Liver Diseases
George Feuer, Felix A. de la Iglesia in Molecular Biochemistry of Human Disease, 2020
In the development of viral hepatitis immunologic mechanisms appear to play a significant role. Among the hepatitis viruses (hepatitis A, hepatitis B, or other viruses), the immunologic features associated with hepatitis B virus infection have been studied extensively. Two phases have been distinguished in the course of chronic hepatitis B infection. In the early replicative phase, the hepatitis B virus DNA in episomal form reacts with the hepatocyte nuclei and infectious viral particles are formed. Simultaneously hepatitis B core antigen (HBcAg) is produced and becomes detectable in serum. This replicative phase is associated with chronic active hepatitis. In the later, nonreplicative phase, the hepatitis B virus DNA is in integrated form and anti-HBc and noninfectious hepatitis B surface (HBsAg) antigens are present in the serum. This nonreplicative phase of the virus is accompanied by inactive liver disease. Hepatitis B virus is not cytotoxic, but leads to immunologically mediated liver injury. Cytotoxic T cells are formed and their action is directed against the core antigen. The cytotoxic action of T cells is expressed on the hepatocyte membrane resulting in liver cell necrosis. Differences in the progress and severity of the chronic hepatitis may depend partly on the modulatory factors which include circulating antibodies to HBcAg, immune mediators, and lymphoid cells.
Liver Cancer
Peter G. Shields in Cancer Risk Assessment, 2005
Hepatitis B virus infection occurs worldwide, but the highest population prevalence of chronic HBV infection is found in Southeast Asia (East of India and excluding Japan), sub-Saharan Africa, north-central South America, and the North American Arctic. Presence of antibodies to the hepatitis B core antigen (anti-HBc) reliably identifies any previous HBV infection. HBV surface antigen (HBsAg), the foremost marker for active HBV infection, was discovered in 1965 by Blumberg (20). HBsAg in serum becomes measurable at the end of a 4–12-week incubation period and typically persists in chronic HBV infection. However, the occurrence of occult HBV infection, defined as the presence of HBV DNA in liver tissue or serum in the absence of measurable HBsAg, has been described as well (21,22). This situation is particularly common in cases of dual HBV and HCV infection, hinting at viral interference and at least partial suppression of HBV replication by HCV (23).
Clinical Applications of Prescriptions Containing Bupleurum Root
Sheng-Li Pan in Bupleurum Species, 2006
When using the recipe/prescription as the principal drug in the treatment of chronic active hepatitis, one dose a day is given; the shortest efficacious time is within 2 months, the longest is 3 years. The result was that among 16 cases, the patients’ serum glutamic-pyruvic transaminase (SGPT) and serum glutamic-oxaloacetic transaminase (SGOT) became normal. Liver function recovered more significantly in 6 patients with positive hepatitis B core antigen (HbsAg). In 45 other cases of chronic active hepatitis when the Xiao-Chaihu-Tang was administered with prednisone, for 2 to 6 months, it had no effect or a negative effect. Omitting the hormone, the auto-symptoms, physical signs, and liver function improved significantly. Administering the extract of Xiao-Chaihu-Tang to 23 cases of non-A non-B hepatitis and 7 cases of hepatitis B for 6 months, the clinical parameter of the patients was improved by about 46.7% and the patients’ SGPT decreased significantly (Xiao, 1986).
Serum biomarkers for diagnosis and monitoring viral hepatitis and hepatocellular carcinoma
Published in Expert Review of Molecular Diagnostics, 2018
Sreelakshmi Kotha, ShuetFong Neong, Keyur Patel
Heptitis B core-related antigen level (HBcrAg) consists of hepatitis B core antigen (HBcAg), HBeAg, and a pre-core protein [43]. There may be a reduction in HBcrAg levels in patients with spontaneous HBeAg seroconversion [44]. HBcrAg correlates with intrahepatic cccDNA and HBV DNA levels [45–47], and may be useful to differentiate between HBeAg-negative chronic infection or hepatitis, predict HBeAg seroconversion, and risk of reactivation in occult infection [48]. Recent studies have shown HBcrAg levels correlate with HCC development [49–51], and potentially better than HBV DNA at predicting HCC risk [51]. HBcrAg may predict HCC recurrence after curative surgery, thus allowing for modified postsurgical surveillance strategies based on risk stratification [52]. HbcrAg assays are not yet available for routine clinical use.
The potential of plant-made vaccines to fight picornavirus
Published in Expert Review of Vaccines, 2020
Omayra C. Bolaños-Martínez, Sergio Rosales-Mendoza
Huang et al. (2005) reported the expression of relevant epitopes from the VP1 and VP4 proteins [31]. The authors fused a VP21 epitope (aa 140–160 at the G-H loop from the VP1 protein) into the internal region of the hepatitis B virus core antigen (HBcAg). Transgenic tobacco plants were obtained via Agrobacterium-mediated transformation. The highest concentration of recombinant HBCVP protein was 0.05% of TSP. Interestingly, this fusion protein formed a VLP structure. BALB/c mice were i.p. immunized four times with 0.25 mL of transgenic tobacco leaf extracts (containing 1.25 µg of recombinant HBCVP protein). Sera analyses showed specific IgG antibody responses to both HBcAg and FMDV VP1, moreover, a virus challenge experiment demonstrated that the immunized mice were protected against the virulent FMDV serotype O.
Safety of biologic agents for psoriasis in patients with viral hepatitis
Published in Journal of Dermatological Treatment, 2018
Nawaf AlMutairi, Hesham Alaadin Abouzaid
Viganò et al. (29) revised the mechanisms of action of TNF in hepatitis B and C, the endorsements for managing HBV and HCV-infected patients receiving anti-TNF drugs, their safety and anti-TNF hepatotoxicity. They recommended that in hepatitis B surface antigen (HBsAg) carriers experiencing anti-TNF therapy, either anti-HBV treatment or prophylaxis is compulsory to inhibit hepatitis reactivation. Whereas, HBsAg-negative antibody to hepatitis B core antigen (anti-HBc) seropositive patients require observant monitoring only. On the contrary, they indicated that in HCV-infected patients, TNF-α inhibition therapy is safe and could be even valuable, as TNF-α pathways are elaborated in sustaining liver inflammation and fibrosis progression in HCV. HBV or HCV-infected patients should be referred to a hepatologist for professional clinical management whenever antiviral therapy is compulsory or hepatitis reactivation ensues (29).