Advances in Metagenomics and Its Application in Environmental Microorganisms

Metagenomics is a new approach to study microorganisms obtained from a specific environment by functional gene screening or sequencing analysis. Metagenomics studies focus on microbial diversity, community constitute, genetic and evolutionary relationships, functional activities, and interactions and relationships with the environment. Sequencing technologies have evolved from shotgun sequencing to high-throughput, next-generation sequencing (NGS), and third-generation sequencing (TGS). NGS and TGS have shown the advantage of rapid detection of pathogenic microorganisms. With the help of new algorithms, we can better perform the taxonomic profiling and gene prediction of microbial species. Functional metagenomics is helpful to screen new bioactive substances and new functional genes from microorganisms and microbial metabolites. In this article, basic steps, classification, and applications of metagenomics are reviewed.

Outcome of Chinese patients with hepatitis B at 96 weeks after functional cure with IFN versus combination regimens

BACKGROUND & AIMS

Nucleotides with add-on interferon treatment (NUC-IFN) provide significantly higher rates of hepatitis B surface antigen (HBsAg) loss in patients with chronic hepatitis B (CHB). This study aimed to investigate the sustainability of HBsAg loss and the prevention of clinical relapse.

METHODS

Patients with CHB who achieved HBsAg loss and HBV DNA levels <20 IU/ml after IFN or NUC-IFN therapy were enrolled and followed up for 96 weeks. The primary outcome was HBsAg negativity without viremia at week 96. Secondary outcomes included virological or clinical relapse and predictors of relapse.

RESULTS

420 patients were included in intention-to-treat analysis with 290 and 130 in the IFN and NUC-IFN groups respectively. At week 96, the intention-to-treat analysis revealed similar outcomes between groups, including HBsAg seroreversion (24.83% vs. 23.08%, P = .70), viremia (16.90% vs 13.08%, P = .32) and clinical relapse (11.38% vs 10.00%, P = .68); the per-protocol analyses also showed HBsAg seroreversion, viremia and clinical relapse in IFN group (15.50%, 6.59% and 0.39%) did not differ from those in NUC-IFN group (15.25%, 4.24% and 0.85%, P > .05). These outcomes were similar between patients who received entecavir and those who received telbivudine/lamivudine/adefovir before the combination therapy. In NUC-IFN-treated patients, fibrosis regression was observed at week 96. Baseline HBsAb negativity was independent predictors of HBsAg sero-reversion and recurrence of viremia in IFN treated group.

CONCLUSION

NUC-IFN and IFN therapies are equally effective in achieving sustained functional cure and fibrosis regression. (ClinicalTrials.gov, Number NCT02336399).

[Spatial distribution of canine echinococcosis in Inner Mongolia Autonomous Region from 2012 to 2018]

OBJECTIVE

To investigate the distribution and changing trend of canine echinococcosis in Inner Mongolia Autonomous Region, so as to provide the scientific evidence for prevention and control of canine echinococcosis in high-risk areas of Inner Mongolia Autonomous Region.

METHODS

All data pertaining to Echinococcus infections in canine feces and sampling survey of human echinococcosis were collected from the echinococcosis-endemic foci of Inner Mongolia Autonomous Region from 2012 to 2018, and the prevalence of Echinococcus infections was investigated in dogs and humans. In addition, the spatial distribution characteristics and clusters of canine echinococcoses were identified.

RESULTS

A total of 164 139 canine fecal samples were detected in the echinococcosis-endemic foci of Inner Mongolia Autonomous Region from 2012 to 2018, and there were 2 136 fecal samples positive for Echinococcus coproantigens. The positive rates of Echinococcus coproantigens were 0.54% to 1.73% in dogs from 2012 to 2018, with a tendency towards a decline seen in the prevalence of Echinococcus infections in dogs (χ² = 108.83, P < 0.01), and there was a significant difference in the positive rate of Echinococcus coproantigens in dogs among years (χ² = 155.27, P < 0.01). Three-dimensional trend analysis showed that canine echinococcosis was mainly concentrated in east of central Inner Mongolia Autonomous Region, and a high prevalence was detected in New Barag Right Banner and Sonid Right Banner. The global spatial distribution of canine echinococcosis appeared a random pattern in Inner Mongolia Autonomous Region from 2012 to 2018 (Moran's I > 0, P > 0.05), and there were "high-high" and "high-low" clusters of canine echinococcosis in local areas. The prevalence of human echinococcosis was 0.08%, and there was a significant difference in the prevalence among regions (χ² = 147.61, P < 0.01), with a high prevalence seen in West Ujimqin Banner, Jarud Banner and New Barag Right Banner. In addition, the prevalence of human echinococcosis correlated positively with the Echinococcus coproantigen-positive rate in dogs (r = 0.52, P < 0.01).

CONCLUSIONS

The prevalence of Echinococcus infections shows an overall tendency towards a decline in dogs in Inner Mongolia Autonomous Region from 2012 to 2018, with a high prevalence found in New Barag Right Banner and Sonid Right Banner. Human echinococcosis is concentrated in clusters of canine echinococcosis, where health education and targeted control interventions requires to be intensified.

[Epidemic situation of human echinococcosis in Inner Mongolia Autonomous Region: a sampling survey from 2012 to 2017]

OBJECTIVE

To investigate the epidemiological characteristics of human echinococcosis in Inner Mongolia Autonomous Region, so as to provide evidence for the development of the precision control strategy of human echinococcosis in the region.

METHODS

A sampling survey of human echinococcosis was conducted in 28 banners (counties, districts) of Inner Mongolia Autonomous Region from 2012 to 2017, and the epidemiological characteristics were descriptively analyzed.

RESULTS

A total of 90 058 residents were examined for echinococcosis in 28 banners (counties, districts) of Inner Mongolia Autonomous Region from 2012 to 2017, and 71 patients were detected with echinococcosis, with a detection rate of 0.08%. No echinococcosis cases were identified in 8 banners (counties), and there were 6 banners (counties) with echinococcosis prevalence of 0.1% to 1%, and 14 with prevalence of 0 to 0.1%. The echinococcosis prevalence was significantly greater in women (0.11%) than in men (0.05%) (χ² = 10.09, P = 0.001), and the highest prevalence was detected in patients at ages of over 50 years (38 cases, 53.52%). In addition, the highest echinococcosis prevalence was detected in herdsmen (0.14%), or in primary school children (0.13%).

CONCLUSIONS

Human echinococcosis is widely, but lowly prevalent in Inner Mongolia Region, with a diverse density of infections. Echinococcosis has remarkable characteristics of regional and population clusters in Inner Mongolia Region, and the management of echinococcosis requires to be reinforced in key regions and populations.

[Spatial distribution characteristics of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018]

OBJECTIVE

To investigate the spatial distribution patterns and changing tendency of reported echinococcosis patients in Inner Mongolia Autonomous Region from 2013 to 2018, so as to provide the evidence for the management of echinococcosis in high-risk areas.

METHODS

All data pertaining to echinococcosis patients in Inner Mongolia Autonomous Region were captured from the National Notifiable Communicable Disease Reporting System from 2013 to 2018 and analyzed using a spatial epidemiological method.

RESULTS

The incidence of reported echinococcosis was 0.22 to 0.41 per 100 000 in Inner Mongolia Autonomous Region from 2013 to 2018, and the number of banner reporting echinococcosis patients increased from 24 in 2013 to 39 in 2018. The highly prevalent areas of echinococcosis were mainly concentrated in West Ujimqin Banner (the highest incidence, 19.23 per 100 000), East Ujimqin Banner (the highest incidence, 12.93 per 100 000) and New Barag Right Banner (the highest incidence, 11.66 per 100 000). Three-dimensional trend analysis showed that the areas with high incidence of reported echinococcosis were mainly located in central by eastern parts of Inner Mongolia Autonomous Region. There was a positive spatial autocorrelation in the number of echinococcosis patients, and the cases appeared a clustering distribution (Moran's I > 0, P < 0.05), with "high-high" and "low-high" regions.

CONCLUSIONS

The reported echinococcosis patients show a spatial aggregation in Inner Mongolia Autonomous Region, and the hotspot areas are mainly concentrated in Xilingol League and Chifeng City, in which targeted control interventions for Inner Mongolia Autonomous Region are recommended to be intensified.

Quantitation of Plasmacytoid Dendritic Cells in Chronic Hepatitis B Patients with HBeAg Positivity During PEG-IFN and Entecavir Therapy

Plasmacytoid dendritic cells (pDCs) are crucial for control of chronic hepatitis B (CHB) virus infection. In this study, we evaluated the frequencies of pDCs and expression of functional molecules on pDCs in patients treated with PEG-IFN-α-2a or entecavir (ETV) and investigated changes during treatment. The mean fluorescence intensity of CD86 (CD86MFI) on the surface of pDCs and frequencies of pDCs and CD86⁺ pDCs in peripheral blood were measured. Compared with baseline, CD86⁺ pDC% and CD86MFI increased obviously after PEG-IFN-α-2a treatment for 12 and 24 weeks. For patients treated with ETV, only pDC% increased observably after treatment weeks 12 and 24 (P < 0.001) compared with baseline. Hepatitis B surface antigen (HBsAg) decline was significantly associated with elevated CD86⁺ pDC% (r = 0.348, P = 0.015) during PEG-IFN-α-2a treatment. In the HBsAg response group, CD86⁺ pDC% and CD86MFI (P < 0.001) increased observably after PEG-IFN-α-2a therapy, whereas only CD86MFI had a statistically significant difference after therapy compared with baseline (12 weeks versus 0 weeks, P = 0.022; 24 weeks versus 0 weeks, P = 0.015) in the HBsAg nonresponse group. CD86⁺ pDC% between the 2 groups had statistically significant differences at baseline (P = 0.001) and at the treatment time points of 12 and 24 weeks (P < 0.001), respectively. For patients receiving ETV therapy, pDC% increased observably, but CD86⁺ pDC% decreased significantly (P < 0.001) in the HBV DNA nonresponse group during early treatment with ETV. In CHB patients, HBsAg response in PEG-IFN-α-2a therapy correlated with the increase of CD86⁺ pDC% and HBV DNA nonresponse in ETV treatment correlated with the decrease of CD86⁺ pDC%.

Evaluation of a logistic regression model for predicting liver necroinflammation in hepatitis B e antigen-negative chronic hepatitis B patients with normal and minimally increased alanine aminotransferase levels

Liver necroinflammation is the indicator for treating patients with chronic hepatitis B (CHB) infection. However, there is no suitable non-invasive index for diagnosing liver necroinflammation. This study aimed to create a non-invasive index to predict liver necroinflammation in patients who lack clear-cut clinical inflammation parameters. Patients who were hepatitis B e antigen (HBeAg)-negative and underwent liver histological diagnosis, had a normal or minimally increased alanine aminotransferase (ALT) level were enrolled. Liver necroinflammation was defined as histological active index ≥4. A logistic regression model (LRM) was established based on the parameters independently associated with liver necroinflammation. Of all 550 patients, 36.73% had necroinflammation. In patients with an abnormal ALT level, the rate of necroinflammation was 52.49%. The area under the curve (AUC) of the ALT level for predicting necroinflammation was 0.655 (95% confidence interval [CI], 0.609-0.702), and that of the HBV DNA level ≥2000 IU/mL combined with an abnormal ALT level was 0.618. By using the LRM, the AUC improved to 0.769 (95% CI, 0.723-0.815) with a Youden index of 0.519 and diagnostic accuracy of 75.3%. The cutoff value ≥0.7 in the LRM had a specificity of 97.4% and positive predictive value of 85.0% for predicting necroinflammation. By using the cutoff value <0.15 in the LRM, the presence of necroinflammation could be excluded with a negative predictive value of 90.8%. This study indicated that the LRM can be used to effectively diagnose liver necroinflammation in HBeAg-negative patients with CHB who have normal or minimally elevated ALT levels.

Predictors of sustained functional cure in hepatitis B envelope antigen-negative patients achieving hepatitis B surface antigen seroclearance with interferon-alpha-based therapy

Hepatitis B surface antigen (HBsAg) loss is considered a functional cure in chronic hepatitis B (CHB). However, the durability of HBsAg loss after stopping treatment remains unknown. This study aimed to assess the sustained functional cure achieved by interferon therapy in hepatitis B envelope antigen (HBeAg)-negative CHB patients. In this prospective study, 176 HBeAg-negative CHB patients with functional cure were enrolled for 12 weeks of cessation treatment, and treatment information and baseline data were collected. Hepatitis B virus (HBV) biomarkers and clinical biochemical indicators were evaluated every 3 months; liver imaging examinations were performed every 3-6 months during the 48-week follow-up. The sustained functional cure was evaluated. After the 48-week follow-up, the sustained functional cure rate was 86.63%. The cumulative rates of HBsAg reversion and HBV DNA reversion were 12.79% and 2.33%, respectively. Consolidation treatment ≥ 12 weeks after HBsAg loss achieved a significantly higher rate of sustained functional cure and significantly lower rate of HBsAg reversion than consolidation treatment < 12 weeks (76.19% vs 90.00%, P = 0.022 and 23.81% vs 9.23%, P = 0.014, respectively). Patients with hepatitis B surface antibody (HBsAb) had higher rate of sustained functional cure than patients achieving HBsAg loss but without HBsAb (89.86% vs 73.53%, P = 0.012). Consolidation treatment ≥ 12 weeks (odds ratio [OR] 16.478; 95% confidence interval [CI], 2.135-127.151; P = 0.007) and high HBsAb levels (OR 8.312; 95% CI, 1.824-37.881; P = 0.006) were independent predictors of sustained functional cure. Results suggested that 12 weeks of consolidation therapy after HBsAg clearance and elevated HBsAb levels help to improve functional cure.

Plasmacytoid Dendritic Cell Function and Cytokine Network Profiles in Patients with Acute or Chronic Hepatitis B Virus Infection

Background:

Plasmacytoid dendritic cells (pDCs) and cytokines play an important role in occurrence and recovery of hepatitis B virus (HBV) infection. The aim of this study was to explore the frequency and function of pDC and serum cytokine network profiles in patients with acute or chronic HBV infection.

Methods:

The healthy individuals (HI group), hepatitis B envelope antigen (HBeAg)-positive chronic HBV patients in immune tolerance (IT) phase (IT group), HBeAg-positive chronic HBV patients (CHB group), and acute HBV patients (AHB group) were enrolled in this study. The frequency of cluster of differentiation antigen 86 (CD86) + pDC and the counts of CD86 molecular expressed on surface of pDC were tested by flow cytometer. The quantitative determinations of cytokines, including Fms-like tyrosine kinase 3 ligand (Flt-3L), interferon (IFN)-α2, IFN-γ, interleukin (IL)-17A, IL-6, IL-10, transforming growth factor (TGF)-β1 and TGF-β2, were performed using Luminex multiplex technology.

Results:

In this study, there were 13 patients in HI group, 30 in IT group, 50 in CHB group, and 32 in AHB group. Compared with HI group, HBV infected group (including all patients in IT, CHB and AHB groups) had significantly higher counts of CD86 molecular expressed on the surface of pDC (4596.5 ± 896.5 vs. 7097.7 ± 3124.6; P < 0.001). The counts of CD86 molecular expressed on the surface of pDC in CHB group (7739.2 ± 4125.4) was significantly higher than that of IT group (6393.4 ± 1653.6, P = 0.043). Compared with IT group, the profile of cytokines of Flt-3L, IFN-γ, and IL-17A was decreased, IFN-α2 was significantly increased (P = 0.012) in CHB group. The contents of IL-10, TGF-β1, and TGF-β2 in AHB group were significantly increased compared with IT and CHB groups (all P < 0.05).

Conclusions:

This study demonstrated that the function of pDC was unaffected in HBV infection. The enhanced function of pDC and IFN-α2 might involve triggering the immune response from IT to hepatitis active phase in HBV infection. Acute patients mainly presented as down-regulation of the immune response by enhanced IL-10 and TGF-β.

Association of Cytokines with Alanine Aminotransferase, Hepatitis B Virus Surface Antigen and Hepatitis B Envelope Antigen Levels in Chronic Hepatitis B

Background

Cytokines play an important role in occurrence and recovery of hepatitis B virus (HBV) infection. The aim of this study was to investigate the changes of cytokines concentration and its correlation to alanine aminotransferase (ALT), HBV deoxyribonucleic acid (HBV-DNA), hepatitis B envelope antigen (HBeAg), and HBV surface antigen (HBsAg) in the development of chronic hepatitis B (CHB).

Methods

Thirteen healthy individuals (HI), 30 chronic HBV-infected patients in immune tolerant (IT) phase, and 55 CHB patients were enrolled between August 2015 and May 2017. The peripheral blood samples were collected from all individuals. The levels of interferon (IFN)-α2, interleukin (IL)-10, transforming growth factor (TGF)-β1, HBV-DNA, HBsAg, and HBeAg and liver function were measured. The quantitative determinations of cytokines levels, including IFN-α2, IL-10, and TGF-β1 were performed using Luminex multiplex technology. The correlation of cytokines to ALT, HBV-DNA, HBsAg, and HBeAg was analyzed by linear regression analysis.

Results

IFN-α2 levels were similar between HI and IT groups (15.35 [5.70, 67.65] pg/ml vs. 15.24 [4.07, 30.73] pg/ml, Z = -0.610, P = 0.542), while it elevated significantly in CHB group (35.29 [15.94, 70.15] pg/ml vs. 15.24 [4.07, 30.73] pg/ml; Z = -2.522, P = 0.012). Compared with HI group (3.73 [2.98, 11.92] pg/ml), IL-10 concentrations in IT group (5.02 [2.98, 10.11] pg/ml), and CHB group (7.48 [3.10, 18.00] pg/ml) slightly increased (χ² = 2.015, P = 0.365), and there was no significant difference between IT and CHB group (Z = -1.419, P = 0.156). The TGF-β1 levels among HI (3.59 ± 0.20 pg/ml), IT (3.62 ± 0.55 pg/ml), and CHB groups (3.64 ± 0.30 pg/ml) were similar (χ² = 2.739, P = 0.254). In all chronic HBV-infected patients (including patients in IT and CHB groups), the elevation of IFN-α2 level was significantly associated with ALT level (β= 0.389, t = 2.423, P = 0.018), and was also negatively correlated to HBV-DNA load (β = -0.358, t = -2.308, P = 0.024), HBsAg (β = -0.359, t = -2.288, P = 0.025), and HBeAg contents (β = -0.355, t = -2.258, P = 0.027). However, when both ALT level and cytokines were included as independent variable, HBV-DNA load, HBsAg, and HBeAg contents were only correlated to ALT level (β = -0.459, t = -4.225, P = 0.000; β = -0.616, t = -6.334, P = 0.000; and β = -0.290, t = -2.433, P = 0.018; respectively).

Conclusions

IFN-α2 elevation was associated with ALT level in patients with chronic HBV infection. However, in CHB patients, only ALT level was correlated to HBV-DNA, HBsAg and HBeAg contents.

Negative Correlation of Serum Hepatitis B Surface Antigen and Hepatitis B e Antigen Levels with the Severity of Liver Inflammation in Treatment-naïve Patients with Chronic Hepatitis B Virus Infection

Background:

Estimating the grades of liver inflammation is critical in the determination of antiviral therapy in patients chronically infected with hepatitis B virus (HBV). The aim of this study was to investigate the correlation of serum levels of hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg) with the liver inflammation grades in treatment-naïve patients with chronic HBV infection.

Methods:

We retrospectively enrolled 584 treatment-naïve HBeAg-positive patients who underwent liver biopsy in Ditan Hospital from January 2008 to January 2016. Based on the severity of liver inflammation, the patients were divided into minimal, mild, and moderate groups. SPSS software was used for statistical analysis of all relevant data.

Results:

The liver histological examinations showed that 324, 194, and 66 patients had minimal, mild, and moderate liver inflammation, respectively. The median age of the three groups was 30, 33, and 38 years, respectively (χ² = 26.00, P < 0.001). The median HBsAg levels in minimal, mild, and moderate inflammation groups were 4.40, 4.16, and 3.67 log U/ml, respectively, and the median HBeAg levels in the three groups were 3.12, 2.99, and 1.86 log sample/cutoff, respectively; both antigens tended to decrease as the grade of inflammation increased (χ² = 99.68 and χ² = 99.23, respectively; both P < 0.001). The cutoff values of receiver operating characteristic curve in the age, HBsAg and HBeAg levels were 36 years, 4.31 log U/ml, and 2.86 log S/CO, respectively, l to distinguish minimal grade and other grades of treatment-naïve HBeAg-positive patients with chronic HBV infection.

Conclusions:

Serum HBsAg and HBeAg quantitation might gradually decrease with aggravated liver inflammation and the corresponding cutoff values might help us to distinguish minimal grades and other grades and detect those who do not need antiviral therapy in treatment-naïve HBeAg-positive patients with chronic HBV infection.

Ratios of T-helper 2 Cells to T-helper 1 Cells and Cytokine Levels in Patients with Hepatitis B

BACKGROUND

Hepatitis B is an immune response-mediated disease. The aim of this study was to explore the differences of ratios of T-helper (Th) 2 cells to Th1 cells and cytokine levels in acute hepatitis B (AHB) patients and chronic hepatitis B virus (HBV)-infected patients in immune-tolerance and immune-active phases.

METHODS

Thirty chronic HBV-infected patients in the immune-tolerant phase (IT group) and 50 chronic hepatitis B patients in the immune-active (clearance) phase (IC group), 32 AHB patients (AHB group), and 13 healthy individuals (HI group) were enrolled in the study. Th cell proportions in peripheral blood, cytokine levels in plasma, and serum levels of HBV DNA, hepatitis B surface antigen, and hepatitis B e antigen were detected.

RESULTS

The Th1 cell percentage and Th2/Th1 ratio in the HBV infection group (including IT, IC, and AHB groups) were significantly different from those in HI group (24.10% ± 8.66% and 1.72 ± 0.61 vs. 15.16% ± 4.34% and 2.40 ± 0.74, respectively; all P < 0.001). However, there were no differences in the Th1 cell percentages and Th2/Th1 ratios among the IT, IC, and AHB groups. In HBV infection group, the median levels of Flt3 ligand (Flt3L), interferon (IFN)-γ, and interleukin (IL)-17A were significantly lower than those in HI group (29.26 pg/ml, 33.72 pg/ml, and 12.27 pg/ml vs. 108.54 pg/ml, 66.48 pg/ml, and 35.96 pg/ml, respectively; all P < 0.05). IFN-α2, IL-10, and transforming growth factor (TGF)-β2 median levels in hepatitis group (including patients in AHB and IC groups) were significantly higher than those in IT group (40.14 pg/ml, 13.58 pg/ml, and 557.41 pg/ml vs. 16.74 pg/ml, 6.80 pg/ml, and 419.01 pg/ml, respectively; all P < 0.05), while patients in hepatitis group had significant lower Flt3L level than IT patients (30.77 vs. 59.96 pg/ml, P = 0.021). Compared with IC group, patients in AHB group had significant higher median levels of IL-10, TGF-β1, and TGF-β2 (22.77 pg/ml, 10,447.00 pg/ml, and 782.28 pg/ml vs. 8.66 pg/ml, 3755.50 pg/ml, and 482.87 pg/ml, respectively; all P < 0.05).

CONCLUSIONS

Compared with chronic HBV-infected patients in immune-tolerance phase, chronic HBV-infected patients in immune-active phase and AHB patients had similar Th2/Th1 ratios, significantly higher levels of IFN-α2, IL-10, and TGF-β. AHB patients had significantly higher IL-10 and TGF-β levels than chronic HBV-infected patients in immune-active phase.

[The correlation study of HBV serological index in neonate's venus, cord blood and mother's venus blood]

OBJECTIVE

In this study, we discussed the consistency and correlation of HBV serological indexes between neonates' venous blood and cord blood whose mothers had chronical HBV infection, as well as the correlation of thoses indexes with the mothers'.

METHOD

Chronically HBV infected mothers who were postive of both HBsAg and HBeAg and also had a HBV DNA virus load above 10(5) copies/ ml and their infants were enrolled. The mothers' venous blood were collected before delivery. The neonates' cord blood were collected at birth after removal of contaminants and disinfected with alcohol on the cord's surface, and the venous blood were collected before hepatitis B virus immune globin(HBIG) and hepatitis B vaccine were given. The levels of HBsAg, anti-HBs, HBeAg and anti-HBeAg were tested with Abbott microparticle chemiluminescence method (Abbott Laboratories, Abbott Architac i2000). HBV DNA quantification were tested by COBAS TagMan real-time PCR Assay.

RESULTS

383 mothers and their infants were enrolled. The positive rates of HBsAg in cord blood and venous blood were 61.2% and 63.9%. The positive rates of HBeAg level in cord blood and venous blood were 83.2% and 83.5%. The positive rates of HBV DNA level in cord blood and venous blood were 56.0% and 59.4%. The state of HBsAg, HBeAg and HBV DNA in cord blood and venous blood were consistency, and significant correlation was observed in their levels with correlation coefficients of 0.766, 0.857, and 0.692, respectively (P < 0.000). Significant correlation of the HBeAg levels were observed between mothers' venous blood and neonates' venous blood, as well as neonates' cord blood with correlation coefficients of 0.362 and 0.352 (P < 0.000). However, there was no significant correlation of HBsAg levels between them (r = 0.023, P = 0.785; r = 0.04, P = 0.604).

CONCLUSIONS

The HBV serological index of neonate's cord blood could reflect the HBV serological indexes in venous blood because of the good correlation and consistency between them.

[Dendritic cell subsets and function in newborns from mothers of different HBV infection status]

OBJECTIVE

The aim of this study was to explore the frequency of mDC and pDC and expression of surface markers of the neonates and to discuss the effect of different status of HBV infection of mother on biological characteristics of DC.

METHODS

Umbilicus cord blood in neonates of HBeAg positive HBV infected mother, HBeAg negative HBV infected mother, and normal mother were collected respectively; peripheral blood of healthy adults were selected as control group. Flow cytometry was employed to detect frequency of the mDC and its expression of CD86, frequency of pDC and its expression of CD80, CD83, CD86, and FlowJo software was used to compare these indicators among the groups.

RESULTS

Compared with control group, the frequency of mDC of cord blood (0.29 +/- 0.16 vs 0.81 +/- 0.17), CD86 positive rate of mDC (10.72 +/- 10.01 vs 32.13 +/- 7.46), the frequency of pDC (0.15 +/- 0.07 vs 0.30 +/- 0.07), and CD86/CD83 positive rate of pDC (31.61 +/- 12.81 vs 74.96 +/- 9.78; 42.66 +/- 20.83 vs 82.00 +/- 6.94) were lower (t = -7.86, P = 0.00; t = -5.36, P = 0.00; t = -5.43, P = 0.00; t = -8.49. P = 0.00; t = -4.90, P = 0.00).

CONCLUSIONS

The frequency of mDC and pDC in umbilical cord blood was lower than the peripheral blood of healthy adult, which was the possible mechanism of newborns easier to chronicity after the infection of hepatitis B virus. A significant correlation was found between different status of HBV infection and costimulatory molecule CD86 positive rate of mDC, but not for the frequency of mDC and pDC, and the expression of pDC molecules.

[Involvement of dendritic cells frequency and function in outcomes of interferon-alpha therapy for chronic hepatitis B patients]

OBJECTIVE

To elucidate the change in frequencies and functions of myeloid dendritic cell (mDC) and plasmacytoid dendritic cell (pDC) before and after interferon-alpha therapy for chronic hepatitis B (CHB) patients, and its correlation with virological and biochemical data.

METHODS

Thirty patients with HBeAg-positive CHB who underwent IFN-alpha therapy were examined. Frequencies and expression of CD86 of mDC and pDC of peripheral blood were measured at baseline and treatment week (TW) 12 by flow cytometry. According to biochemical and virological parameters, the 30 patients were divided into ALT normalized group, ALT non-normalized group and virological responder group, virological non-responder group respectively. Statistical analysis of DC changes among different groups at baseline and TW12 was proceeded.

RESULTS

(1) In the ALT normalized group, the pDC frequency at TW12 (0.25 +/- 0.14%) was higher than that at baseline (0.18 +/- 0.09%) (P = 0.023); in the ALT non-normalized group, the mDC frequency (0.58 +/- 0.34%) and its surface CD86 expression (61.80 +/- 22.52%) decreased significantly as compared with baseline (0.88 +/- 0.51%, 79.92 +/- 25.94%, respectively), (P = 0.025, P = 0.036, respectively). (2) In the virological responder group, the CD86 expression on pDC at TW12 (46.86 +/- 12.22%) was higher than that at baseline (29.42 +/- 15.16%) (P = 0.002); in the virological non-responder group, the mDC frequency (0.51 +/- 0.22%) and its surface CD86 expression (59.63 +/- 22.94% ) decreased significantly as compared with baseline (0.94 +/- 0.58%, 80.11 +/- 29.34%, respectively), (P = 0.006; P = 0.049, respectively).

CONCLUSION

In IFN-alpha therapy for CHB patients, the increments of pDC frequency and function were related to biochemical and viral response, and decreases of mDC frequency and function were related to non-biochemical and non-viral response.

[Predictive study of HBsAg in different stages of neonatal venous blood on failure of blocking HBV mother to infant transmission]

OBJECTIVE

In this study, we discuss the predictive value of different content of HBsAg in different stages of neotal venous blood on failure of blocking mother to infant transmission of HBV.

METHODS

150 infants born of chronically HBV infected mothers who were positive of both HBsAg and HBeAg and who also had a HBV DNA virus load above 10(5) copies/ml were enrolled. These infants were given hepatitis B virus immune globin (HBIG) 200 IU immediately after birth and were given hepatitis B vaccine 10 or 20 microg at brith, 1 month and 6 months after birth. HBV serological index of these infants were test at birth, 1 month and 7 months after birth respectively. Different content of HBsAg in different stages of neonatal venus blood were analyzed to predict the failure of blocking mother to infant transmission of HBV.

RESULTS

11 infants failed in blocking of HBV mother to infant transmission. The positive rate of HBsAg at birth, 1 month and 7 months after birth were 41.26%, 10.49% and 7.69% respectively, and were 97.90%, 65.73% and 13.29% of HBeAg. The positive predictive value of HBsAg > or = 0.05 and HBsAg > or = 1 IU/ml at birth were 18.64% and 70% respectively, and were 73.33% and 100% one month after birth.

CONCLUSIONS

Infants with HBsAg > or = 1 IU/ml at birth should be suspicious of failure on blocking HBV mother-to-infant transmission and it should be more credible if the infant has HBsAg > or = 1 IU/ml one month after birth. How to improve the blocking rate of neonates who were positive of HBsAg at birth and one month after birth should be the focus of our future research.