Evaluation of the Relationship between Insulin Resistance and HBV DNA Level in Patients with HBeAg-negative Chronic HBV Infection (Natural Course Phase 3)

This review aimed to provide an update on the impact of pregnancy on the natural course of hepatitis B virus (HBV) infection and also on the impact of HBV infection on adverse pregnancy outcomes, including mother-to-child transmission (MTCT). For the literature review, original research articles, review articles, and guidelines were narratively reviewed and comprehensively validated. The databases of PubMed, EMBASE, and CINAHL were carefully searched for articles in English on topics related to HBV infection, pregnancy, and vertical transmission from 1960 to May 2021. Immunological changes during pregnancy such as suppression of Th1 response and induction of Th2 immunity lead to an impaired immune reaction to HBV and stimulate viral activity along with the reduction of CD8 T cells to escape immune detection. The impact of pregnancy on the natural course of chronic HBV infection seems to be minimal, while pregnancy can increase morbidity and mortality in the case of advanced HBV hepatitis or cirrhosis. Importantly, hepatitis flare or alanine aminotransferase (ALT) flare can occur during pregnancy and is more common during the postpartum period due to the interaction between HBV and the immune response. Interestingly, the impact of HBV infection on adverse pregnancy outcomes is more serious than ever thought. Updated evidence indicates that pregnancies with chronic HBV infection increase the risk of preterm birth and gestational diabetes, especially in cases of positive hepatitis e antigen (HBeAg).

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Outcome of chronic HBV infection and disease in children: Implications of HBV-DNA pre-core heterogeneity

Journal of Hepatology ◽

10.1016/s0168-8278(05)80884-0 ◽

1994 ◽

Vol 21 ◽

pp. S59

Keyword(s):

Hbv Dna ◽

Hbv Infection ◽

Chronic Hbv Infection ◽

Chronic Hbv

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Serum TNF-receptor 1 and 2 in the natural course and during interferon treatment of chronic HBV infection

Hepatology ◽

10.1016/0270-9139(93)91999-9 ◽

1993 ◽

Vol 18 (4) ◽

pp. A118

Author(s):

G MARINOS

Keyword(s):

Natural Course ◽

Hbv Infection ◽

Interferon Treatment ◽

Tnf Receptor ◽

Chronic Hbv Infection ◽

Chronic Hbv

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

Journal of Nepalgunj Medical College ◽

10.3126/jngmc.v16i2.24801 ◽

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.

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

Clinical Infectious Diseases ◽

10.1093/cid/ciaa1814 ◽

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<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.

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