The use of Ingaron® in the treatment of chronic viral hepatitis B

The possibility of antiviral therapy with the direct antiviral drugs Entecavir and Ingaron, as an antiviral and immunomodulating therapy, was studied in patients with the recurrent chronic viral hepatitis B. The study showed the applicability of this treatment regimen, due to the increase in the number of patients with SVR, high tolerability and the absence of clinically significant side effects.

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THE PREVALENCE CLINICALLY SIGNIFICANT VIRUS MUTATIONS AMONG PATIENTS WITH CHRONIC VIRAL HEPATITIS B

Russian Clinical Laboratory Diagnostics ◽

10.18821/0869-2084-2020-65-1-61-66 ◽

2020 ◽

Vol 65 (1) ◽

pp. 61-66

Author(s):

Yu. V. Ostankova ◽

A. V. Semenov ◽

E. B. Zueva ◽

K. A. Nogoybaeva ◽

K. T. Kasymbekova ◽

...

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Viral Hepatitis ◽

Vaccination Strategy ◽

Chronic Viral Hepatitis ◽

Kyrgyz Republic ◽

Chronic Hepatitis B Virus ◽

B Virus ◽

Viral Hepatitis B ◽

Clinically Significant

The prevalence of clinically significant virus mutations in patients with chronic viral hepatitis B from the Kyrgyz Republic was analyzed. Blood plasma samples of 64 patients with verified chronic viral hepatitis B obtained from Kyrgyzstan indigenous people were used in the work. Asymmetric PCR was carried out with extended oligonucleotides and the first reaction amplification product was further used in a new PCR with one of the nested pairs overlapping primers that flanked the entire HBV genome together, followed by sequencing. Based on the phylogenetic analysis of 64 HBV isolates obtained from patients from the Kyrgyz Republic, it was shown that only the genotype D virus was present in the examined group, the HBV subgenotype D1 (68.75%) prevailed compared with the HBV subgenotype D2 (18.75%) and subgenotype D3 (12.5%). For all subgenotypes, several independent infection sources are obvious, subclusters that include isolates from Kyrgyzstan, Kazakhstan and Uzbekistan are distinguished, as well as subclusters that include isolates only from Kyrgyzstan, which are less similar to isolates previously deposited in the international database, which probably indicates an independent HBV homologous evolution in the region. Clinically significant mutations were identified in 26.5% of patients. Including 12.5% with escape mutations that prevent the virus detection and / or allow the virus to replicate despite the vaccine (122K, 128V, 133I, 134N). Another 12.5% of the isolates are characterized by mutations that are independently associated with the liver cirrhosis and hepatocellular carcinoma development, including 21, 24, 27 nucleotides deletions in the Pre-S2 region and the S11F mutation in the PreCore region. In one case, unusual 236S and 250P mutations were found in the positions described as drug resistance sites of the P region associated with the resistance development to adefovir, tenofovir, and entecavir. The hepatitis B virus genetic structure analysis, early virus mutations detection in patients with chronic hepatitis B virus can help to choose the right vaccination strategy, antiviral and immunosuppressive therapy, as well as predict the clinical course and disease progression.

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THE TACTICS OF ANTIVIRAL THERAPY FOR CHRONIC VIRAL HEPATITIS B IN PREGNANT WOMEN

Technology transfer innovative solutions in medicine ◽

10.21303/2585-663.2020.001478 ◽

2020 ◽

pp. 14-16

Author(s):

Yuliia Mudra

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Pregnant Women ◽

Viral Hepatitis ◽

Antiviral Therapy ◽

Late Pregnancy ◽

Chronic Viral Hepatitis ◽

Sharp Drop ◽

B Virus ◽

Viral Hepatitis B

The aim of the study. Analysis of tactics of antiviral therapy for chronic viral hepatitis b in pregnant women. Methods. Theoretical analysis of scientific literature; analysis and generalization. Statistics and comparisons. Classification of theoretical material and development of recommendations. Research results. Today, there are about 2 billion people in the world ill with a chronic infection caused by the hepatitis B virus, 350 million of whom suffer from chronic hepatitis B, and most are asymptomatic carriers of the Australian antigen (HBsAg). Up to 50 % of all new cases of hepatitis B virus infection are due to vertical infection. Despite the lack of increase in viral load during pregnancy, alanine aminotransferase tends to increase in late pregnancy and in the postpartum period. A sharp drop in postpartum corticosteroids may create favourable conditions for hepatitis B virus activation. It is emphasized that the current treatment of hepatitis B virus includes the use of antiviral drugs, where Peg-IFN is absolutely contraindicated in pregnancy, lamivudine and entecavir are classified by the FDA as category C, and tenofovir and telbivudine are classified as category B. During pregnancy, it is recommended to use mainly category B drugs. Conclusions. The use of antiviral therapy in combination with immunoprophylaxis of new-borns is the optimal strategy for implementation as a universal program, as the success of such an intervention can make a significant contribution to achieving the ultimate goal of global elimination of hepatitis B virus.

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Modern aspects of the natural course of chronic viral hepatitis B

Kazan medical journal ◽

10.17816/kmj2279 ◽

2012 ◽

Vol 93 (2) ◽

pp. 161-166

Author(s):

D Sh Enaleeva

Keyword(s):

Hepatitis B Virus ◽

Hepatitis B ◽

Viral Hepatitis ◽

Antiviral Therapy ◽

Genetic Material ◽

Passive Immunization ◽

Chronic Viral Hepatitis ◽

Diagnostic Methods ◽

B Virus ◽

Viral Hepatitis B

Currently there are about 400 million people infected with the hepatitis B virus, including five million people - in Russia. A serious problem is the development of complications of chronic viral hepatitis’ - liver cirrhosis and hepatocellular carcinoma, from which eventually 20-35% of patients die. Undoubtedly, the outstanding science achievement of the XX century was the creation of a genetically engineered vaccine against hepatitis B. The pursued immunizations on a global scale has led to significant results - reduction of the number of cases of acute forms of viral hepatitis B, the frequency of formation of the chronic variant of the disease. Despite these successes, there remains the problem of prevention of the perinatal transmission path. Identified were the risk factors for neonatal infection, amongst which the most significant are the presence of the antigen of the hepatitis B virus, which is not a part of the Dane particles (HBEAg), and the level of viremia prior to delivery. The basis of prevention is an active-passive immunization, which helps prevent infection in infants in 90-95% of cases. Encouraging results (reduction in the risk of infant infection) were obtained in studies of antiviral therapy in the III trimester of pregnancy. The introduction of new molecular biological diagnostic methods (polymerase chain reaction) made it possible to determine the genetic material of the virus in serum and tissues, the presence of mutations and genetic variability of the virus. At present, identified are the factors that determine the progression of the disease, the efficacy of antiviral therapy. Identified are the new variants of the clinical course of viral hepatitis B, depending on the profile of the serological (antigen-antibody) markers. The latent course of viral hepatitis B deserves special attention. The serological feature of this variant is the presence of «isolated» antibodies and/or deoxyribonucleic acid of the virus, or the absence of all markers of hepatitis B. It is obvious that patients with a latent course of infection pose a real threat in spreading viral hepatitis B.

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