Anti-HDV seroprevalence in patients with decompensated liver cirrhosis due to hepatitis B

Abstract Background Cerebral microbleeds (CMBs) are small, rounded, dark-signal lesions on brain MRI that represent cerebral hemosiderin deposits resulting from prior microhemorrhages and are neuroimaging biomarkers of cerebral amyloid angiopathy (CAA). Here, we report a case of innumerable CMBs in a patient with hepatic encephalopathy underlying decompensated liver cirrhosis. Case presentation An 83-year-old woman diagnosed with hepatitis B virus-related liver cirrhosis 40 years before was referred to our neurology clinic for progressive disorientation of time and place, personality changes, and confusion with somnolence over 2 weeks. Based on the laboratory, neuroimaging, and electrophysiological findings, we diagnosed the patient with hepatic encephalopathy, and her symptoms recovered within 12 h after proper medical management. Brain MRI showed innumerable CMBs in the bilateral frontal, parietal, temporal, and occipital lobes. Since the distribution of CMBs in the patient was mainly corticosubcortical and predominantly in the posterior cortical regions, and the apolipoprotein E genotype was ε4/ε4, we speculated that CAA and hepatic encephalopathy coexisted in this patient. Conclusions We suggest that severe liver dysfunction associated with long-term decompensated liver cirrhosis may be related to an increased number of CMBs in the brain. Our findings indicate that decompensated liver cirrhosis may be a risk factor for the development of CMBs and corroborate a link between the liver and the brain.

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Treg/Th17 imbalance and its clinical significance in patients with hepatitis B-associated liver cirrhosis

Diagnostic Pathology ◽

10.1186/s13000-019-0891-4 ◽

2019 ◽

Vol 14 (1) ◽

Cited By ~ 3

Author(s):

Yong-Ting Lan ◽

Zhen-li Wang ◽

Peng Tian ◽

Xiao-Na Gong ◽

Yu-Chen Fan ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis B ◽

Regression Model ◽

Peripheral Blood ◽

Th17 Cells ◽

Cox Regression ◽

Prognostic Significance ◽

Decompensated Liver Cirrhosis ◽

Cox Regression Model ◽

Potential Marker

Abstract Background Recent studies have shown that T cell-mediated cellular immune mechanisms play important roles in the progression of hepatitis B to liver cirrhosis, but the underlying mechanisms remain unclear. This present study was aimed to determine the relationship between Treg/Th17 and hepatitis B-associated liver cirrhosis. Methods The Treg and Th17 cell frequencies in the peripheral blood of all participants, including 93 patients with hepatitis B-associated liver cirrhosis and 40 healthy subjects, were measured by flow cytometer. Cox regression model and receiver operating characteristic(ROC) curves were applied to investigate the prognostic significance of Treg/Th17 ratio in decompensated liver cirrhosis. Results We observed the Treg/Th17 imbalance was present in patients with hepatitis B-associated liver cirrhosis, with reduced Treg cells in their peripheral blood, increased Th17 cells and decreased Treg/Th17 ratio. Treg and Th17 cells were negatively correlated. Treg/Th17 imbalance was closely related to the clinical stage of hepatitis B-associated liver cirrhosis. The Virus load, Treg frequencies and the Treg/Th17 ratio were independent factors predicting decompensated liver cirrhosis from a Cox regression model. The ROC analysis showed that the Treg/Th17 ratio was the best marker for predicting decompensated liver cirrhosis. Conclusions Treg/Th17 imbalance is involved in the pathogenesis of hepatitis B-associated liver cirrhosis and the Treg/Th17 ratio can be used as a potential marker for predicting decompensated liver cirrhosis.

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Long-term efficacy of entecavir therapy on hepatitis B patients with decompensated liver cirrhosis

Pharmaceutical Care and Research ◽

10.5428/pcar20140614 ◽

2014 ◽

Vol 14 (6) ◽

pp. 443-446

Author(s):

REN Hui ◽

MA XueMei ◽

YU DeLei ◽

ZHAO Lin ◽

WANG HongBo ◽

...

Keyword(s):

Liver Cirrhosis ◽

Hepatitis B ◽

Decompensated Liver Cirrhosis ◽

Term Efficacy

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Compliance with the clinical practice guidelines for the management of hepatitis B and C virus-related chronic liver disease: a survey based on hospitalized cirrhotic patients

Italian Journal of Medicine ◽

10.4081/itjm.2013.107 ◽

2013 ◽

pp. 107-112

Author(s):

Emanuele La Spada ◽

Giuseppe Augello ◽

Giovanni Anastasi ◽

Aldo Spadaro ◽

Francesco Taormina ◽

...

Keyword(s):

Liver Cirrhosis ◽

Liver Disease ◽

Hepatitis B ◽

Chronic Liver Disease ◽

Management Practices ◽

Antiviral Treatment ◽

Specific Treatment ◽

Chronic Liver ◽

Ultrasound Screening ◽

Decompensated Liver Cirrhosis

In recent years, significant progress has been made in furthering our knowledge of chronic liver disease (CLD) and evaluating the therapeutic approaches. These have been updated in the form of recommendations by international scientific societies. Through a retrospective analysis, this study aimed to verify whether these recommendations have been applied in real practice. The study design included data gathered from all patients consecutively hospitalized for decompensated liver cirrhosis during one year. A pre-made master form was used to record data on the patients’ past knowledge of the etiology and management of their liver disease. As expected, hepatitis C virus (HCV) was the most frequent cause of CLD, while 41 cases were cryptogenic. In 69 of 263 patients with HCV infection, viral genotyping had been performed, although only 39 of these cases had been treated. Only 3 of 44 patients suffering from hepatitis B virus (HBV)-related liver cirrhosis had been treated in the past, while 11 patients were still being treated. Among the remaining patients, 15 were not aware that they had CLD and 15 had never been considered for antiviral treatment. In 81 cases, the disease had progressed to hepatocellular carcinoma, but only 19 patients had discovered the tumor following regular ultrasound screening. Thirty-seven patients were receiving specific treatment consistent with the stage of their disease. The management of HBV- and HCV-related CLD in Sicily is far from optimal, and although the natural history and management practices of these diseases are well known, this knowledge is a long way from being applied in our daily practice.

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