scholarly journals Protracted HBsAg-aemia in a Patient with Acute Hepatitis B

2018 ◽  
Vol 28 (5) ◽  
pp. 126-133
Author(s):  
K. R. Dudina ◽  
O. O. Znoyko
Keyword(s):  
Hepatitis B ◽  
Acute Hepatitis ◽  
Dynamic Assessment ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Observation Study ◽  
Viral Kinetics ◽  
Chronic Hbv Infection ◽  
Acute Hepatitis B ◽  
Chronic Hbv

Aim.This clinical observation was aimed at analysing the course of the disease in a patient with a protracted persistence of HBsAg and HBV DNA in the blood in the outcome of acute hepatitis B and the possible formation of a latent HBV infection in the phase of clinical recovery.General findings. We carried out a 31-month observation study of a patient suffering from acute hepatitis B. Subsequently, we performed a dynamic assessment of the viral kinetics and qualitative and quantitative assessment of HBsAg in the blood using highly sensitive analytical methods. These methods allowed a protracted persistence of HBV DNA in the blood and a late seroconversion of HBsAg/anti-HBs to be revealed.Conclusion.The described clinical case demonstrates the possibility of an atypically protracted persistence of  HBsAg in the outcome of acute hepatitis B, which is followed by a clinical and laboratory picture of recovery and the formation of latent chronic HBV infection, as an example of the 5th phase of chronic HBV infection (HBsAg-negative), according to a new classification, reflected in the clinical guidelines for the treatment of hepatitis B (EASL 2017). 

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.

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 The Combination of Nucleotide Analog Therapy and Steroid Pulse Therapy for Acute HBV Infection Effectively Promotes HBV Clearance

2021 ◽  
Vol 13 (1) ◽  
pp. 1-8
Author(s):  
Takeshi Goya ◽  
Tomoyuki Kurashige ◽  
Miho Kurokawa ◽  
Masatake Tanaka ◽  
Tomomi Aoyagi ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Acute Hepatitis ◽  
Pulse Therapy ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Steroid Pulse Therapy ◽  
Therapeutic Effects ◽  
Nucleotide Analogs ◽  
Steroid Pulse ◽  
Acute Hepatitis B

Acute hepatitis B virus (HBV) infection occasionally progresses to acute liver failure, often with poor prognosis. The appropriate pharmacological approach is yet to be established. Although nucleotide analogs (NA) and corticosteroids are candidates for the treatment of acute HBV infection, their therapeutic effects, especially their effect on HBV clearance, remain unclear. To clarify effects on the HBV clearance of combination therapy of NA and steroid pulse therapy (SPT) for acute HBV infection, we first analyze the effectiveness of this therapy in patients with HBV infection compared with NA monotherapy (NAM). Of the 57 consecutive patients with acute hepatitis B infection from May 2007 to December 2018, we have included 25 patients for this study, whom we followed up until HBV clearance. According to the administration of NA and SPT, we divided patients into two groups (NAM group and NA + SPT group) and compared their results. Of the 25 patients, 10 received NAM, whereas 15 received NA + SPT. There were no appreciable adverse effects related to SPT. The time required for the clearance of HBsAg (76 (43–116) days vs. 26 (14–51) days, p = 0.0418) and HBV-DNA (NAM group vs. NA + SPT group: 180 (83.5–220) vs. 69 (43–136) days, p = 0.0420) was significantly shorter in the NA + SPT group than in the NAM group. The hazard ratio of NA + SPT for the clearance of HBsAg and HBV-DNA were 0.45 (0.19–1.09) and 0.35 (0.14–0.89), respectively. In conclusion, we showed that NA + SPT promoted HBV elimination. These findings support the use of the NA + SPT combination for acute HBV infection without the concern of persistent HBV infection.

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 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 Booster immunity – diagnosis of chronic hepatitis B viral infection

2019 ◽  
Vol 13 (03) ◽  
pp. 255-260
Author(s):  
Radka T Komitova ◽  
Ani K Kevorkyan ◽  
Maria V Atanasova ◽  
Aneta V Ivanova ◽  
Elica Golkocheva-Markova
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Hepatitis A ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
Occult Hbv ◽  
Chronic Hbv ◽  
Family Outbreak

Introduction: Diagnosis of chronic hepatitis B virus (HBV) infection particularly its occult form requires monitoring and repeat serological and molecular studies. The aim of the study was to investigate the possible relation between the case of a family outbreak of hepatitis A and the finding that a member of this family was diagnosed with chronic hepatitis B. Methodology: A mother and her two sons, one previously diagnosed with chronic HBV infection, were hospitalized due to suspected acute hepatitis. Serological markers for hepatitis A, hepatitis B and hepatitis C were assessed. Additionally, HBV DNA was tested with a sensitive PCR. Hepatitis B vaccine was administered to the mother to differentiate resolved from occult HBV infection. Results: A family outbreak of hepatitis A was confirmed, alongside a focus of chronic HBV infection. The serological profile for two brothers was HBsAg(+), anti-HBcIgM(-), anti-HBc(+), HBcAg(-)/anti-HBe(+). The mother was negative for all HBV markers except anti-HBc. HBV DNA was detected at a level of 461 IU/mL in the elder brother, 3647 IU/mL in the younger brother and was negative in the mother on two occasions. Her anti-HBc alone, having two sons with chronic HBV infection, and her lack of antibody response to hepatitis B vaccine despite being negative for HBV DNA, led to the diagnosis of probable occult HBV infection. Conclusion: Our results confirmed that a vaccination approach could facilitate diagnosis of chronic HBV infection in the presence of isolated anti-HBc. If it were not for a family outbreak of hepatitis A, this unexpected family HBV focus would not have been revealed.

scholarly journals Clinical Diagnostic Value of Quantitative Hepatitis B Virus Core Antibody Test in Chronic Viral Hepatitis B

2021 ◽  
Vol 2021 ◽  
pp. 1-6
Author(s):  
Xi Su ◽  
Huangping Chen ◽  
Zifei Zhu ◽  
Wanying Xie ◽  
Jianqiao Peng ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Antibody Test ◽  
Diagnostic Value ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Quantitative Detection ◽  
Roc Curve Analysis ◽  
Chronic Hbv Infection ◽  
Chronic Hbv

The level of CHB virus (HBV) core antibody (HBcAb) is different in four stages of chronic HBV infection and may be used for differential diagnosis of the natural history of chronic HBV infection. To address this question, we examined multiple blood biomarkers and assessed the efficacy to diagnose different stages of chronic HBV infection. The quantitative detection of HBcAb, hepatitis B surface antigen (HBsAg), HBV DNA, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and platelet count (PLT) were determined in the serum of 73 cases of low-replicative phase (LR), 46 cases of immune-tolerant phase (IT), 44 cases of immune clearance phase (IC), and 57 cases of HBeAg-negative hepatitis (ENH). Differentiating performance of these serum protein levels was analyzed by receiver operating characteristic (ROC) curve analysis. Our results showed that the levels of HBcAb, ALT, and AST levels were significantly higher in IC and ENH than those in LR and IT (both P ≤ 0.001 ). The levels of HBV DNA and HBsAg were higher in IC and IT than those in LR and ENH (both P ≤ 0.001 ). Logistic regression models showed that HBcAb, HBsAg, HBV DNA, ALT, and AST were the independent variables, respectively, and when combined, they provided high diagnostic accuracy for the staging of CHB. To sum up, HBcAb quantification is a new index, which can reflect whether the liver is in the immune activation state of HBV infection, and is related to the inflammatory state of the host liver. The combined detection of HBcAb quantification and other indicators has showed promising efficiency for staging of IC and ENH and can assist the diagnosis and treatment of CHB.

scholarly journals Quantitative HBsAg versus HBV DNA in Predicting Significant Hepatitis Activity of HBeAg-Positive Chronic HBV Infection

2021 ◽  
Vol 10 (23) ◽  
pp. 5617
Author(s):  
Zhanqing Zhang ◽  
Wei Lu ◽  
Dong Zeng ◽  
Dan Huang ◽  
Weijia Lin ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Hepatitis B Surface Antigen ◽  
Hbv Dna ◽  
Hbv Infection ◽  
Chronic Hbv Infection ◽  
Hbv Replication ◽  
Regression Curves ◽  
Chronic Hepatitis B Virus ◽  
Positive Chronic Hepatitis ◽  
Chronic Hbv

(1) Background: As specialparameters in predicting significant hepatitis activity of hepatitis B e antigen (HBeAg)-positive chronic hepatitis B virus (HBV) infection, the quantitative standard of HBV DNA has not been agreed and that of hepatitis B surface antigen(HBsAg) has not been formed. Our objective is to evaluate the validity of HBsAg and HBV DNA in predicting the significant hepatitis activity of HBeAg-positive patients. (2) Methods: A population of 516 patients with HBeAg-positive chronic HBV infection was enrolled. Serum ALT was measured using an Abbott Architect c16000 autoanalyzer; diagnoses of liver pathological grade and stage referred to the Scheuer standard. Three levels of significant hepatitis activity were preset, which were successively “ALT ≥ 20 IU/L or Grade > G1 or Stage > S1”, “ALT ≥ 30 IU/L or Grade > G1 or Stage > S1” and “ALT ≥ 40 IU/L or Grade > G1 or Stage > S1”. (3) Results: A subpopulation of 288 patients with possible high HBV replication was selected based on locally weighted scatterplot smoothing regression curves between ALT and HBsAg, HBeAg and HBV DNA. In the subpopulation with possible high HBV replication, areas under receiver operating characteristic curves of HBsAg for predicting the three levels of significant hepatitis activity were successively 0.868, 0.839 and 0.789, which were all significantly greater than those of HBV DNA, as those were successively 0.553, 0.550 and 0.574 (p = 0.0002, p < 0.0001 and p < 0.0001). With the standard of HBsAg ≤ 4.699 log10 IU/mL, the sensitivity and specificity of HBsAg for predicting the three levels of significant hepatitis activity were successively 75.81% and 81.82%, 79.23% and 78.57% and 80.82% and 67.44%. (4) Conclusion: Quantitative HBsAg instead of HBV DNA is valuable in predicting significant hepatitis activity of HBeAg-positive chronic HBV infection.

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