Maki Kojima

HLA DRB1 and DQB1 alleles and haplotypes influencing the progression of hepatitis C

Some HLA class II alleles and haplotypes were examined by restriction fragment length polymorphism of corresponding DNA fragments amplified by the polymerase chain reaction in 117 patients with chronic hepatitis C in Japan. The prevalence rates were compared between patients and 1216 controls and in 67 patients with liver cirrhosis, of whom 20 had hepatocellular carcinoma and 50 patients with chronic hepatitis who did not have cirrhosis or hepatocellular carcinoma. Notably, DRB1*0405 (49% [95% confidence range 38‐60%] vs. 26% [16‐40%]; P < 0.05, relative risk [rr] = 2.8) and DQB1*0401 (43% [33‐54%] vs. 22% [13‐34%]; P < 0.05, rr = 2.1) were detected more frequently in patients with cirrhosis than in those without cirrhosis. By contrast, DRB1*0901 (11% [6‐19%] vs. 28% [18‐40%]; P < 0.05; rr = 0.3) and DQB1*0303 (11% [6‐19%] vs. 36% [25‐49%]; P < 0.01; rr = 0.2) were detected less frequently in patients with cirrhosis than those without cirrhosis. Accordingly, the DRB1*0405‐DQB1*0401 haplotype was more common (43% [33‐54%] vs. 22% [13‐34%]; P < 0.05; rr = 2.7), while the DRB1*0901‐DQB1*0303 haplotype was less common (9% [4‐17%] vs. 28% [18‐40%]; P < 0.05; rr = 0.3) in patients with cirrhosis than in those without cirrhosis. These results suggest that there would be HLA class II alleles and haplotypes which may be associated with an accelerated or slower progression of chronic hepatitis C towards cirrhosis and eventually to hepatocellular carcinoma.

Identification of Indigenous Hepatitis E Virus from a Japanese Patient Who Contracted Sporadic Acute Hepatitis in 1982

Figure 1. Phylogenetic tree constructed by the neighbor-joining method and based on the partial nucleotide sequence (301 nt) of the open reading frame 2 region of 50 human and swine hepatitis E virus (HEV) isolates. The nucleotide sequences of 49 known human and swine HEV isolates were retrieved from GenBank/DDBJ/EMBL databases on 22 July 2002. The partial nucleotide sequence of HE-JO-1982 obtained in the present study is deposited under accession no. AB088418 and is boxed for visual clarity. All human and swine HEV strains of Japanese origin are indicated by boldface type. Bootstrap values 170% are indicated for the major nodes as a percentage of the data obtained from 1000 resamplings [9]. Identification of Indigenous Hepatitis E Virus from a Japanese Patient Who Contracted Sporadic Acute Hepatitis in 1982

Cold activation of complement in sera from patients with persistent hepatitis C virus infection on interferon therapy.

The loss of haemolytic activity in sera during storage at low temperature (the cold activation of complement) was observed in 136 of 184 (74%) patients with chronic liver disease associated with hepatitis C virus (HCV) infection. This was more frequent than observed in the three of 40 (8%) patients with chronic hepatitis B (P < 0.001) or none in 43 normal controls (P < 0.001). Of 103 patients with chronic hepatitis C who had completed a full course of recombinant interferon‐α2a therapy (total dose: 516×106U), 40 responded completely and 21 responded partially, as judged by the normalization or decrease of alanine aminotransferase levels 6 months after the completion of therapy; 42 patients did not respond at all. The cold activation of complement persisted in five (13%) complete responders, less often than in 33 (79%) non‐responders (P < 0.001). At the completion of interferon therapy, the cold activation of complement persisted in 12 of 54 patients despite the normalization of alanine aminotransferase. Spontaneous exacerbation of hepatitis occurred in seven of 12 (58%) patients with cold activation, which was more frequent than in the four of 42 patients (10%) without it (P < 0.01). The cold activation of complement disappeared along with the loss of HCV‐RNA in five of six responders during the 6 month period after the completion of interferon therapy, while both cold activation and HCV‐RNA persisted in all eight non‐responders. These results indicate that the cold activation of complement may be useful as a marker of HCV viraemia for monitoring the response to interferon in patients with HCV infection.

Pretreatment Antimicrobial Susceptibilities of Paired Gastric Helicobacter pylori Isolates: Antrum Versus Corpus

Background. Antimicrobial susceptibility testing of Helicobacter pylori isolates is the most useful tool for guiding specific therapy, especially when primary resistance is suspected. However, the most informative gastric biopsy site for detection of resistant H. pylori isolates is uncertain. We sought to determine whether susceptibilities to commonly used antimicrobials (amoxicillin, clarithromycin, minocycline, and metronidazole) were related to biopsy site.

Hepatitis C virus RNA in blood units with antibodies detectable by a second-generation passive hemagglutination assay, antibodies to synthetic core peptides or elevated transaminase levels

Abstract Blood units from 3383 donors were tested for antibodies to hepatitis C virus (HCV) by a second-generation passive hemagglutination assay (PHA-2) with detector cells coated with three recombinant HCV proteins. They were tested also for antibodies to synthetic HCV core peptides (anti-CP9 and anti-CP10) by enzyme immunoassays and for alanine aminotransferase (ALT). PHA-2 was reactive in 32 (0.9%) units, high-titered anti-CP9 and/or anti-CP10 was detected in 101 (3.0%), and elevated ALT levels (> 45IU/L) in 99 (2.9%). At least one of these markers were detected in 209 units (6.2%), and HCV RNA was tested for in 197 of them. HCV RNA was detected in 21 units including 19 initially reactive on PHA-2 of which 17 were repeatedly reactive, 19 with anti-CP9 and/or anti-CP10 in high titers, and 5 with elevated ALT levels. Two units were reactive only on PHA-2, while the other two had anti-CP9/anti-CP10 as the sole indicator of hepatitis C viremia. These results indicated that PHA-2 and anti-CP9/anti-CP10 would be complementary in detecting blood units with HCV RNA, and effective in further decreasing the risk of post-transfusion hepatitis C.

Infection with hepatitis G virus (GBV-C/HGV) in patients with chronic liver disease.

慢性肝疾患患者333例について, PCR法を用いてHGV RNAを測定した. B型慢性肝疾患85例では1例 (1.2%), C型慢性肝疾患患者189例では22例 (11.6%), 非B非C型慢性肝疾患患者54例では, 1例 (1.9%) にそれぞれHGV RNAが検出された. B型慢性肝疾患, 非B非C型慢性肝疾患におけるHGVの関与は大きくないと考えられた. C型慢性肝疾患については, 慢性肝炎141例中16例 (11.4%), 肝硬変35例中3例 (8.6%), 肝癌13例中3例 (23.1%) でHGV RNAが陽性であり, HCVの推定感染経路によって分類すると, 輸血歴を有する場合, 8.3%であったのに対し, 経静脈的薬物濫用歴を有する場合に24.0%と極めて高率にHGVRNAが陽性であった. HGV RNAの陽性, 陰性群で年齢, 性別, 肝疾患, 肝機能等に有意の差は認められなかった.