Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-76fb5796d-2lccl Total loading time: 0 Render date: 2024-04-29T22:55:11.419Z Has data issue: false hasContentIssue false

2 - Chronic Hepatitis B and D

Published online by Cambridge University Press:  08 August 2009

By
Dimitrios Vassilopoulos  and
Stephanos J. Hadziyannis
Edited by
Zobair M. Younossi
Zobair M. Younossi
Affiliation:
Inova Fairfax Hospital, Annandale, VA
Get access

Summary

BACKGROUND

Despite the widespread application of vaccination programs, chronic hepatitis B virus (HBV) infection remains a significant public health problem with 350–400 million people infected worldwide. The prevalence of chronic HBV infection displays a significant geographic variation with areas of high (8–15%), intermediate (1–7%), and low (<1%) endemicity.

Differences in the prevalence and incidence rates of HBV infection are largely linked to different modes and age of HBV transmission as well as with socioeconomic factors. In areas of high HBV endemicity such as the East Asia and sub-Saharan Africa, transmission occurs mainly during the perinatal or during the early childhood period. On the other end, in industrialized countries of North Europe, Australia, and North America where the endemicity is very low (<1%), HBV is transmitted mainly in high-risk adult populations through injection drug use, high-risk sexual behavior, and occupation-related needlesticks (health care workers). However, even in these populations perinatal and early childhood transmission still accounts for the majority of chronic HBV infections.

PATHOGENESIS

The transition of an acute to a chronic HBV infection is mainly influenced by the age of the host at which exposure to the virus occurs. During the perinatal and early childhood period (< 5 years), the majority of infections lead to chronicity. So far, it is unclear what are the exact immune mechanisms that contribute to the inability of the host to eradicate the virus. A role of the secreted HBe protein as a potential tolerogen during the neonatal period has been suggested.

Type
Chapter
Information
Practical Management of Liver Diseases , pp. 26 - 38
Publisher: Cambridge University Press
Print publication year: 2008

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Alter, M. J.. Epidemiology of hepatitis B in Europe and worldwide. J Hepatol, 2003; 39 Suppl 1:S64–9.CrossRefGoogle ScholarPubMed
Lok, A. S. and McMahon, B. J.. Chronic hepatitis B. Hepatology, 2007;45:507– 39.CrossRefGoogle ScholarPubMed
Chisari, F. V. and Ferrari, C.. Hepatitis B virus immunopathogenesis. Annu Rev Immunol, 1995;13:29–60.CrossRefGoogle ScholarPubMed
Rehermann, B. and Nascimbeni, M.. Immunology of hepatitis B virus and hepatitis C virus infection. Nat Rev Immunol, 2005;5:215–29.CrossRefGoogle ScholarPubMed
Milich, D. and Liang, T. J.. Exploring the biological basis of hepatitis B e antigen in hepatitis B virus infection. Hepatology, 2003;38:1075–86.CrossRefGoogle ScholarPubMed
Ferrari, C., Missale, G., Boni, C.et al. Immunopathogenesis of hepatitisB. J Hepatol, 2003;39 Suppl 1:S36–42.CrossRefGoogle ScholarPubMed
Visvanathan, K. and Lewin, S. R.. Immunopathogenesis: role of innate and adaptive immune responses. Semin Liver Dis, 2006;26:104–15.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J.. Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepat Rev, 1995;1:7–36.Google Scholar
Maini, M. K., Boni, C., Lee, C. K. et al. The role of virus-specific CD8+; cells in liver damage and viral control during persistent hepatitis B virus infection. J Exp Med, 2000;191:1269–80.CrossRefGoogle ScholarPubMed
Webster, G. J., Reignat, S., Brown, D. et al. Longitudinal analysis of CD8+ T cells specific for structural and nonstructural hepatitis B virus proteins in patients with chronic hepatitis B: implications for immunotherapy. J Virol, 2004;78:5707–19.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J. and Vassilopoulos, D.. Hepatitis B e antigen-negative chronic hepatitis B. Hepatology, 2001;34:617–24.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J. and Vassilopoulos, D.. Immunopathogenesis of hepatitis B e antigen negative chronic hepatitis B infection. Antiviral Res, 2001;52:91–8.CrossRefGoogle ScholarPubMed
Fattovich, G.. Natural history and prognosis of hepatitis B. Semin Liver Dis, 2003;23: 47–58.CrossRefGoogle ScholarPubMed
Yim, H. J. and Lok, A.S.. Natural history of chronic hepatitis B virus infection: what we knew in 1981 and what we know in 2005. Hepatology, 2006;43:S173–81.CrossRefGoogle ScholarPubMed
Bowden, S.. Serological and molecular diagnosis. Semin Liver Dis, 2006;26:97–103.CrossRefGoogle ScholarPubMed
Franchis, R., Hadengue, A., Lau, G. et al. EASL International Consensus Conference on Hepatitis B. 13–14 September, 2002 Geneva, Switzerland. Consensus statement long version; J Hepatol, 2003;39 Suppl 1:S3–25.Google ScholarPubMed
Chu, C. J., Hussainand, M. and Lok, A. S.. Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection. Hepatology, 2002;36:1408–15.CrossRefGoogle ScholarPubMed
Manesis, E. K., Papatheodoridis, G.V. and Hadziyannis, S. J.. Serum HBV-DNA levels in inactive hepatitis B virus carriers. Gastroenterology, 2002;122:2092–3.CrossRefGoogle ScholarPubMed
Keeffe, E. B., Dieterich, D.T., Han, S. H. et al. A treatment algorithm for the management of chronic hepatitis B virus infection in the United States: an update. Clin Gastroenterol Hepatol, 2006;4:936–62.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J.. New developments in the treatment of chronic hepatitis B. Expert Opin Biol Ther, 2006;6:913–21.CrossRefGoogle ScholarPubMed
Locarnini, S.. Molecular virology of hepatitis B virus. Semin Liver Dis, 2004; 24 Suppl 1:3–10.CrossRefGoogle ScholarPubMed
Perrillo, R. P.. Therapy of hepatitis B – viral suppression or eradication? Hepatology, 2006;43:S182–93.CrossRefGoogle ScholarPubMed
Osborn, M. K. and Lok, A. S.. Antiviral options for the treatment of chronic hepatitisB. J, Antimicrob Chemother, 2006;57:1030–4.CrossRefGoogle ScholarPubMed
Manno, M., Camma, C., Schepis, F. et al. Natural history of chronic HBV carriers in northern Italy: morbidity and mortality after 30 years. Gastroenterology, 2004;127:756–63.CrossRefGoogle ScholarPubMed
Feld, J. J. and Heathcote, E. J.Hepatitis B e antigen-positive chronic hepatitis B: natural history and treatment. Semin Liver Dis, 2006; 26:116–29.CrossRefGoogle Scholar
Papatheodoridis, G. V., Dimou, E., Dimakopoulos, K. et al. Outcome of hepatitis B e antigen-negative chronic hepatitis B on long-term nucleostide analog therapy starting with lamivudine. Hepatology, 2005;42:121–9.CrossRefGoogle Scholar
Fung, S. K., Wong, F., Hussain, M. et al. Sustained response after a 2-year course of lamivudine treatment of hepatitis B e antigen-negative chronic hepatitis B. J Viral Hepat, 2004;11:432–8.CrossRefGoogle ScholarPubMed
Santantonio, T., Mazzola, M., Iacovazzi, T. et al. Long-term follow-up of patients with anti-HBe/HBV DNA-positive chronic hepatitis B treated for 12 months with lamivudine. J Hepatol, 2000;32:300–6.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J., Tassopoulos, N. C., Heathcote, E. J. et al. Adefovir dipivoxil for the treatment of hepatitis B e antigen-negative chronic hepatitisB. N Engl J Med, 2003;348: 800–7.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J., Tassopoulos, N. C., Heathcote, E. J. et al. Long-term Therapy With Adefovir Dipivoxil for HBeAg-Negative Chronic Hepatitis B for up to 5 Years. Gastroenterology, 2006;131:1743–51.CrossRefGoogle ScholarPubMed
Lai, C. L., Shouval, D., Lok, A.S. et al. Entecavir versus lamivudine for patients with HBeAg-negative chronic hepatitisB. N Engl J Med,2006;354:1011–20.CrossRefGoogle ScholarPubMed
Thongsawat, S., Lai, C. L., Gane, E. et al. Telbivudine displays consistent antiviral efficacy across patient subgroups for the treatment of chronic hepatitis B: Results from the GLOBE study. J Hepatol 2006;44 Suppl 2:S49.CrossRefGoogle Scholar
Lai, C. L., Leung, N., Teo, E. K. et al. A 1-year trial of telbivudine, lamivudine, and the combination in patients with hepatitis B e antigen-positive chronic hepatitis B. Gastroenterology, 2005;129:528–36.CrossRefGoogle ScholarPubMed
Lai, C. L., Gane, E., Liaw, Y. F. et al. Telbivudine LdT; vs. lamivudine for chronic hepatitis B: First-year results from the international phase III globe trial. Hepatology, 2005;42 Suppl 1:748A.Google Scholar
Cooksley, H., Hou, J., Vitek, L. et al. Impact Of Nucleoside Treatment On Antiviral T-Cell Reactivity In Chronic Hepatitis B: Major Differences Depending On Early Viral Suppression, HBeAg Status And HBV Genotype. Hepatology, 2006;44 Suppl 1:547–8A.Google Scholar
Chu, C. M. and Liaw, Y. F.. Hepatitis B virus-related cirrhosis: natural history and treatment. Semin Liver Dis, 2006;26:142–52.CrossRefGoogle ScholarPubMed
Liaw, Y. F., Sung, J. J., Chow, W. C. et al. Lamivudine for patients with chronic hepatitis B and advanced liver disease. N Engl J Med, 2004;351;1521–31.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J.. Treatment paradigms on hepatitis B e antigen-negative chronic hepatitis B patients. Expert Opin Investig Drugs, 2007;16:777–86.CrossRefGoogle ScholarPubMed
Bartholomeusz, A. and Locarnini, S. A.. Antiviral drug resistance: clinical consequences and molecular aspects. Semin Liver Dis, 2006;26:162–70.CrossRefGoogle ScholarPubMed
Fung, S. K., Chae, H. B., Fontana, R. J. et al. Virologic response and resistance to adefovir in patients with chronic hepatitisB. J Hepatol, 2006;44:283–90.CrossRefGoogle ScholarPubMed
Dimou, I. Rapti, E., Mitsoula, P. et al. Adding-on versus switching-to adefovir therapy in lamivudine-resistant HBeAg-negative chronic hepatitis B. Hepatology, 2007;45:307–13.Google Scholar
Liaw, Y. F.. Rescue therapy for lamivudine-resistant chronic hepatitis B: When and how? Hepatology, 2007;45:266–68.CrossRefGoogle Scholar
Colonno, R. J., Rose, R. E., Pokomowski, K. et al. Assessment At Three Years Shows High Barrier To Resistance Is Maintained In Entecavir-Treated Nucleoside Naive Patients While Resistance Emergence Increases Over Time In Lamivudine Refractory Patients. Hepatology, 2006; 44, Suppl 1:229A–30AGoogle Scholar
Keeffe, E. B., Zeuzem, S., Koff, R. S. et al. Report of an international workshop: roadmap for management of patients receiving oral therapy for chronic hepatitis B. Clin Gastroenterol Hepatol, 2007;5:890–7.CrossRefGoogle ScholarPubMed
Hadziyannis, S. J.. Hepatitis D. Clin Liver Dis, 1999;3:309–25.CrossRefGoogle Scholar
Farci, P.. Treatment of chronic hepatitis D: New advances, old challenges. Hepatology, 2006;44:536–9.CrossRefGoogle ScholarPubMed
Wedemeyer, H., Heidrichand, B., Manns, M. P.. Hepatitis D virus infection – not a vanishing disease in Europe! Hepatology, 2007;45:1331–2.CrossRefGoogle ScholarPubMed
Taylor, J. M.. Hepatitis delta virus. Virology, 2006;344:71–6.CrossRefGoogle ScholarPubMed
Fiedler, M. and Roggendorf, M.. Immunology of HDV infection. Curr Top Microbiol Immunol, 2006;307:187–209.Google ScholarPubMed
Su, C. W., Huang, Y. H., Huo, T. I. et al. Genotypes and viremia of hepatitis B and D viruses are associated with outcomes of chronic hepatitis D patients. Gastroenterology, 2006;130:1625–35.CrossRefGoogle Scholar
Deny, P.. Hepatitis delta virus genetic variability: from genotypes I, II, III to eight major clades? Curr Top Microbiol Immunol, 2006;307:151–171.Google ScholarPubMed
Castelnau, C., Gal, F., Ripault, M. P. et al. Efficacy of peginterferon alpha-2b in chronic hepatitis delta: relevance of quantitative RT-PCR for follow-up. Hepatology, 2006;44: 728–35.CrossRefGoogle ScholarPubMed
Niro, G. A., Ciancio, A., Gaeta, G. B. et al. Pegylated interferon alpha-2b as monotherapy or in combination with ribavirin in chronic hepatitis delta. Hepatology, 2006;44:713–20.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure coreplatform@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×