Polymerase chain reaction to detect hepatitis B virus DNA and RNA sequences in primary liver cancers from patients negative for hepatitis B surface antigen

Article Abstract:

Results of epidemiologic studies strongly suggest that chronic infection with hepatitis B virus (HBV) is associated with liver cancer. HBV infection also contributes to liver cirrhosis (a chronic, degenerative disease), and cirrhosis is also correlated with liver cancer. These results are best established in patients who are HBsAg-positive (have antigens associated with hepatitis B virus on the surfaces of their cells), but the possible role of HBV in HBsAg-negative patients with liver cancer has not been as extensively explored. To better evaluate this issue, 28 HBsAg-negative patients with liver cancer were studied, using a highly sensitive assay (the polymerase chain reaction). The patients came from Italy (nine), France (10), South Africa (eight), and Japan (one). Cirrhosis was present in 22 patients. Tumor tissue was evaluated for HBV viral DNA and RNA (genetic material), and blood samples were taken to determine the presence of HBsAg and antibodies against hepatitis B proteins (anti-HBc or anti-HBs). Results showed that 10 of 23 patients had anti-HBc antibodies, anti-HBs, or both, while 13 had no markers for HBV. Eight of these 10 patients were from South Africa. HBV DNA was detected in liver tissue from 17 of the 28 patients; five from Italy, six from South Africa, five from France, and the one patient from Japan. Eight were positive for one of the anti-hepatitis B antibodies, and six had no HBV markers. Fourteen of these HBV DNA-positive tumors were from patients with cirrhosis, and three were associated with normal liver. Of the 22 patients with cirrhosis, HBV DNA was found in 14. Further investigation indicated that in some tumors the viral DNA was partially deleted. The findings suggest that in patients who are positive for anti-HBc or anti-HBs and who develop liver cancer, the viral genome may decline, resulting in HBsAg-negative test results. The persistence of HBV DNA sequences in people who have been exposed to the disease represents a risk for cancer through an unexplained mechanism. Overall, HBV DNA capable of replication was present in patients with liver cancer, even though they tested negative for HBsAg. (Consumer Summary produced by Reliance Medical Information, Inc.)

Diagnosis, Measurement, Identification and classification, Liver cancer, Liver cirrhosis, Hepatitis associated antigen, Hepatitis B e-antigen

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Membranous nephropathy related to hepatitis B virus in adults

Article Abstract:

Infection with the hepatitis B virus (HBV) is associated not only with hepatitis, but also with liver cirrhosis and liver cancer. However, in parts of the world where hepatitis B virus infection is common, the infection seems to be associated with several forms of kidney disease as well. The most widely studied kidney disease associated with HBV infection is called membranous nephropathy, but many of the reported cases involve children, and little is known about the natural course of this disease in adults. Careful studies were conducted of 21 adults with membranous nephropathy to tabulate the clinical features, antibody profiles, therapeutic responses, pathological effects, and prognosis of this disorder. The medical histories of the patients suggested that the kidney disease was not the result of a recently acquired HBV infection, but was the result of childhood infection with HBV. One of the features that distinguishes an endemic area for HBV, that is, an area in which the risk of infection is always high, is that most patients are first exposed during childhood. Attempts to treat the kidney disorder were largely ineffective. In six patients, the disease slowly but relentlessly progressed and two patients required dialysis treatment for kidney failure. The results of the study show that spontaneous remissions are rare in adult cases of membranous nephropathy. Furthermore, in roughly one-third of the patients the disease is progressive and may result in chronic kidney failure. (Consumer Summary produced by Reliance Medical Information, Inc.)

Kidney diseases

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The new and the old - molecular diagnostics and hemolytic disease of the newborn

Article Abstract:

Polymerase chain reaction (PCR) may be an effective method to determine the Rh status of a fetus with an Rh-negative mother and a Rh-positive father early in a pregnancy. PCR is a molecular biology technique used to analyse small segments of DNA. If the fetus of an Rh-negative mother is Rh-positive, the mother will produce anti-Rh antibodies. These antibodies can bind the red blood cells of an Rh-positive fetus and destroy them. Hemolytic disease of the newborn can kill the fetus. Rh-negative women with an Rh-positive fetus should be followed closely. A research study found that PCR correctly determined the Rh status of both amniotic cells and fetal blood. It also correctly determined the Rh status of fetal tissue obtained from chorionic villi sampling. Use of this technique may enable Rh typing during the first trimester of pregnancy. It also may prevent additional blood tests and invasive procedures.

Editorial, Analysis, Prevention, Rh factor, Erythroblastosis fetalis

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