Treatment strategies of hepatitis B in China

2009 ◽  
pp. 96-104
Author(s):  
G. B. Yao
Keyword(s):  
Hepatitis B ◽  
Treatment Strategies

scholarly journals Hepatitis D virus in 2021: virology, immunology and new treatment approaches for a difficult-to-treat disease

Gut ◽  
2021 ◽  
pp. gutjnl-2020-323888
Author(s):  
Stephan Urban ◽  
Christoph Neumann-Haefelin ◽  
Pietro Lampertico
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Treatment Strategies ◽  
Phase Iii ◽  
Interferon Α ◽  
T Cell Epitopes ◽  
The European Union ◽  
Hepatitis D ◽  
Hepatitis D Virus

Approximately 5% of individuals infected with hepatitis B virus (HBV) are coinfected with hepatitis D virus (HDV). Chronic HBV/HDV coinfection is associated with an unfavourable outcome, with many patients developing liver cirrhosis, liver failure and eventually hepatocellular carcinoma within 5–10 years. The identification of the HBV/HDV receptor and the development of novel in vitro and animal infection models allowed a more detailed study of the HDV life cycle in recent years, facilitating the development of specific antiviral drugs. The characterisation of HDV-specific CD4+ and CD8+T cell epitopes in untreated and treated patients also permitted a more precise understanding of HDV immunobiology and possibly paves the way for immunotherapeutic strategies to support upcoming specific therapies targeting viral or host factors. Pegylated interferon-α has been used for treating HDV patients for the last 30 years with only limited sustained responses. Here we describe novel treatment options with regard to their mode of action and their clinical effectiveness. Of those, the entry-inhibitor bulevirtide (formerly known as myrcludex B) received conditional marketing authorisation in the European Union (EU) in 2020 (Hepcludex). One additional drug, the prenylation inhibitor lonafarnib, is currently under investigation in phase III clinical trials. Other treatment strategies aim at targeting hepatitis B surface antigen, including the nucleic acid polymer REP2139Ca. These recent advances in HDV virology, immunology and treatment are important steps to make HDV a less difficult-to-treat virus and will be discussed.

scholarly journals Sociocultural Factors That Potentially Affect the Institution of Prevention and Treatment Strategies for Hepatitis B in Chinese Canadians

2009 ◽  
Vol 23 (1) ◽  
pp. 31-36 ◽  
Author(s):  
Harry Wu ◽  
Colina Yim ◽  
Alex Chan ◽  
Michael Ho ◽  
Jenny Heathcote
Keyword(s):  
Health Care ◽  
Hepatitis B ◽  
Access To Health Care ◽  
Severe Disease ◽  
Tertiary Care ◽  
Treatment Strategies ◽  
Chinese Patients ◽  
Medical Attention ◽  
Sociocultural Factors ◽  
Tertiary Care Centre

BACKGROUND: Despite the availability of screening for chronic hepatitis B (CHB) infection and effective treatments now available, many at-risk individuals fail to seek appropriate medical attention.OBJECTIVE: To identify the barriers to care for CHB infection in a Chinese Canadian community.METHODS: A survey conducted in English or Chinese collected information from individuals with CHB infection that evaluated the level of understanding and identified the barriers that may prevent Chinese patients from undergoing monitoring, screening and/or treatment for CHB infection.RESULTS: Among the 204 patients enrolled, common misconceptions were that sharing food transmits hepatitis B and that patients with severe disease are always symptomatic. Patients with a better understanding of hepatitis B were better educated, younger and were being followed at a tertiary care centre (P<0.01 for all). Prominent barriers to health care were time, inconvenience and language difficulties. Patients under the care of family physicians who had extended office hours were less likely to cite time (P=0.06) and distance (P=0.05) as barriers.CONCLUSION: Patient misconceptions that severe liver disease due to hepatitis B infection is symptomatic may factor into the unwillingness to spare the time and undergo the inconvenience associated with regular medical follow-up. Implementation of programs that increase awareness of the silent progression of CHB infection and provide culturally responsive clinics, better able to work within patients’ time constraints may improve Chinese patients’ access to health care.

Hepatitis B Virus (HBV) Disease

2021 ◽  
Author(s):  
Chun-Jen Liu
Keyword(s):  
Hepatitis B ◽  
Treatment Strategies ◽  
Future Generation ◽  
Main Mode ◽  
Therapeutic Vaccines ◽  
Hbv Vaccine ◽  
Hbsag Carriers ◽  
B Virus ◽  
Hepatitis B Immunoglobulin ◽  
Mode Of Transmission

HBV disease is a significant cause of acute and chronic liver disease worldwide. Mother-to-infant transmission is the main mode of transmission to susceptible subjects, which can be prevented with HBV vaccine alone or in combination with hepatitis B immunoglobulin. This intervention markedly reduces the number of new HBsAg carriers. For subjects not responding to current HBV vaccines as reflected by an inadequate anti-HBs titer, future generation vaccines incorporating additional vaccine components such as preS1 and preS2 may improve the efficacy of protective antibody production. Apart from preventative vaccines, future therapeutic vaccines along with current anti-HBV treatment strategies might enhance the rate of functional cures as indicated by the loss of HBsAg.

scholarly journals Acute-on-Chronic Liver Failure From Chronic-Hepatitis-B, Who Is the Behind Scenes

2020 ◽  
Vol 11 ◽  
Author(s):  
Qian Li ◽  
Jun Wang ◽  
Mengji Lu ◽  
Yuanwang Qiu ◽  
Hongzhou Lu
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Liver Failure ◽  
Chronic Hepatitis B ◽  
Systemic Inflammation ◽  
Inflammatory Responses ◽  
Treatment Strategies ◽  
Chronic Liver ◽  
Chronic Liver Failure ◽  
Immune Imbalance

Acute-on-chronic liver failure (ACLF) is an acute syndrome accompanied with decompensation of cirrhosis, organ failure with high 28-day mortality rate. Systemic inflammation is the main feature of ACLF, and poor outcome is closely related with exacerbated systemic inflammatory responses. It is well known that severe systemic inflammation is an important event in chronic hepatitis B (CHB)-ACLF, which eventually leads to liver injury. However, the initial CHB-ACLF events are unclear; moreover, the effect of these events on host immunity as well as that of immune imbalance on CHB-ACLF progression are unknown. Here, we investigate the initial events of ACLF progression, discuss possible mechanisms underlying ACLF progression, and provide a new model for ACLF prediction and treatment. We review the characteristics of ACLF, and consider its plausible immune predictors and alternative treatment strategies.

scholarly journals Chronic Hepatitis B Treatment Strategies Using Polymerase Inhibitor-Based Combination Therapy

Viruses ◽  
2021 ◽  
Vol 13 (9) ◽  
pp. 1691
Author(s):  
Eriko Ohsaki ◽  
Yadarat Suwanmanee ◽  
Keiji Ueda
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Treatment Strategies ◽  
Therapeutic Strategies ◽  
Hbv Infection ◽  
Antiviral Therapies ◽  
Polymerase Inhibitors ◽  
Hepatitis B Treatment ◽  
Polymerase Inhibitor ◽  
Essential Enzyme

Viral polymerase is an essential enzyme for the amplification of the viral genome and is one of the major targets of antiviral therapies. However, a serious concern to be solved in hepatitis B virus (HBV) infection is the difficulty of eliminating covalently closed circular (ccc) DNA. More recently, therapeutic strategies targeting various stages of the HBV lifecycle have been attempted. Although cccDNA-targeted therapies are attractive, there are still many problems to be overcome, and the development of novel polymerase inhibitors remains an important issue. Interferons and nucleos(t)ide reverse transcriptase inhibitors (NRTIs) are the only therapeutic options currently available for HBV infection. Many studies have reported that the combination of interferons and NRTI causes the loss of hepatitis B surface antigen (HBsAg), which is suggestive of seroconversion. Although NRTIs do not directly target cccDNA, they can strongly reduce the serum viral DNA load and could suppress the recycling step of cccDNA formation, improve liver fibrosis/cirrhosis, and reduce the risk of hepatocellular carcinoma. Here, we review recent studies on combination therapies using polymerase inhibitors and discuss the future directions of therapeutic strategies for HBV infection.

scholarly journals Case Report: Severe non-immune mediated haemolytic anaemia associated with acute hepatitis B and E co-infection in a patient with normal G6PD levels

F1000Research ◽  
2015 ◽  
Vol 4 ◽  
pp. 1002 ◽  
Author(s):  
Michael Wang ◽  
Florence Yap ◽  
Gavin Joynt
Keyword(s):  
Hepatitis B ◽  
Viral Hepatitis ◽  
Haemolytic Anaemia ◽  
Acute Viral Hepatitis ◽  
Treatment Strategies ◽  
Red Cell ◽  
Immune Mediated ◽  
Cell Enzyme ◽  
Erythrocyte Metabolism ◽  
Viral Subtypes

Severe non-immune mediated haemolytic anaemia (HA) rarely occurs in acute viral hepatitis, unless patients have underlying red cell enzyme abnormalities or pre-existing liver disease. We report such a case and provide a summary of other available cases to date.Overall, young and fit patients suffering from acute viral hepatitis seem to be affected. Several viral subtypes have been associated, although we report the first hepatitis B and E co-infection case. It seems to occur when patients are recovering from hepatitis and the disease course is variable. The degree of anaemia is always severe, and is inevitably associated with increased morbidity and mortality.Several theories exist with regard to its aetiology, including the disruption of erythrocyte metabolism. Although its optimal treatment strategies remain unclear, some evidence suggests a possible role for steroid therapy.

scholarly journals Inflammation Pharmacological Reaction and YMDD Mutational Patterns in Lamivudine Therapeutics Hepatitis B Virus

2021 ◽  
Vol 12 ◽  
Author(s):  
Hongcan Liu ◽  
Zemin Wan ◽  
Lanhui She ◽  
Yajuan Zhu ◽  
Zhiliang Cai ◽  
...  
Keyword(s):  
Hepatitis B Virus ◽  
Hepatitis B ◽  
Time Course ◽  
Treatment Strategies ◽  
Pathological Process ◽  
Significant Difference ◽  
B Virus ◽  
Choice Of Treatment ◽  
Ymdd Mutation ◽  
Ymdd Motif

Background/Aims: Emergence of tyrosine-methionine-aspartate-aspartate (YMDD) motif in reverse transcriptase is a serious problem in chronic hepatitis B(CHB) patients after Lamivudine (LAM) therapy. However, the relationship between inflammation pharmacological reaction and YMDD mutational patterns of CHB has not been well-characterized. The aim of this study was to investigate the inflammation pharmacological reaction and different YMDD mutants patterns of CHB patients.Methods: We investigated the inflammation pharmacological reaction and YMDD mutational patterns through biochemical, serological and virological detection among 83 CHB patients, including 25 YMDD mutants, 25 under detection, and 33 control patients without YMDD mutants.Results: Prevalence of YMDD mutation patterns is different. Among 25 YMDD mutants patients, YIDD was the dominant mutation (72%), followed YVDD (16%) and the hybrid YIDD + YVDD (12%). The time course during the YMDD mutations was also different. 52.4% patients developed the mutation less than 12 months after the LAM therapy. Serum hepatitis B virus (HBV) DNA level in patients with YMDD mutants were significantly higher than that in control and negative groups. Serum HbsAg and HbeAg in patients with YMDD mutants were also higher than those in control and negative groups, despite no significant difference was found forserum HbeAb. ALT and AST levels were also significantly higher in mutants group.Conclusions: Illuminating inflammation pharmacological reaction and YMDD mutational patterns of CHB during pathological process may have implications for future therapy in YMDD mutation patients. This may have impact on the choice of treatment strategies for lamivudine-resistant HBV.

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