Acute exacerbation in hepatitis B e antigen positive chronic type B hepatitis

Liaw, Yun–Fan; Yang, Sien–Sing; Chen, Tong‐Jong; Chu, Chia–Ming

doi:10.1016/s0168-8278(85)80050-7

Cited by 86 publications

(60 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…At this time, there is low hepatitis activity, as reflected by normal serum transaminase level despite active HBV replication (Yim and Lok, 2006). When the second immune clearance phase ensues, the liver cells suffer continuous damage due to immune-mediated cytotoxic responses (Liaw et al, 1985;Sprengers et al, 2006). However, following immune attacks, HBV replication is impermanently suppressed.…”

Section: Discussionmentioning

confidence: 99%

A large-scale analysis study on the clinical and viral characteristics of hepatitis B infection with concurrence of hepatitis B surface or E antigens and their corresponding antibodies

Xiang¹,

Chen²,

Xia

et al. 2017

Genet. Mol. Res.

View full text Add to dashboard Cite

ABSTRACT. Concurrent detection of hepatitis B surface antigen (HBsAg) and anti-HBs antibody or hepatitis B surface E antigen (HBeAg) and anti-HBe antibody in patients with chronic hepatitis B (CHB) infection is well established. However, the clinical implications of these proteins remain largely unknown. In this study, demographic, clinical, and laboratory data from 124,865 patients with chronic CHB infection were analyzed. Viral genotypes were determined by nested polymerase chain reaction. A chemiluminescent assay was applied to measure HBsAg, HBsAb, HBeAg, HBeAb, and HBcAb in sera. Among 124,865 patients with CHB infection, 324 (0.3%) were concurrently positive for HBsAg and anti-HBs, and 206 (0.2%) were concurrently positive for HBeAg and anti-HBe. The HBeAg+/anti-HBe+ group was composed of younger patients (P < 0.05). Subgenotype B2 was prevalent in HBV patients concurrently positive for HBeAg and anti-HBe, while HBV patients positive for both HBsAg and anti-HBs exhibited the C2 subgenotype. Among 530 concurrent patients, 126 (39%) HBsAg+/ anti-HBs+ patients were in the low-replication phase, and 62 (19%) were in the reactivation phase; 87 (42%) HBeAg+/anti-HBe+, and 19 (6%) HBsAg+/anti-HBs+ patients were in the immune clearance phase. In this large-scale analysis, the clinical and viral characteristics of HBV infections with concurrent HBs Ag/antibody or HBe Ag/antibody presentations have been examined, and the results may contribute to the diagnosis and treatment of CHB patients.

show abstract

Section: Discussionmentioning

confidence: 99%

A large-scale analysis study on the clinical and viral characteristics of hepatitis B infection with concurrence of hepatitis B surface or E antigens and their corresponding antibodies

Xiang¹,

Chen²,

Xia

et al. 2017

Genet. Mol. Res.

View full text Add to dashboard Cite

show abstract

“…The immune clearance phase is characterized by HBeAg seropositivity, fluctuating or high HBV-DNA and ALT levels, hepatitis flares, and increased inflammatory activity in the liver [32]. The clinical and histologic events that occur during this phase often influence the progression to liver disease.…”

Section: Natural Course Of Disease and Hbeag Seroconversionmentioning

confidence: 99%

“…On the basis of these results, it can be concluded that the persistence of HBeAg positivity in patients beyond the age of 40 years was associated with a poorer prognosis. Given that hepatitis flares occur frequently during the HBeAg-positive phase [32], patients with a longer HBeAg-positive phase could conceivably have more frequent or prolonged necroinflammatory liver damage, leading to a higher degree of hepatic fibrosis or cirrhosis development [42].…”

Section: Hbeag Positivity and Disease Progressionmentioning

confidence: 99%

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

2009

Self Cite

View full text Add to dashboard Cite

During the natural history of chronic hepatitis B virus (HBV) infection, the loss of serum hepatitis B e antigen (HBeAg) and the development of anti-HBe antibodies (HBeAg seroconversion) mark a transition from the immune-active phase of disease to the inactive carrier state. This review examines the evidence from natural history and cohort studies on the relationship between HBeAg seroconversion and disease progression. The role of HBeAg seroconversion as an important milestone in the management of HBeAg-positive patients with chronic hepatitis B (CHB), as well as the advantages and disadvantages of administering a finite course of therapy for HBeAg-positive CHB, is also discussed. The evidence from natural history and cohort studies indicates that spontaneous or treatment-induced HBeAg seroconversion is associated with lower rates of disease progression to cirrhosis and hepatocellular carcinoma, a potential of hepatitis B surface antigen seroconversion, and improved survival rates. Updated guidelines developed by major liver associations recommend stopping oral therapy for HBeAgpositive patients who achieve sustained HBeAg seroconversion with polymerase chain reaction-undetectable HBV-DNA on two separate occasions for 6 or more months apart, taking into consideration the individual's clinical and virologic response to therapy, as well as the severity of liver disease. Thus, early induction of HBeAg seroconversion with interferon-based therapy or oral nucleos(t)ide analogues has important clinical and socioeconomic implications for the management of CHB.

show abstract

“…After 2-3 decades of persistent infection, chronic hepatitis B enters the second immune clearance phase. During this phase, the previously symptomless carriers may start to have bouts of symptoms and signs suggestive of acute hepatitis flare [11,12]. With intense immune-mediated cytotoxic response toward infected hepatocytes, the liver cells suffer continuous or repeated bouts of damage, documented by elevated serum alanine aminotransferase (ALT) levels.…”

Section: Natural Course Of Chronic Hepatitis Bmentioning

confidence: 99%

Role of viral factors in the natural course and therapy of chronic hepatitis B

Kao

2007

Hepatol Int

View full text Add to dashboard Cite

Hepatitis B virus (HBV) infection is a global health problem that causes a wide spectrum of liver disease, including acute or fulminant hepatitis, inactive carrier state, chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). The pathogenesis of hepatocyte damage associated with HBV is mainly through immune-mediated mechanisms. On the basis of the virus and host interactions, the natural history of HBV carriers who are infected in early life can be divided into four dynamic phases. The frequency, extent, and severity of hepatitis flares or acute exacerbation in the second immune clearance and/or fourth reactivation phase predict liver disease progression in HBV carriers. In the past decade, hepatitis B viral factors including serum HBV DNA level, genotype, and naturally occurring mutants predictive of clinical outcomes have been identified. The higher the serum HBV DNA level after the immune clearance phase, the higher the incidence of adverse outcomes over time. In addition, high viral load, genotype C, basal core promoter mutation, and pre-S deletion correlate with increased risk of cirrhosis and HCC development. As to the treatment of chronic hepatitis B, patients with high HBV DNA level and genotype C or D infection are shown to have a worse response to interferon therapy. In conclusion, serum HBV DNA level, genotype, and naturally occurring mutants are identified to influence liver disease progression and therapy of chronic hepatitis B. More investigations are needed to clarify the molecular mechanisms of the viral factors involved in the pathogenesis of each stage of liver disease and the response to antiviral treatments.

show abstract

Acute exacerbation in hepatitis B e antigen positive chronic type B hepatitis

Cited by 86 publications

References 13 publications

A large-scale analysis study on the clinical and viral characteristics of hepatitis B infection with concurrence of hepatitis B surface or E antigens and their corresponding antibodies

A large-scale analysis study on the clinical and viral characteristics of hepatitis B infection with concurrence of hepatitis B surface or E antigens and their corresponding antibodies

HBeAg seroconversion as an important end point in the treatment of chronic hepatitis B

Role of viral factors in the natural course and therapy of chronic hepatitis B

Contact Info

Product

Resources

About