scholarly journals Absence of Hepatitis B Resistance Mutants before Introduction of Oral Antiviral Therapy

2013 ◽  
Vol 2013 ◽  
pp. 1-5 ◽  
Author(s):  
Martin Moehlen ◽  
Maria De Medina ◽  
Mary Hill ◽  
Lennox Jeffers ◽  
Eugene R. Schiff ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Antiviral Therapy ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Drug Resistant ◽  
Induced Mutations ◽  
Resistance Mutations ◽  
Chronic Hbv Infection ◽  
Treatment Naïve ◽  
Chronic Hbv

Introduction. The aim of this study was to assess whether hepatitis B virus drug resistant mutations antedated the widespread use of nucleos(t)ide analogues in treatment naïve patients. A number of reports have suggested that drug resistant mutants can be detected in apparently treatment naïve patients. Study. Fifty deidentified serum samples collected from 1986 to 1992 from patients with replicative chronic HBV infection at the University of Miami were genotyped and tested for resistance mutations using a line probe assay InnoLiPA HBV DR v2/v3. Serum HBV DNA was measured. All patients had documented chronic HBV infection with a detectable viral load, HBeAg seropositivity, and absence of HIV infection. Results. Of the 50 individuals included, 86% were male, mean age was 40 ± 12 years, and mostly genotype A. The mean HBV DNA was 126 pg/mL (range 6.4 to 557.0). No mutations were identified. Conclusions. The absence of drug induced mutations in these sera collected several years prior to the introduction of oral antiviral therapy suggests that these mutations do not occur in treatment naïve populations. Detection of drug resistance in an apparently treatment naïve subject suggests either unrecognized prior antiviral therapy or infection by an inoculum from a treatment experienced patient.

scholarly journals Spectrum of Hepatits B Infection Among Patients Attending Liver Unit in Nepalgunj Medical College – Kohalpur

2018 ◽  
Vol 16 (2) ◽  
pp. 2-5
Author(s):  
Dipendra Khadka ◽  
Sudhamshu KC ◽  
Niyanta Karki ◽  
Sandip Khadka ◽  
Kiran Regmi
Keyword(s):  
Liver Disease ◽  
Hepatitis B ◽  
Tertiary Care ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Hepatitis B Infection ◽  
Chronic Hbv Infection ◽  
Medical College ◽  
Liver Unit ◽  
Chronic Hbv

Introduction: Hepatitis B infection is a global problem. Hepatitis B virus (HBV) infection related liver disease is also not an uncommon problem in our country too. Reports regarding pattern of chronic HBV infection are also lacking. The aim of the present study was to determine the spectrum of chronic HBV infection among patients attending the liver clinic in a tertiary care center. Method: A hospital based descriptive cross-sectional study was carried out in Liver unit of Nepalgunj Medical College, Kohalpur, from April 2018 to November 2018. All patients with HBsAg positive were further tested for HBeAg, HBeAb, HBV DNA quantitative and liver function test. Ultrasound examination was advised for any evidence of chronic liver disease. Staging was done according to viral serology, liver biochemistry and ultrasonography of liver Results: Total patients enrolled were 119. Majority of patents were in between 30-60 years (51.3%) with male predominance 59.7%. Most of patients were in the stage of HBeAg negative chronic infection 66.4% with normal transaminase and HBV DNA <2000 IU/ML. Majority of patients having unknown source of infection 90.8%. Incidental detection (67.2%) was common mode of detection. Conclusions: Majority of patients were in HBeAg negative chronic hepatitis B infection phase with normal transaminase and low HBV DNA not requiring treatment.

Assessment and simplification of treatment eligibility among patients with chronic hepatitis B infection in Vietnam

2020 ◽  
Author(s):  
Vinh Vu Hai ◽  
Yusuke Shimakawa ◽  
Jin Kim ◽  
Hai Do Ngoc ◽  
Quang Le Minh ◽  
...  
Keyword(s):  
Antiviral Therapy ◽  
Scale Up ◽  
Hbv Dna ◽  
Dna Quantification ◽  
Hbv Infection ◽  
National Guidelines ◽  
Middle Income ◽  
Who Criteria ◽  
Chronic Hbv Infection ◽  
Chronic Hbv

Abstract Background Treatment eligibility and the accuracy of its simplified criteria have been poorly documented in patients with chronic HBV infection worldwide, especially in low-and-middle-income countries. Methods From a cohort of HBV-infected patients in Vietnam, we assessed the proportion of patients eligible for treatment using the national guidelines based on reference tests (HBV DNA quantification and FibroScan); and the accuracy of simplified treatment criteria free from HBV DNA and FibroScan (TREAT-B score and simplified WHO criteria) to select patients for antiviral therapy using the national guidelines as a reference. Results We analysed 400 consecutive treatment-naïve HBV-monoinfected patients: 49% males, median age 38 years (range: 18-86), 32% HBeAg-positive, median HBV DNA 4.8 log10 IU/ml (undetectable-8.4), median FibroScan 5.3kPa (3.0-67.8), 25% having significant liver fibrosis including 12% with cirrhosis. Of them 167 (42%) fulfilled treatment criteria according to the national guidelines. Using the national criteria as a reference, the performance of TREAT-B to select patients for treatment was high (AUROC: 0.89 (95%CI: 0.87-0.92)) with a sensitivity of 74.3% and a specificity of 88.4%. In a subset of patients with two ALT measurements over a 6-month period (n=89), the AUROC of TREAT-B was significantly higher than that of the simplified WHO criteria (p&lt;0.001). Conclusion Our study suggests that a large proportion of patients with chronic HBV infection require antiviral therapy in Vietnam. Compared to the simplified WHO criteria free from HBV DNA quantification, TREAT-B is a better alternative to easily indicate treatment eligibility and might help scale-up treatment intervention in Vietnam.

scholarly journals Hepatitis B Core-related Antigen: An Alternative to Hepatitis B Virus DNA to Assess Treatment Eligibility in Africa

2019 ◽  
Author(s):  
Yusuke Shimakawa ◽  
Gibril Ndow ◽  
Ramou Njie ◽  
Harr Freeya Njai ◽  
Kazuaki Takahashi ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Antiviral Therapy ◽  
Characteristic Curve ◽  
Scale Up ◽  
Treatment Algorithm ◽  
Hbv Dna ◽  
Hbv Infection ◽  
B Virus ◽  
Treatment Naïve

Abstract Background To eliminate hepatitis B virus (HBV) infection, it is essential to scale up testing and treatment. However, conventional tools to assess treatment eligibility, particularly nucleic acid testing (NAT) to quantify HBV DNA, are hardly available and affordable in resource-limited countries. We therefore assessed the performance of a novel immunoassay, hepatitis B core-related antigen (HBcrAg), as an inexpensive (US$ <15/assay) alternative to NAT to diagnose clinically important HBV DNA thresholds (≥2000, ≥20 000, and ≥200 000 IU/mL) and to select patients for antiviral therapy in Africa. Methods Using a well-characterized cohort of treatment-naive patients with chronic HBV infection in The Gambia, we evaluated the accuracy of serum HBcrAg to diagnose HBV DNA levels and to indicate treatment eligibility determined by the American Association for the Study of Liver Diseases, based on reference tests (HBV DNA, hepatitis B e antigen, alanine aminotransferase, liver histopathology, and/or FibroScan). Results A total of 284 treatment-naive patients were included in the analysis. The area under the receiver operating characteristic curve (AUROC), sensitivity, and specificity of serum HBcrAg were 0.88 (95% confidence interval [CI], .82–.93), 83.3%, and 83.9%, respectively, to diagnose HBV DNA ≥2000 IU/mL; and 0.94 (95% CI, .88–.99), 91.4%, and 93.2% for ≥200 000 IU/mL. A simplified treatment algorithm using HBcrAg without HBV DNA showed high AUROC (0.91 [95% CI, .88–.95]) with a sensitivity of 96.6% and specificity of 85.8%. Conclusions HBcrAg might be an accurate alternative to HBV DNA quantification as a simple and inexpensive tool to identify HBV-infected patients in need of antiviral therapy in low- and middle-income countries.

scholarly journals Benefits and Risks of Antiviral Treatment during Pregnancy in Patients with Chronic Hepatitis B

2021 ◽  
Vol 10 (11) ◽  
pp. 2320
Author(s):  
Yoon Seok Lee ◽  
Soo Min Bang ◽  
Young-Sun Lee
Keyword(s):  
Hepatitis B ◽  
Antiviral Therapy ◽  
Antiviral Treatment ◽  
Hbv Infection ◽  
World Health ◽  
Chronic Hbv Infection ◽  
B Virus ◽  
Chronic Hbv ◽  
Health Organization ◽  
Meta Analyses

Hepatitis B virus (HBV) is a main cause of chronic liver disease worldwide and can lead to severe liver diseases. The World Health Organization has planned to eliminate viral hepatitis, including hepatitis caused by HBV and hepatitis C virus, by 2030. As mother-to-child transmission (MTCT) of HBV is a main cause of chronic HBV infection, MTCT prevention is the main target to reduce the risk of chronic HBV infection and eliminate the disease. Recent clinical trials and meta-analyses found that antiviral therapy could prevent MTCT effectively in mothers with ≥200,000 IU/mL of HBV DNA, in combination with serial vaccination and hepatitis B immune globulin administration in infants. Despite the preventive role of antivirals for MTCT of HBV, there are several concerns regarding antiviral therapy with respect to the safety of the mother and fetus during pregnancy. This review summarizes the benefits and risks of antiviral treatment during pregnancy in women with chronic HBV infection.

HBsAg level as a predictor of disease activity in patients with chronic hepatitis B infection with delta-agent

2020 ◽  
Vol 18 (4) ◽  
pp. 149-152
Author(s):  
M.A. Abdukadyrova ◽  
◽  
S.M. Sharapov ◽  
A.S. Khikmatullaeva ◽  
◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Disease Activity ◽  
Chronic Hepatitis B ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Hbsag Level ◽  
Chronic Hbv Infection ◽  
Chronic Hbv

We have conducted a pilot study to identify the association between the HBsAg level and activity of the pathological process in the liver, as well as possibility of quantitative assessment of HBsAg for monitoring chronic liver diseases caused by hepatitis B virus (HBV) and hepatitis D virus (HDV). Objective. To assess the possibility of using HBsAg levels as a predictor of disease activity and prognosis in patients with chronic HBV infection with delta-agent. Patients and methods. We analyzed serum specimens from 30 patients with HDV and HBV co-infection. Among 15 patients with chronic hepatitis B with delta-agent, there were 5 HBV DNA positive and 10 HBV DNA negative. Among patients with liver cirrhosis, HBV DNA was detected in 11 individuals, while 4 individuals had undetectable HBV DNA levels. Results. We found that mean HBsAg level in patients with chronic HBV infection and negative HBV DNA was 1.9 ± 0.56 IU/mL. Mean HBsAg level in patients with chronic HBV infection with delta-agent and positive HBV DNA was 4.3 ± 0.62 IU/mL (p < 0.05). High HBsAg levels correlated with elevated ALT in patients with chronic hepatitis B and delta-agent. Patients with liver cirrhosis caused by HDV had normal ALT levels, but elevated bilirubin concentrations regardless of HBV DNA presence and HBsAg level. Conclusion. High levels of HBsAg can be considered as a predictor of active disease in patients with chronic HBV infection with delta-agent and also a marker of transformation of chronic hepatitis B with delta-agent into liver cirrhosis. Key words: chronic hepatitis B with delta agent, liver cirrhosis, enzyme-linked immunosorbent assay, HBsAg levels, polymerase chain reaction

scholarly journals Quantification of intrahepatic hepatitis B virus (HBV) DNA in patients with chronic HBV infection

Hepatology ◽  
2000 ◽  
Vol 31 (2) ◽  
pp. 507-512 ◽  
Author(s):  
Irene Cacciola ◽  
Teresa Pollicino ◽  
Giovanni Squadrito ◽  
Giovanni Cerenzia ◽  
Daniela Villari ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
B Virus ◽  
Chronic Hbv

scholarly journals Antiviral Therapy for Chronic HBV Infection With Persistently Normal Alanine Aminotransferase: Controversy and Consensus

2021 ◽  
Vol 8 ◽  
Author(s):  
Jing Zhou ◽  
Fa-Da Wang ◽  
Meng-Lan Wang ◽  
Ya-Chao Tao ◽  
Dong-Bo Wu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Antiviral Therapy ◽  
Immune Tolerance ◽  
Stable State ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
Number Of Patients ◽  
Chronic Hbv ◽  
Normal Alanine Aminotransferase ◽  
Normal Alt

ALT is one of the most sensitive biochemical indexes to reflect liver injury. It is generally believed that hepatitis B virus (HBV) infected patients with normal ALT levels are in either immune tolerance or low replication stage of the natural history of hepatitis B, and there is no or only mild inflammation in liver tissue, so antiviral therapy is not recommended. However, chronic HBV-infected patients with normal ALT levels are not always in a stable state. A considerable number of patients will develop active hepatitis or occult progress to liver fibrosis, cirrhosis, and hepatocellular carcinoma. Therefore, whether antiviral therapy should be recommended for chronic HBV infection with normal ALT level has been a hot topic in clinical practice. In this paper, the definition of immune tolerance, the relationship between ALT and liver inflammation, and the benefits of antiviral therapy were reviewed, and we hope it will be helpful for clinicians to have a deeper understanding of whether antiviral therapy should be considered for chronic HBV infection with normal ALT.

Sign in / Sign up

Export Citation Format

Share Document