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Hepatitis B
Published in Vincenzo Berghella, Maternal-Fetal Evidence Based Guidelines, 2022
Laura Felder, Zimeng Gao, Danielle Tholey
Hepatitis D virus: Incomplete RNA virus, which can superinfect 20–25% of chronic HBV-infected patients. As HDV requires the HBV machinery to replicate, the HDV cannot exist without HBV. HDV infection worsens chronic HBV infection, so that 25% may die from disease [2]. If HBV is prevented, HDV infection is prevented, too. HDV has no effect on pregnancy or fetus/neonate.
General healthcare of drug users
Published in Berry Beaumont, David Haslam, Care of Drug Users in General Practice, 2021
Serological testing for hepatitis B markers will identify which patients have previously been exposed to the disease, which remain carriers and which should be offered hepatitis B immunisation. Hepatitis B remains prevalent amongst intravenous drug users and up to half of those screened show evidence of previous infection,11 although many can recall no episode of jaundice. The disease is particularly virulent in drug users because there is often concomitant infection with hepatitis D.12 Few drug users show evidence of previous immunisation against hepatitis B despite the fact that vaccine has been available since 1981 and they are at high risk of contracting the illness.13 This may reflect the limited availability of both screening and vaccine in drug treatment clinics,14 the difficulty that some drug users experience registering with a GP and the fact that there is some evidence suggesting that intravenous drug users may not mount as effective an immune response when vaccine is administered.15 Hepatitis B is likely to remain an important cause of mortality and morbidity in substance misusers until effective immunisation rates are achieved.
Viral hepatitis.
Published in Michael JG Farthing, Anne B Ballinger, Drug Therapy for Gastrointestinal and Liver Diseases, 2019
Eleanor Barnes, George Webster, Geoffrey M Dusheiko
Patients co-infected with hepatitis D tend to progress more rapidly to cirrhosis. Trials with α-IFN have demonstrated a reduction in serum transaminases and HDAg and hepatitis D RNA; unfortunately, the majority of patients relapse when treatment is discontinued. Lamivudine has not been shown to be effective in hepatitis D-positive patients.
Emerging drugs for hepatitis D
Published in Expert Opinion on Emerging Drugs, 2023
Hepatitis D virus (HDV) is the most aggressive form of chronic viral hepatitis for which an effective treatment is still lacking [1]. According to a recent study, it is estimated that approximately 4.5% of hepatitis B surface antigen (HbsAg)-positive individuals are also infected with HDV, which corresponds to 0.16% of the entire world population, and roughly 12 million people are infected with HDV [2]. It needs to be mentioned that two other studies have reported far higher (48–60 million) estimates [3,4]. The most recent figure has been mentioned as 0.44% of the world population (33 million) based on studies in the 2010 to 2019 period [5]. Current global HDV endemic regions include Mongolia, Pakistan, Middle East countries, Uzbekistan and other Central Asian countries in Asia, Cameroon and countries of sub-Saharan Africa in Africa, Western Pacific islands in Oceania, regions close to the Amazon river in South America and some eastern European countries such as Romania, Albania and Turkey [6]. Although there are findings suggesting that its incidence has decreased in Western countries, HDV infection is still a problem in these countries due to recent migration from endemic regions [7].
Association of Elongation Factor Tu GTP-binding Domain-containing 2 Gene (EFTUD2) Polymorphism with the Risk of Hepatitis B Virus Infection
Published in Immunological Investigations, 2022
Anran Tian, Yuwen Li, Haozhi Fan, Pingping Hu, Ruirui Xu, Hui Yuan, Jinyuan Cai, Wen Zhang, Ming Yue, Jun Li, Chen Dong, Chuanlong Zhu
In total, 827 subjects including 448 healthy subjects (control group) and 379 patients with chronic hepatitis B (CHB) (case group) were recruited between January 2016 and December 2017 at the Zhangjiagang First People’s Hospital. The diagnosis of CHB was based on the guidelines for the prevention and treatment of chronic hepatitis B (2015 update) (Chinese Society of Hepatology 2016): sustained seropositivity for HBsAg and/or HBV DNA over a 6-month period. Healthy individuals in the non-HBV control group were recruited from the medical examination center at the time of routine physical examination during the same period. Exclusion criteria were as follows: patients co-infected with HCV, hepatitis D virus, or human immunodeficiency virus; patients with autoimmune diseases; and patients with tumors. All participants were of Han Chinese ethnicity. The study was approved by the Medical Ethics Committee of the First Affiliated Hospital of Nanjing Medical University.
TLR3 and TLR4 SNP variants in the liver disease resulting from hepatitis B virus and hepatitis C virus infection
Published in British Journal of Biomedical Science, 2019
I Sghaier, S Zidi, L Mouelhi, E Ghazoueni, E Brochot, WY Almawi, BY Loueslati
We recruited 100 chronic HBV carriers and 174 chronic HCV carriers at Charles Nicolle Hospital in Tunis, Tunisia. In addition, 360 individuals who were seronegative for both HBV and HCV served as the control group (Table 1). HBV- or HCV-infected patients were sub-grouped into patients with chronic hepatitis, those with liver cirrhosis and those with HCC. Inclusion criteria were HBsAg seropositivity (HBV group), or positive anti-HCV antibodies and HCV RNA (HCV group) for ≥ 6 months, with or without persistently elevated alanine aminotransferase (ALT) levels. Individuals who did not meet these criteria or were co-infected with hepatitis D virus (HDV) and/or HIV were excluded. Additional exclusion criteria included Wilson’s Disease, autoimmune hepatitis and non-alcoholic steatohepatitis in the absence of diabetes, hypertriglyceridemia and related risk factors. Clinical and laboratory evaluation included biochemical [ALT and aspartate aminotransferase (AST)] and serological tests for HBV (HBsAg, HBeAg, anti-HBeAg, anti-HBctotal) and HCV (anti-HCV), and histopathology of liver biopsy. HCC was diagnosed by ultrasound, computerised tomography, magnetic resonance imaging, arteriography and tumour biopsy. Patients were characterised by alpha-fetoprotein (AFP) levels, and further classified by METAVIR score [16]; F0–F2 scores indicated mild fibrosis, while F3 and F4 indicated severe fibrosis. Necro-inflammatory activity was graded on 0–3 scale according to METAVIR activity grading. LFTs and AFP were measured by standard methods in the routine pathology laboratory. The approval of the local research ethics committee was obtained, as was written informed consent from each subject.