Epidemiology and Natural History of Hepatitis B

Liver Disease and Hepatitis Program, Alaska Native Medical Center, Anchorage, Alaska, USA.
Seminars in Liver Disease (Impact Factor: 4.95). 02/2005; 25 Suppl 1(Suppl 1):3-8. DOI: 10.1055/s-2005-915644
Source: PubMed


Hepatitis B virus (HBV) is a common viral pathogen that currently infects an estimated 4 million people worldwide, including 400 million who have chronic infection. Persons with chronic HBV infection are at a lifelong risk of developing hepatocellular carcinoma (HCC) or cirrhosis, or both. Many persons with HBV are unaware that they carry the infection, and, of those who are chronically infected, only a minority receives routine, scheduled follow-up to monitor their disease status. Persons from high-risk populations, especially immigrants from nations where hepatitis B is highly endemic, should be tested for HBV seromarkers and should be vaccinated if they are found to be negative. The natural history of chronic HBV is a dynamic one: patients can fluctuate between periods of active liver inflammation and periods of inactive disease. Disease progression is influenced by various factors, including viral genotype and specific mutations, demographic features, concurrent viral infections, and social and environmental factors. Recent data suggest that antiviral therapy can decrease the risk of liver decompensation and liver-related death and reduce the risk of HCC in selected individuals with active liver disease and severe fibrosis. Persons identified with chronic HBV infection need lifelong, regular monitoring for the development of active liver disease and HCC.

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    • "Chronic hepatitis B (CHB) is a global health problem with an estimated 400 billion people worldwide being chronically infected with the virus (HBV) [1]. Chronic infection with HBV can significantly impair the quality of life and life expectancy of patients. "
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    ABSTRACT: Objective . To evaluate the efficacy and safety of Kushenin (KS) combined with nucleoside analogues (NAs) for chronic hepatitis B (CHB). Methods . Randomized controlled trials (RCTs) of KS combined with NAs for CHB were identified through 7 databases. Frequencies of loss of serum HBeAg, HBeAg seroconversion, undetectable serum HBV-DNA, ALT normalization, and adverse events at 48 weeks were abstracted by two reviewers. The Cochrane software was performed to assess the risk of bias in the included trials. Data were analyzed with Review Manager 5.3 software. Results . 18 RCTs involving 1684 subjects with CHB were included in the analysis. KS combined with NAs including lamivudine (LAM), entecavir (ETV), adefovir dipivoxil (ADV), and telbivudine (TLV) showed different degree of improvement in CHB indices. KS combined with NAs increased the frequency of loss of serum HBeAg, HBeAg seroconversion, undetectable HBV-DNA levels, and ALT normalization compared with single agents. It also decreased serum ALT and AST level after one-year treatment. However, KS combined with TLV did not show a significant difference in CHB indices. The side-effects of KS combined with NAs were light and of low frequency. Conclusion . KS combined with NAs improves the efficacy of NAs in CHB.
    Evidence-based Complementary and Alternative Medicine 09/2015; 2015(3):529636. DOI:10.1155/2015/529636 · 1.88 Impact Factor
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    • "Chronic infection with the hepatitis B virus (HBV), accounting for 350–400 millions of patients worldwide, is a predominant etiological factor for liver disease in China [1] [2]. In particular, about 7.8% of China population are HBV carriers (93 million, two-thirds of the world's total number of carriers) [3]. "
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    ABSTRACT: It has been reported that hepatitis B virus (HBV) replication can be suppressed by microRNA-210 (miR-210). However, whether serum miR-210 levels can serve as disease parameters in patients with chronic hepatitis B (CHB) remains unclear. Serum miR-210 levels were quantified in 115 CHB patients and 20 healthy controls by real-time PCR. We found that serum miR-210 levels can discriminate the different groups of CHB patients from healthy control (P<0.05), as well as patients with HBe antigen positive from those with HBe antigen negative (P<0.05). Serum miR-210 levels correlated with HBV DNA and HBs antigen (r= 0.525, P<0.001 and r= 0.348, P<0.001). Notably, inactive carrier patients with high (>3500 IU/mL) or low (<3500 IU/mL) levels of HBs antigen were differentiated by serum miR-210 levels (P<0.05). Moreover, serum miR-210 levels correlated with liver inflammatory activity markers including alanine aminotransferase (ALT) and HAI score. However, there was no correlation of serum miR-210 levels with parameters of liver function including serum albumin, international normalized ratio and bilirubin, as well as the stages of liver fibrosis. Serum miR-210 can be used as an indicator of HBV replication and translation, and a potential marker of necroinflammation in patients with CHB. Copyright © 2015. Published by Elsevier B.V.
    Clinica chimica acta; international journal of clinical chemistry 08/2015; 450. DOI:10.1016/j.cca.2015.08.022 · 2.82 Impact Factor
    • "HBV is viable for a long time in the environment as shown in a study conducted by the Centre for Disease Control (CDC). A highly infective serum placed on a glass slide left in the environment for a week, was infective to a chimpanzee (McMahon 2005). This suggests that any kind of accidental exposure to articles contaminated by blood and body fluids of HBV carriers could also transmit the infection . "
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    ABSTRACT: Abstract: Hepatitis B virus (HBV) currently infects an estimated population of 2 billion individuals in the world, including 400 million people with chronic HBV infection. HBV virology, replication and the host’s immune response to HBV infection contribute to different infection outcomes. Acute hepatitis HBV infection is self-limiting but it leaves a residual infection that can become active in an individual during immunosuppression. In chronic HBV infection, the virus persistently replicates in hepatocytes leading to immune mediated hepatocellular damage. Despite the inability to remove the virus in more than 70 % of patients, current treatments for chronic HBV infection, interferon alpha and antiviral nucleotide/nucleoside analogues, aim to reduce viral replication to prevent or at least delay the progression to cirrhosis and hepatocellular carcinoma. In both self resolved acute and persistent HBV infection, the long term existence of chromatinised covalently closed circular DNA (cccDNA) in the nuclei of infected hepatocytes cannot be targeted by current treatments to eliminate these templates to eradicate the viral persistence. Identifying the mechanisms involve in the removal of infected hepatocytes will be useful as treatment options. In this context, DNA based novel therapeutic and immunization strategies might help to remove stable cccDNA and thus viral persistence. Keywords Hepatitis B virus � Natural history � Infection outcomes � Vaccination and treatment
    VirusDisease 04/2015; 26(1-2):1-8. DOI:10.1007/s13337-015-0247-y
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