|
|
|
题名
|
作者
|
年代
|
出处
|
被引量
|
| 1 | Effectiveness of hepatitis B virus vaccination program in Egypt:Multicenter national project显示文摘AIM:To assess the effectiveness of hepatitis B virus(HBV) vaccination program among fully vaccinated children.METHODS:A national community based crosssectional study was carried out in 6 governorates representing Egypt. A total of 3600 children aged from 9 mo to 16 years who were fully vaccinated with HBV vaccine during infancy were recruited. Face to face interviews were carried out and sera were evaluated for hepatitis B surface antigen(HBsA g),anti-HBV core antibodies(total) and quantitative detection of hepatitis B surface antibody using enzyme linked immunoassays techniques. Samples positive to HBs Ag/anti-HBV core antibodies were subjected to quantitative HBV-DNA detection by real time polymerase chain reaction with 3.8 IU/L detection limit. RESULTS:Sero-protection was detected among 2059 children(57.2%) with geometric mean titers 75.4 ± 3.6 IU/L compared to 3.1 ± 2.1 IU/L among nonseroprotected children. Multivariate logistic analysis revealed that older age and female gender were the significant predicting variables for having non seroprotective level,with adjusted odds ratio 3.3,9.1and 14.2 among children aged 5 to < 10,10 to < 15 and ≥ 15 years respectively compared to those < 5 years and 1.1 among girls compared to boys with P < 0.01. HBs Ag was positive in 0.11% and breakthrough infection was 0.36% and 0.39% depending on positivity of anti-HBc and DNA detection respectively. The prevalence of HBV infection was significantly higher among children aged ≥ 7 years(0.59%) compared to 0.07% among younger children with odds ratio equal to 8.4(95%CI:1.1-64.2) and P < 0.01.The prevalence was higher among girls(0.48%) than boys(0.29%) with P > 0.05. C ON C LU S I ON :T he E gy pt ian c ompuls or y H B V vaccination program provides adequate protection. Occult HBV infection exists among apparently healthy vaccinated children. Adherence to infection control measures is mandatory. | Iman I Salama Samia M Sami Zeinab Nabil Ahmed Said Manal H El-Sayed Lobna A El Etreby Thanaa M Rabah Dalia M Elmosalami Amany T Abdel Hamid Somaia I Salama Aida M Abdel Mohsen Hanaa M Emam Safaa M Elserougy Amal I Hassanain Naglaa F Abd Alhalim Fatma A Shaaban Samia A Hemeda Nihad A Ibrahim Ammal M Metwally | 2015 | World Journal of Hepatology2015，7，22： | 2 |
| 2 | Impact of direct-acting antiviral regimens on hepatic and extrahepatic manifestations of hepatitis C virus infection显示文摘Hepatitis C virus(HCV)is a common cause of liver disease and is associated with various extrahepatic manifestations(EHMs).This mini-review outlines the currently available treatments for HCV infection and their prognostic effect on hepatic manifestations and EHMs.Direct-acting antiviral(DAA)regimens are considered pan-genotypic as they achieve a sustained virological response(SVR)>85%after 12 wk through all the major HCV genotypes,with high percentages of SVR even in advanced fibrosis and cirrhosis.The risk factors for DAA failure include old males,cirrhosis,and the presence of resistance-associated substitutions(RAS)in the region targeted by the received DAAs.The effectiveness of DAA regimens is reduced in HCV genotype 3 with baseline RAS like A30K,Y93H,and P53del.Moreover,the European Association for the Study of the Liver recommended the identification of baseline RAS for HCV genotype 1a.The higher rate of hepatocellular carcinoma(HCC)after DAA therapy may be related to the fact that DAA regimens are offered to patients with advanced liver fibrosis and cirrhosis,where interferon was contraindicated to those patients.The change in the growth of pre-existing subclinical,undetectable HCC upon DAA treatment might be also a cause.Furthermore,after DAA therapy,the T cell-dependent immune response is much weaker upon HCV clearance,and the down-regulation of TNF-αor the elevated neutrophil to lymphocyte ratio might increase the risk of HCC.DAAs can result in reactivation of hepatitis B virus(HBV)in HCV coinfected patients.DAAs are effective in treating HCV-associated mixed cryoglobulinemia,with clinical and immunological responses,and have rapid and high effectiveness in thrombocytopenia.DAAs improve insulin resistance in 90%of patients,increase glomerular filtration rate,and decrease proteinuria,hematuria and articular manifestations.HCV clearance by DAAs allows a significant improvement in atherosclerosis and metabolic and immunological conditions,with a reduction of major cardiovascular events.They also improve physical function,fatigue,cognitive impairment,and quality of life.Early therapeutic approach with DAAs is recommended as it cure many of the EHMs that are still in a reversible stage and can prevent others that can develop due to delayed treatment. | Iman Ibrahim Salama Hala M Raslan Ghada A Abdel-Latif Somaia I Salama Samia M Sami Fatma A Shaaban Aida M Abdelmohsen Walaa A Fouad | 2022 | World Journal of Hepatology2022，14，6： | 0 |
| 3 | Current and novel modalities for management of chronic hepatitis B infection显示文摘Over 296 million people are estimated to have chronic hepatitis B viral infection(CHB),and it poses unique challenges for elimination.CHB is the result of hepatitis B virus(HBV)-specific immune tolerance and the presence of covalently closed circular DNA as mini chromosome inside the nucleus and the integrated HBV.Serum hepatitis B core-related antigen is the best surrogate marker for intrahepatic covalently closed circular DNA.Functional HBV“cure”is the durable loss of hepatitis B surface antigen(HBsAg),with or without HBsAg seroconversion and undetectable serum HBV DNA after completing a course of treatment.The currently approved therapies are nucleos(t)ide analogues,interferon-alpha,and pegylated-interferon.With these therapies,functional cure can be achieved in<10%of CHB patients.Any variation to HBV or the host immune system that disrupts the interaction between them can lead to reactivation of HBV.Novel therapies may allow efficient control of CHB.They include direct acting antivirals and immunomodulators.Reduction of the viral antigen load is a crucial factor for success of immune-based therapies.Immunomodulatory therapy may lead to modulation of the host immune system.It may enhance/restore innate immunity against HBV(as toll-like-receptors and cytosolic retinoic acid inducible geneⅠagonist).Others may induce adaptive immunity as checkpoint inhibitors,therapeutic HBV vaccines including protein(HBsAg/pre S and hepatitis B core antigen),monoclonal or bispecific antibodies and genetically engineered T cells to generate chimeric antigen receptor-T or T-cell receptor-T cells and HBV-specific T cells to restore T cell function to efficiently clear HBV.Combined therapy may successfully overcome immune tolerance and lead to HBV control and cure.Immunotherapeutic approaches carry the risk of overshooting immune responses causing uncontrolled liver damage.The safety of any new curative therapies should be measured in relation to the excellent safety of currently approved nucleos(t)ide analogues.Development of novel antiviral and immune modulatory therapies should be associated with new diagnostic assays used to evaluate the effectiveness or to predict response. | Iman Ibrahim Salama Samia M Sami Somaia I Salama Ghada A Abdel-Latif Fatma A Shaaban Walaa A Fouad Aida M Abdelmohsen Hala M Raslan | 2023 | World Journal of Hepatology2023，15，5： | 0 |
您所在的机构暂未开通此部分的功能，请联系管理员