Background and Aims:Recently,the World Health Organization adopted the first-ever global hepatitis strategy with the dream of eliminating viral hepatitis as a public health threat by 2030.However,the epidemiology and treatment rates of hepatitis C virus(HCV)infection in Western China are still unknown.Methods:A total of 111,916 adult individuals(15-96 years)who underwent the HCV-antibody(HCV-Ab)test in the Second Affiliated Hospital of Chongqing Medical University between 2013 and 2015 were included in this study.We retrospectively analyzed the electronic medical records'data for each,and the positivity of HCV-Ab and the treatment of HCV RNA-positive patients were evaluated.Results:During 2013-2015,the crude prevalence of HCVAb was 1.4%(95%CI:1.4-1.5;1,611/111,916)and the adjusted prevalence of HCV-Ab was 1.7%(95%CI:1.6-1.8),which was higher than in the 2006 national study(0.43%).The prevalence was 2-times higher in males than females(2.0%vs.1.1%,p<0.01).Notably,only 46%(434/951)of the HCV RNA-positive patients received standard peginterferon plus ribavirin treatment,with 370(82%)that completed treatment,of whom 272(74%)achieved sustained virologic response(SVR).Particularly,11%(32/292)of HCV RNA-positive patients were HBsAg-positive,and the SVR rate for them was lower than for the HBsAg-negative patients,but no significant difference was observed.Conclusions:HCV infection may have increased since 2006 in Western China.The SVR rate of peg-interferon plus ribavirin treatment was high,but the proportion of untreated HCV patients was large.Thus,more efforts need to be made by the government to create a scientific-based policy for HCV treatment and prevention.
Zhi-Wei ChenZhao LiQiao-He WangXiao-Ling WuHu LiHong RenPeng Hu
Natural killer(NK)cells have a vital role in killing hepatocellular carcinoma(HCC)cells;however,the mechanism underlying tumor-infiltrating NK(TINK)-cell dysfunction remains poorly understood.Using flow cytometry staining,we precisely characterized the frequency,phenotype and function of NK subsets distinguished by CD27 and CD11b in 30 patients with HCC in comparison to 30 healthy controls.Interestingly,we found a substantial proportion of liver-infiltrating CD11b−CD27−(DN)NK subsets in tumor tissue from HCC patients.Remarkably,these relatively expanded DN NK subsets exhibited an inactive and immature phenotype.By detecting the expression of CD107a and interferon-gamma(IFN-γ)on NK subsets and NK cells,we demonstrated that DN NK subsets exhibited a poor cytotoxic capacity and deficient potential to produce IFN-γin comparison to the other three subsets,which contributed to the dysfunction of TINK cells in HCC patients.In addition,we found that the presence of DN NK cells was closely associated with the clinical outcomes of HCC patients,as the frequency of DN NK cells among TINK cells was positively correlated with tumor stage and size.A large percentage of DN NK cells among TINK cells was an independent prognostic factor for lower survival in the 60-month follow-up period.In conclusion,a substantial proportion of CD11b−CD27−NK subsets among TINK cells accounts for NK-cell dysfunction in patients with HCC and is associated with tumor progression.Our study may provide a novel therapeutic target for the treatment of patients with HCC.
