Background Hepatitis delta virus (HDV) is a satellite RNA virus that relies on hepatitis B virus (HBV) for transmission. HIV/HBV/HDV coinfection or triple infection is common and has a worse prognosis than monoinfection. Objective We aimed to reveal the epidemiological characteristics of HIV/HBV/HDV triple infection in the global population. Methods A systematic literature search in PubMed, Embase, and the Cochrane Library was performed for studies of the prevalence of HIV/HBV/HDV triple infection published from January 1, 1990, to May 31, 2021. The Der Simonian-Laird random effects model was used to calculate the pooled prevalence. Results We included 14 studies with 11,852 participants. The pooled triple infection rate in the global population was 7.4% (877/11,852; 95% CI 0.73%-29.59%). The results of the subgroup analysis showed that the prevalence of triple infection was significantly higher in the Asian population (214/986, 21.4%; 95% CI 7.1%-35.8%), in men (212/5579, 3.8%; 95% CI 2.5%-5.2%), and in men who have sex with men (216/2734, 7.9%; 95% CI 4.3%-11.4%). In addition, compared with people living with HIV, the HIV/HBV/HDV triple infection rate was higher in people with hepatitis B. Conclusions This meta-analysis suggests that the prevalence of HIV/HBV/HDV triple infection in the global population is underestimated, and we should focus more effort on the prevention and control of HIV/HBV/HDV triple infection. Trial Registration PROSPERO CRD42021273949; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=273949
Background/Aims: To investigate the autoantibody against fumarate hydratase (FH), which is a specific liver failure-associated antigen (LFAA) and determine whether it can be used as a biomarker to evaluate the prognosis of acute-on-chronic liver failure (ACLF).Methods: An immunoproteomic approach was applied to screen specific LFAAs related to differential prognosis of ACLF (n=60). Enzyme-linked immunosorbent assay (ELISA) technology was employed for the validation of the frequency and titer of autoantibodies against FH in ACLF patients with different prognoses (n=82). Moreover, we clarified the expression of autoantibodies against FH in patients with chronic hepatitis B (n=60) and hepatitis B virus-related liver cirrhosis (n=60). The dynamic changes in the titers of autoantibodies against FH were analyzed by sample collection at multiple time points during the clinical course of eight ACLF patients with different prognoses.Results: Ultimately, 15 LFAAs were screened and identified by the immunoproteomic approach. Based on ELISA-based verification, anti-FH/Fumarate hydratase protein autoantibody was chosen to verify its expression in ACLF patients. ACLF patients had a much higher anti-FH autoantibody frequency (76.8%) than patients with liver cirrhosis (10%, p=0.000), patients with chronic hepatitis B (6.7%, p=0.022), and normal humans (0%, p=0.000). More importantly, the frequency and titer of anti-FH protein autoantibodies in the serum of ACLF patients with a good prognosis were much higher than that of patients with a poor prognosis (83.9% vs 61.5%, p=0.019; 1.41±0.85 vs 0.94±0.56, p=0.017, respectively). The titer of anti-FH autoantibodies showed dynamic changes in the clinical course of ACLF. Conclusions:The anti-FH autoantibody in serum may be a potential biomarker for predicting the prognosis of ACLF.
BACKGROUND Coronavirus disease 2019 (COVID-19) is long-lasting and has an adverse effect on liver function. However, the impact of COVID-19 on the outcome of patients with liver cirrhosis has not been consistently clear. OBJECTIVE We aimed to conduct a systematic review and meta-analysis to explore whether COVID-19 negatively impacts cirrhosis patients. METHODS We conducted a systematic search of the PubMed/Medline, Embase, and Cochrane Library databases to compare cirrhosis patients with and without COVID-19. Two authors independently performed data extraction and quality evaluation using the Newcastle‒Ottawa Scale. Data pooling was conducted using random-effects or fixed-effects models based on the heterogeneity of the included studies. RESULTS A total of 13 studies were included that involved 949 patients with cirrhosis and COVID-19 and 15,196 patients with cirrhosis only. Of the 13 studies, ten were studies among hospitalized patients, and three were studies among discharged patients. COVID-19 infection increased the mortality, ICU (Intensive Care Unit) admission rate, length of hospital stay and incidence of acute-on-chronic liver failure (ACLF), Child‒Pugh C and hepatic encephalopathy among hospitalized patients with liver cirrhosis. However, COVID-19 infection did not affect the mortality rate or the incidence of Child‒Pugh C among patients with cirrhosis after discharge. CONCLUSIONS In hospitalized patients with cirrhosis, infection with COVID-19 may be a potential risk factor for adverse clinical outcomes. However, COVID-19 infection seems to have no effect on patients with cirrhosis after discharge. It is recommended that clinicians pay more attention to the prevention and treatment of COVID-19 in patients with preexisting liver cirrhosis. CLINICALTRIAL PROSPERO CRD42023429256; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=429256
Background and Aims Hepatitis delta virus (HDV) is a defective virus and causes severe liver disease. Several HDV RNA assays have been developed, however the diagnostic efficacy remains unclear.This systematic review and meta-analysis aims to evaluate the diagnostic accuracy of HDV RNA assays to aid in the diagnosis of active hepatitis D. Methods The PubMed, Embase, and Cochrane Library databases were systematically searched from the beginning to June 31, 2022. Information on the characteristics of the literature and data on sensitivity, specificity, and area under curve (AUC) of the receiver operating characteristic (ROC) were extracted. Stata 14.0 was used for meta-analysis of the combined sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Results A total of 10 studies were included in the meta-analysis. The summary sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of HDV RNA assays for HDV diagnosis were 0.92 (95% CI: 0.87–0.95), 0.90 (95% CI: 0.86–0.93), 7.74 (95% CI: 5.31–11.29), 0.10 (95% CI: 0.06–0.18) and 99.90 (95% CI: 47.08–211.99), respectively. The AUC of the pooled ROC curve was 0.95 (95% CI: 0.92–0.96). Conclusions The results show that HDV RNA assays had high diagnostic performance. However, that is limited by the number and quality of studies. Standard protocols for the development of assays by manufacturers and larger studies on the use of the assays are needed.
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