| Part oneHBV, HCV and HDV infection shows distinct patterns betweeninjection drug users and general populationBackground Hepatitis B, C and D virus(HBV, HCV and HDV) infections are known to be prevalent in injection drug users(IDUs), however in the same area correlation and molecular epidemiologic features of hepatitis viruses infection between high risk and general population have not been established yet.Methods Total 1049 IDUs and 672 individuals who underwent physical examinations at Chenzhou hospital, Hunan Province, China were enrolled. HBV, HCV and HDV infections were screened with serologic tests in both populations. HBs Ag, anti-HCV Ig G and anti-HDV Ig G positive samples were further confirmed by PCR, q PCR and DNA sequencing.Results Significantly higher HBV(21.54 vs 16.52% p =0.01), HCV(45.95% vs 1.34% p < 0.001) and HDV(5.62% vs 0.30% p <0.001) infections were detected in IDUs comparing general population. The dual-infection of HBV/HCV or HBV/HDV was also significantly higher in IDUs than in general population. HBV genotype B and HDV genotype ? were dominants in both populations. HCV infection showed genotype 6a(49.52%) dominant in IDUs, but genotype 1b accounted for 50% infection, which was followed by genotype 6a(33.33%) in general population. Higher viral loads were associated with HBV genotype B and HCV genotype 6a comparing non-dominant genotypic infections.Conclusions HBV and HDV infections shared similar patterns by IDUs and general populations, and HCV infection exhibited distinct features between two populations. Our results suggest IDUs are of high risk of hepatitis virus infection, we should strength the prevention and treatment of hepatitis virus in IDUs. Part twoHBV/HCV Co-infection impact viral load, antibody and cytokinelevel comparing with HBV or HCV mono-infectionBackground HBV/HCV co-infection is common among high risk individuals and associated with serious liver diseases. However, virological and immunological features in HBV/HCV co-infection are not clearly defined.Methods To examine the features of antibody, cytokine response and viral replication in HBV/HCV co-infection, total 1049 injection drug users were enrolled from Chenzhou, Hunan Province, China. HBV and HCV serological markers were performed by ELISA. HBV and HCV viral load were measured by real-time PCR. Serum IL-1, IL-6, IL-8, TNF–? and IFN-? level were measured by Bio-Plex Pro Assay or ELISA.Results We found HCV viral load was significantly lower(p=0.011), however HBV viral load was significantly higher(p=0.021) in HBV/HCV co-infection by comparing with HCV mono infection and HBV mono infection, respectively. HBV/HCV co-infection decreased the anti-HCV E2 antibody binding activity comparing with HCV mono infection(p<0.001), in HBV spontaneous clearance individuals with HCV infection also show lower anti-HBs level comparing with HBV spontaneous clearance individuals without HCV infection(p<0.001). Serum cytokines analysis show significant decreased IL-6, IL-8 and TNF–? level HBV/HCV co-infection than in HBV or HCV mono-infection.Conclusions Two viral replications are imbalanced in co- infected patients, and viral replication level favors HBV. HBV/HCV co-infection decrease antibody and cytokine IL-6, IL-8 and TNF–?.HBV/HCV co-infection down-regulated the immune response, this may relate to chronic infection in co-infection. These findings shed light on virological and immunological feather of HBV/HCV co-infection. |
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