This consensus was developed by Chinese Society of Hepatology, Chinese Medical Association. It includes introduction, etiology, epidemiology and prevention, pathology, laboratory examination, clinical manifestation, treatment, issues to be studied and solved.
Consensus ; Gastroenterology ; Hepatitis E/prevention & control* ; Humans

Hepatitis E ; immunology ; prevention & control ; Humans ; Viral Hepatitis Vaccines

This paper summarizes the incidence, modes of transmission, diagnosis, treatment and prevention of chronic hepatitis E.
Humans ; Hepatitis E/prevention & control* ; Hepatitis, Chronic/epidemiology* ; Incidence

Hepatitis E ; etiology ; prevention & control ; Hepatitis E virus ; immunology ; Humans ; Viral Hepatitis Vaccines ; immunology

Animals ; Hepatitis E ; prevention & control ; Hepatitis E virus ; immunology ; Humans ; Viral Hepatitis Vaccines

BACKGROUNDTo observe the protective effect of hepatitis E virus (HEV) ORF2 recombinant protein expressed in prokaryote cell cynomolgus macaques (cynos) against challenging with wild-type HEV.

METHODSCynos were immunized with HEV ORF2 recombinant protein and then challenged with wild-type HEV, the unimmunized cynos were used as control. Blood samples were collected and tested to see if there were dynamic changes of ALT and antibody to HEV before and after challenge with wild-type HEV.

RESULTSAll the five unimmunized cynos re-presented hepatitis 3 weeks after challenging with wild-type HEV. However, all the five immunized cynos showed no hepatitis and pathological changes.

CONCLUSIONSCynos can be efficiently protected by immunization with HEV ORF2 recombinant protein against wild-type HEV. This protein can be a promising candidate for HEV vaccine.

Animals ; Female ; Hepatitis Antibodies ; blood ; Hepatitis E ; immunology ; prevention & control ; Hepatitis E virus ; immunology ; Macaca mulatta ; Male ; Recombinant Proteins ; immunology ; Viral Proteins ; immunology

OBJECTIVETo observe anti-HEV IgG response to vaccination of recombinant antigen fragments and evaluate its protection from Hepatitis E Virus infection in rhesus monkeys (Macaca mulatta).

METHODSTwelve monkeys were divided into three groups and immunized respectively with three different recombinant antigens: namely Ag1 (carboxyl terminal 431 amino acids of ORF2), Ag2 (128aa fragment at the carboxyl terminal of ORF2), and Ag3 (full length ORF3 ligated with two ORF2 fragments encoded by 6743-7126nt and 6287-6404nt). The monkeys were challenged intravenously with fecal suspension from experimentally infected rhesus monkeys, and the other three monkeys served as the placebo group for challenge with HEV. The dynamic changes of the levels of ALT and anti-HEV IgG were examined. Pathological changes of liver tissue were observed by light microscope. Excretion of virus was detected by RT-nPCR.

RESULTSHepatic histopathology of two monkeys in the placebo group was consistent with acute viral hepatitis, and ALT was elevated 3-4 weeks after inoculated with virus, up to 10-20 times higher than normal level. The liver tissue of monkeys immunized with antigen kept normal, ALT in several monkeys elevated mildly, and anti-HEV IgG conversation occurred at 1-2 weeks after vaccination, with the titer reaching 1:12,800. The virus RNA could be detected by RT-nPCR from days 7 to 50 in monkeys of control group, and from days 7 to 21 in vaccinated monkeys after challenged with virus.

CONCLUSIONSThe recombinant antigens could induce the production of anti-HEV IgG, which protected rhesus monkeys from acute Hepatitis symptoms related to HEV infection.

Animals ; Antigens, Viral ; immunology ; Hepatitis E ; prevention & control ; Hepatitis E virus ; immunology ; Immunoglobulin G ; immunology ; Macaca mulatta ; RNA, Viral ; blood ; Recombinant Proteins ; immunology ; Vaccination ; Viral Hepatitis Vaccines ; immunology

In an attempt to clarify the protective action of an antioxidant agent against acute toxicity of thioacetamide (TAA) and in order to throw some light on an satisfying concept of the mechanism of its action, a single dose of alphatocopherol (200 mg per kg) was given orally by stomch tube to male mice prior to the administration of thioacetamide in a dose of 200 mg per kg of body weight. Sections of liver samples, obtained from the mice which were sacrificed at intervals of 3, 6, 9, or 12 hours after TAA administration, were stained using the methyl green-pyronin technique. At 3 hours following TAA administration, the pretreatment with alpha-tocopherol inhibited almost completely such alterations of the hepatocytes in the animals given TAA alone, as revealed by loss and clumping of cytoplasmic pyroninophilic granules in the periportal zone of the lobule. At 6, 9, and l2 hours, the prevention of alpha-tocopherol was incomplete in degree and extent. The changes of the hepatocytes were more intense and extensive in the TAA-treated 6 to 12 hour-groups than in the 3 hour-group of TAA-treated ones. Some discussion is given of the mechanism of TAA toxicity, with respect to the microsoma1 lipid peroxidation.
Acetamides/poisoning* ; Animal ; Hepatitis, Toxic/pathology* ; Hepatitis, Toxic/prevention & control ; Liver/pathology* ; Male ; Mice ; Vitamin E/pharmacology* ; Vitamin E/therapeutic use

The World Health Organization (WHO) has set the goal of eliminating viral hepatitis as a threat to public health by 2030. Blocking mother-to-child transmission (MTCT) of hepatitis B virus (HBV) is the key step for eliminating viral hepatitis, at the same time, it is the hotspot in the field of hepatitis B prevention and control as well. The China Foundation of Hepatitis Prevention and Control (CFHPC) organized a team of specialists to develop an algorithm for preventing MTCT of HBV, based on the most recent hepatitis B guidelines and the latest evidence. The algorithm covers 10 continuous steps from pregnant management to follow-up postpartum. Among the 10 steps, screening, antiviral therapy during pregnancy, and infant's immunization are the core components in the algorithm.
Algorithms ; Antiviral Agents/therapeutic use* ; Child ; China ; Female ; Hepatitis B/prevention & control* ; Hepatitis B Surface Antigens ; Hepatitis B e Antigens ; Hepatitis B virus ; Humans ; Infant ; Infectious Disease Transmission, Vertical/prevention & control* ; Pregnancy ; Pregnancy Complications, Infectious/prevention & control*

OBJECTIVETo investigate the risk factors for mother-to-child transmission of hepatitis B virus (HBV) and the efficacy of hepatitis B immunoprophylaxis in children at high risk of hepatitis B.

METHODSA questionnaire survey was performed on 539 HBsAg-positive mothers and their 551 children (aged from 6 months to 5 years) at high risk of hepatitis B. Serum markers of hepatitis B in the children at high risk of hepatitis B were measured. Univariate logistic regression analysis was used to investigate the risk factors for mother-to-child transmission of HBV.

RESULTSThe rate of hepatitis B vaccination in the children at high risk of hepatitis B was 100%, and 96.6% received injections of hepatitis B vaccine and hepatitis B immunoglobulin (HBIG). The HBsAg positive rate showed no significant differences between different age groups. The HBsAb positive rate gradually decreased with the increasing age (P<0.01). The children born to HBsAg- and HBeAg-positive mothers had a significantly higher hepatitis B infection rate than those born to HBsAg-positive mothers (15.1% vs 0.2%; P<0.01). The high-risk children who received hepatitis B vaccination alone had a significantly higher hepatitis B infection rate than those who received both hepatitis B vaccine and HBIG injections (28.6% vs 2.8%; P<0.01).

CONCLUSIONSThe HBsAb positive rate gradually decreases with the increasing age in children at high risk of hepatitis B. Maternal HBsAg and HBeAg positivity and the absence of HBIG combined with hepatitis B vaccine injections for children at high risk of hepatitis B are the risk factors for mother-to-child transmission of HBV.

Child, Preschool ; Female ; Hepatitis B ; etiology ; prevention & control ; Hepatitis B Surface Antigens ; analysis ; Hepatitis B Vaccines ; immunology ; Hepatitis B e Antigens ; analysis ; Humans ; Immunoglobulins ; immunology ; Infant ; Infectious Disease Transmission, Vertical ; prevention & control ; Male ; Risk Factors