乙肝的发展恶化取决于HBV基因型

liver411

(谢谢帮忙翻译)



[B]Hepatitis B Disease Progression Dependent on HBV Genotype[/B]

By Brian Boyle, MD

The course of chronic hepatitis B virus (HBV) infection varies widely from patient-to-patient. Some patients with HBV experience little or no progression of their liver disease and may spontaneously undergo seroconversion from being HBV e antigen (HBeAg) positive to negative, and, in some cases, this may be accompanied by the loss of HBV DNA.

In other cases, however, HBV is associated with significant liver damage, which, in come cases, ultimately leads to cirrhosis or hepatocellular carcinoma (HCC) and death.

Unlike hepatitis C virus (HCV), the liver damage caused by HBV is largely due to the host immune response and not a direct cytopathic effect. As a result, host and viral factors may significantly influence the likelihood and rate of HBV disease progression.

Genetic variability of HBV may be one of these factors and HBV has been classified into at least 7 genotypes, named A to G, with the prevalence of each genotype varying by geographical region. It has been proposed that HBV genotype may correlate with the clinical progression of HBV disease, and in some studies genotype C has been shown to be more frequent in severe liver disease.

In order to evaluate the association of HBV genotype and HBV disease progression, investigators from Japan, a country with high rates of HBV infection, examined the influence of HBV genotypes on the progression of liver disease in patients with HBV.

In the study, the medical records of 585 patients with chronic HBV infection, including 258 with biopsy-proven chronic liver disease (CLD) and 74 with HCC, were examined. The investigators found that the mean ages of both patients with advanced fibrosis/cirrhosis and with HCC were significantly older in genotype B than in genotype C patients (P = .018, P = .024, respectively).

Both the HBeAg negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P < .01, P = .022, respectively). A multivariate analysis showed that genotype B, presence of precore mutation, higher ALT levels, and severe histologic activity were independent factors for HBe seroconversion.

Among all the biopsy-proven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 (13%) vs. 74/224 (33%), respectively; P = .034). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively).

The authors conclude from these data that "based on the clinical data of 258 patients with biopsy-proven CLD, the proportion of patients with advanced fibrosis (F3 or F4) in genotype B was significantly lower than that in genotype C, suggesting that genotype C was associated more with advanced fibrotic liver disease.

"The median age of patients with advanced fibrosis (F3 or F4) with genotype B was significantly higher than patients with the same condition with genotype C. Because in most Japanese patients with chronic hepatitis B, HBV infections occur vertically from their mothers at birth, the duration of infection is almost the same as the age of the patients. Therefore, these data suggest that genotype B HBV chronic infection required a longer duration for progression of liver fibrosis than genotype C infection."

01/03/03

Reference
H Sumi and others. Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease. Hepatology 2003; 37:19-26.


Copyright 2002 by HIV and Hepatitis. All Rights Reserved.



(内部交流)

liverbj

以下是引用liver411在2003-1-8 18:38:00的发言： (谢谢帮忙翻译) [B]Hepatitis B Disease rogression Dependent on HBV Genotype[/B] 乙型肝炎的恶化取决于HBV基因型 By Brian Boyle, MD The course of chronic hepatitis B virus (HBV) infection varies widely from patient-to-patient. Some patients with HBV experience little or no progression of their liver disease and may spontaneously undergo seroconversion from being HBV e antigen (HBeAg) positive to negative, and, in some cases, this may be accompanied by the loss of HBV DNA.  In other cases, however, HBV is associated with significant liver damage, which, in come cases, ultimately leads to cirrhosis or hepatocellular carcinoma (HCC) and death. Unlike hepatitis C virus (HCV), the liver damage caused by HBV is largely due to the host immune response and not a direct cytopathic effect. As a result, host and viral factors may significantly influence the likelihood and rate of HBV disease progression.  Genetic variability of HBV may be one of these factors and HBV has been classified into at least 7 genotypes, named A to G, with the prevalence of each genotype varying by geographical region. It has been proposed that HBV genotype may correlate with the clinical progression of HBV disease, and in some studies genotype C has been shown to be more frequent in severe liver disease.  In order to evaluate the association of HBV genotype and HBV disease progression, investigators from Japan, a country with high rates of HBV infection, examined the influence of HBV genotypes on the progression of liver disease in patients with HBV. In the study, the medical records of 585 patients with chronic HBV infection, including 258 with biopsy-proven chronic liver disease (CLD) and 74 with HCC, were examined. The investigators found that the mean ages of both patients with advanced fibrosis/cirrhosis and with HCC were significantly older in genotype B than in genotype C patients (P = .018,  = .024, respectively).  Both the HBeAg negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P < .01,  = .022, respectively). A multivariate analysis showed that genotype B, presence of precore mutation, higher ALT levels, and severe histologic activity were independent factors for HBe seroconversion.  Among all the biopsy-proven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 (13%) vs. 74/224 (33%), respectively;  = .034). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively). The authors conclude from these data that "based on the clinical data of 258 patients with biopsy-proven CLD, the proportion of patients with advanced fibrosis (F3 or F4) in genotype B was significantly lower than that in genotype C, suggesting that genotype C was associated more with advanced fibrotic liver disease.  "The median age of patients with advanced fibrosis (F3 or F4) with genotype B was significantly higher than patients with the same condition with genotype C. Because in most Japanese patients with chronic hepatitis B, HBV infections occur vertically from their mothers at birth, the duration of infection is almost the same as the age of the patients. Therefore, these data suggest that genotype B HBV chronic infection required a longer duration for progression of liver fibrosis than genotype C infection." 01/03/03 Reference H Sumi and others. Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease. Hepatology 2003; 37:19-26. Copyright 2002 by HIV and Hepatitis. All Rights Reserved. (内部交流)

liverbj

气死了！翻译了一半没保存突然就没了！！！

[此贴子已经被作者于2003-1-10 17:17:58编辑过]

liverbj

以下是引用liver411在2003-1-8 18:38:00的发言： (谢谢帮忙翻译) [B]Hepatitis B Disease rogression Dependent on HBV Genotype[/B] 乙型肝炎的恶化取决于HBV基因型 By Brian Boyle, MD The course of chronic hepatitis B virus (HBV) infection varies widely from patient-to-patient. Some patients with HBV experience little or no progression of their liver disease and may spontaneously undergo seroconversion from being HBV e antigen (HBeAg) positive to negative, and, in some cases, this may be accompanied by the loss of HBV DNA.  HBV病毒感染慢性化的进程在不同病人之间会有很大的不同。有一些病人会伴有很轻的或者根本就没有经历肝脏的病变，并且有可能会自发的产生从HBV e抗原阳性到阴性的血清转换，而且在某些情况下同时会发生HBV DNA的减少。 In other cases, however, HBV is associated with significant liver damage, which, in come cases, ultimately leads to cirrhosis or hepatocellular carcinoma (HCC) and death. 在另外一些情况，HBV要伴随着非常严重的肝脏损害，并有可能最终导致硬化或者是肝癌并最终死亡。 Unlike hepatitis C virus (HCV), the liver damage caused by HBV is largely due to the host immune response and not a direct cytopathic effect. As a result, host and viral factors may significantly influence the likelihood and rate of HBV disease progression.  不同于丙型肝炎，有HBV引起的肝脏损害很大程度上要归因于个人的免疫应答,而不是肝细胞直接病变的影响。因此，宿主和病毒的因素会很大程度上影响HBV疾病恶化的可能性和几率。 Genetic variability of HBV may be one of these factors and HBV has been classified into at least 7 genotypes, named A to G, with the prevalence of each genotype varying by geographical region. It has been proposed that HBV genotype may correlate with the clinical progression of HBV disease, and in some studies genotype C has been shown to be more frequent in severe liver disease.  HBV基因型的不同也许是这些因素之一。HBV目前已经至少被分为7种基因型，分别命名为A到G， 根据地域的不同，流行程度也不同。有提议说HBV基因型也许和HBV疾病的临床表现有关。有些研究说明C基因型会更多可能导致严重的肝脏疾病。 In order to evaluate the association of HBV genotype and HBV disease progression, investigators from Japan, a country with high rates of HBV infection, examined the influence of HBV genotypes on the progression of liver disease in patients with HBV. 为了评估HBV基因型同HBV疾病恶化的关系，日本，一个有高HBV感染率的国家，的研究者们调查了HBV基因型对于带有HBV的肝脏病患者病情恶化的影响。 In the study, the medical records of 585 patients with chronic HBV infection, including 258 with biopsy-proven chronic liver disease (CLD) and 74 with HCC, were examined. The investigators found that the mean ages of both patients with advanced fibrosis/cirrhosis and with HCC were significantly older in genotype B than in genotype C patients (P = .018,  = .024, respectively).  研究中共有585位慢性乙肝患者，其中包括258位为经过肝活检证实为慢性肝病的患者和74位肝癌患者，参加了调查。研究者发现那些伴有严重纤维化／硬化和肝癌的患者中，B基因型患者的平均年龄要远远大于C基因型的患者（分别为P=.018，P=.024）。 Both the HBeAg negativity rate at biopsy and the cumulative HBe seroconversion rate in patients with CLD were significantly higher in genotype B patients than genotype C patients (P < .01,  = .022, respectively). A multivariate analysis showed that genotype B, presence of precore mutation, higher ALT levels, and severe histologic activity were independent factors for HBe seroconversion.  经肝活检那些慢性肝脏疾病患者的e抗原阴性率和e抗原的累积血清转换率，B基因型的患者都要远远高于C基因型患者（分别为P<.01， P=.022）。 多变量分析显示B基因型，前C区变异？（precore mutation), 高水平的ALT， 和严重的？？（histologic activity）同e抗原的血清转换率之间并没有直接的关系。 Among all the biopsy-proven CLD patients, the ratio of patients with advanced fibrosis in genotype B was significantly lower than that in genotype C (4/30 (13%) vs. 74/224 (33%), respectively;  = .034). The distribution of each genotype between CLD and HCC was very similar (B and C: 11.2% and 87.0% vs. 10.8% and 89.2%, respectively). 在所有肝活检证明为慢性肝病的患者中，B基因型的患者中严重纤维化的要明显低于C基因型的患者（分别为4/30（13％）对 74/224(33%)；P=.034）。 在慢性肝炎和肝癌患者中基因型的分布非常相似（B和C分别为11.2% 和 87% 对 10.8% 和 89.2%）. The authors conclude from these data that "based on the clinical data of 258 patients with biopsy-proven CLD, the proportion of patients with advanced fibrosis (F3 or F4) in genotype B was significantly lower than that in genotype C, suggesting that genotype C was associated more with advanced fibrotic liver disease.  作者从这些数据中得出：“基于258例肝活检证明为慢性肝炎的临床数据， 患者中带有严重纤维化（F3或F4）的，B基因型要明显低于C基因型，建议C基因型和严重肝纤维化疾病更具有关联。 "The median age of patients with advanced fibrosis (F3 or F4) with genotype B was significantly higher than patients with the same condition with genotype C. Because in most Japanese patients with chronic hepatitis B, HBV infections occur vertically from their mothers at birth, the duration of infection is almost the same as the age of the patients. Therefore, these data suggest that genotype B HBV chronic infection required a longer duration for progression of liver fibrosis than genotype C infection." 患者中带有严重纤维化(F3或F4)的平均年龄,B基因型的要明显高于同等情况下C基因型的.因为在大多数日本B基因型的患者中,HBV感染途径都是母婴垂直传播,感染的期间基本上都是在同一个年龄.因此,这些数据表明B基因型的慢性HBV感染的肝纤维化进程要明显长于那些C基因型的患者. 01/03/03 Reference 参考 H Sumi and others. Influence of hepatitis B virus genotypes on the progression of chronic type B liver disease. Hepatology 2003; 37:19-26. Copyright 2002 by HIV and Hepatitis. All Rights Reserved. (内部交流)

hchu

谢谢liverbj。辛苦了。如有时间，把那篇“长效干扰素”也译译好么？真不好意思。