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HBV-HCV Coinfection: viral Interactions, Management, and viral reactivation

Journal of Clinical and Translational Hepatology 2018年第3期6卷 296-305页

作者： Marianna G.Mavilia George Y.Wu Department of Medicine Division of Gastroenterology-HepatologyUniversity of Connecticut Health CenterFarmingtonCTUSA

Hepatitis B virus(HBV)and hepatitis C virus(HCV)coinfec-tion is a complex clinical entity that has an estimated world-wide prevalence of 1–15%.Most clinical studies have shown that progression of disease is faster in HBV-HCV coinfected patients compared to those with ***-lular carcinoma development appears to have higher rate in *** replication in coinfected cells is character-ized by a dominance of HCV over HBV *** are no established guidelines for treatment of HBV-HCV *** on interferon-based therapies and direct-acting antivirals have shown varying levels of *** reports have indicated that treatment of HCV without sup-pression of HBV increases the risk for HBV *** this review,we appraise studies on both direct-acting antivirals and interferon-based therapies to evaluate the efficacy and rates of reactivation with each *** for and prevention of coinfection are important to prevent serious HBV reactivations.

关键词： Hepatitis B virus Hepatitis C virus Coinfection viral reactivation

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Contributions of neurotropic human herpesviruses herpes simplex virus 1 and human herpesvirus 6 to neurodegenerative disease pathology

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Neural Regeneration Research 2018年第2期13卷 211-221页

作者： Jessica M.Hogestyn David J.Mock Margot Mayer-Proschel Department of Neuroscience University of Rochester Department of Biomedical Genetics University of Rochester

Human herpesviruses （HVs） have developed ingenious mechanisms that enable them to traverse the defenses of the central nervous system （CNS）. The ability of HVs to enter a state of latency, a defining char- acteristic of this viral family, allows them to persist in the human host indefinitely. As such, HVs represent the most frequently detected pathogens in the brain. Under constant immune pressure, these infections are largely asymptomatic in healthy hosts. However, many neurotropic HVs have been directly connected with CNS pathology in the context of other stressors and genetic risk factors. In this review, we discuss the potential mechanisms by which neurotropic HVs contribute to neurodegenerative disease （NDD） patholo- gy by highlighting two prominent members of the HV family, herpes simplex virus 1 （HSV-1） and human herpesvirus 6 （HHV-6）. We （i） introduce the infectious pathways and replicative cycles of HSV-1 and HHV-6 and then （ii） review the clinical evidence supporting associations between these viruses and the NDDs Alzheimer＇s disease （AD） and multiple sclerosis （MS）, respectively. We then （iii） highlight and dis- cuss potential mechanisms by which these viruses exert negative effects on neurons and glia. Finally, we （iv） discuss how these viruses could interact with other disease-modifying factors to contribute to the initiation and/or progression of NDDs.

关键词： herpes simplex virus 1 human herpesvirus 6 central nervous system neurodegeneration demyelination Alzheimer's disease multiple sclerosis viral latency viral reactivation

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Hepatitis B in renal transplant patients

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World Journal of Hepatology 2017年第25期9卷 1054-1063页

作者： Smaragdi Marinaki Kyriaki Kolovou Stratigoula Sakellariou John N Boletis Ioanna K Delladetsima Department of Nephrology and Renal Transplantation Unit Medical SchoolNational and Kapodistrian University of AthensLaiko General Hospital First Department of Pathology Medical SchoolUniversity of Athens

Hepatitis B virus(HBV) poses a significant challenge for both dialysis patients and kidney transplant recipients despite its decreasing rates, especially in developed countries. The best preventive method is vaccination. Patients with chronic renal disease should ideally be vaccinated prior to dialysis, otherwise, reinforced vaccination practices and close antibody titer monitoring should be applied while on dialysis. HBV infected dialysis patients who are renal transplant candidates must be thoroughly examined by HBV-DNA, and liver enzyme testing and by liver biopsy. When needed, one must consider treating patients with tenofovir or entecavir rather than lamivudine. Depending on the cirrhosis stage, dialysis patients are eligible transplant recipients for either a combined kidney-liver procedure in the case of decompensated cirrhosis or a lone kidney transplantation since even compensated cirrhosis after sustained viral responders is no longer considered an absolute contraindication. Nucleoside analogues have led to improved transplantation outcomes with both long-term patient and graft survival rates nearing those of HBs Ag(-) recipients. Moreover, in the cases of immunized HBs Ag(-) potential recipients with concurrent prophylaxis, we are enabled today to safely use renal grafts from both HBs Ag(+) and HBs Ag(-)/antiHBc(+) donors. In so doing, we avoid unnecessary organ discarding. Universal prophylaxis with entecavir is recommended in HBV kidney recipients and should start perioperatively. One of the most important issues in HBV(+) kidney transplantation is the duration of antiviral prophylaxis. In the absence of robust data, it seems that prophylactic treatment may be discontinued in selected stable, low-risk recipients during maintenance immunosuppression and should be reintroduced when the immune status is altered. All immunosuppressive agents in kidney transplantation can be used in HBV(+) recipients. Immunosuppression is intimately associated with increased

关键词： Hepatitis B virus(+) donor Hepatitis B virus(+) recipient Renal transplantation viral reactivation Immunosuppression Nucleoside analogues Antiviral discontinuation Antiviral prophylaxis Hepatitis B

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