现显着的临床和病毒学差异... ，这可能是由于乙肝病毒流行病学及基因型差异， ”研究人员指出。他们呼吁更多的研究工作要做，以便在这些肝损害的风险较高（非裔美国人和西非），可以监测和充分治疗。

来源1 。美国肝病学会控制编号： 1730673 。的慢性B型肝炎的人在美国主要城市中心人口，病毒学和结果特性比较。

源2。 AASLD控件ID 1731291 。差异在美国与非洲裔慢性乙型肝炎就读于HBRN队列外国出生的美国人的流行病学和临床特征。