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巴西东南部的乙型肝炎病毒基因型及其与组织学特征的关系。

Hepatitis B virus genotypes in Southeast Brazil and its relationship with histological features.

机构信息

Divisão de Hepatologia, [corrected] Hospital Universitário Clementino Fraga Filho, Universidade Federal do Rio de Janeiro, Rio de Janeiro, RJ, Brasil.

出版信息

Mem Inst Oswaldo Cruz. 2012 Sep;107(6):785-9.

Abstract

Data concerning the relationship between hepatitis B virus (HBV) genotypes and liver histology are scarce. The aim of this study was to compare HBV non-B and non-C genotypes according to demographic features, clinical status, HBV-DNA levels and liver histology in Rio de Janeiro. One hundred twenty one consecutive chronic HBV-infected patients were enrolled during two-year period and data were prospectively collected. Sera were tested for HBV genotyping using restriction fragment length polymorphism. Liver biopsy was obtained from patients with either increased alanine aminotransferase (ALT) or HBV-DNA levels. Genotype A was the most common, found in 82 (68%) patients, followed by F in 19 (15%), D in 17 (14%), B in one (1%) and C in two (2%). There was no association between HBV genotypes A, D and F and gender (p = 0.37), age (p = 0.78), race (p = 0.22), mode of infection (p = 0.94), HB "e" antigen status (p = 0.37) and HBV-DNA levels (p = 0.47). The ALT levels were lower in genotype D (75%) compared with A (47%) and F (55%) (p = 0.05). Liver biopsy showed lower inflammation [histological activity index (HAI) = 4] and fibrosis (F) (= 0) scores in genotype D than in genotypes A (HAI = 5, p < 0.001; F = 2, p = 0.008) or F (HAI = 5, p = 0.009; F = 2, p = 0.01). Genotype A was the most prevalent in chronic HBV-infected patients and genotype D patients presented with less intense liver disease.

摘要

关于乙型肝炎病毒(HBV)基因型与肝组织学之间关系的数据较为匮乏。本研究旨在比较里约热内卢地区非乙型和非丙型肝炎病毒基因型患者的人口统计学特征、临床状态、HBV-DNA 水平和肝组织学特征。在两年的时间内,连续招募了 121 例慢性 HBV 感染患者,并前瞻性收集数据。采用限制性片段长度多态性检测血清 HBV 基因型。对 HBV-DNA 水平或丙氨酸氨基转移酶(ALT)升高的患者进行肝活检。最常见的基因型为 A 型,共 82 例(68%),其次为 F 型 19 例(15%)、D 型 17 例(14%)、B 型 1 例(1%)和 C 型 2 例(2%)。HBV 基因型 A、D 和 F 与性别(p = 0.37)、年龄(p = 0.78)、种族(p = 0.22)、感染模式(p = 0.94)、HBV“e”抗原状态(p = 0.37)和 HBV-DNA 水平(p = 0.47)无关。与基因型 A(47%)和 F(55%)相比,基因型 D(75%)的 ALT 水平较低(p = 0.05)。与基因型 A(HAI = 5,p < 0.001;F = 2,p = 0.008)或 F(HAI = 5,p = 0.009;F = 2,p = 0.01)相比,基因型 D 的肝组织学炎症(组织学活动指数(HAI)= 4)和纤维化(F)评分较低。基因型 A 是慢性 HBV 感染患者中最常见的基因型,而基因型 D 患者的肝脏疾病程度较轻。

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