Hepatitis B and its Relationship With Oxidative Stress

Abstract

ContextDespite the great breakthroughs we have witnessed in the last 50 years in the prevention, diagnosis, and treatment of hepatitis B, we are still far from eradicating or even curing the disease. Achieving further progress in controlling this disease will not be possible without discovering the exact pathogenesis behind it. One prime suspect in the pathogenesis of various diseases is oxidative stress. This review will exclusively explore hepatitis B in the context of oxidative stress to obtain a more comprehensive clinical perspective on its pathogenesis and eventual medical therapy.Evidence AcquisitionWe systematically searched PubMed, Google Scholar, Web of Science, EMBASE, and Scopus using an extensive list of keywords in the following three categories: 1) Hepatitis B and oxidation 2) Hepatitis B and antioxidant system 3) Effects of approved anti-hepatitis B drugs on redox status. All relevant articles were obtained and reviewed carefully after the exclusion criteria were deployed.ResultsThere is great evidence indicating extensive oxidative stress occurs in hepatitis B. This oxidative stress takes place on multiple levels, including lipid peroxidation, DNA oxidation, protein oxidation, and reactive oxygen and nitrogen species production. However, there are also conflicting results with regard to antioxidant therapy and antioxidant status in hepatitis B, some of which may be explained by the concept of “compensatory gaps.” Nevertheless, further studies are indicated to reach a more thorough judgment.ConclusionsDespite the presence of vast oxidative stress in hepatitis B, antioxidant therapy is not always effective as a treatment strategy, especially considering that antioxidants can act as “double-edged swords” or antioxidants; if not used at the right time or place or in the right combination, these substances can easily become pro-oxidants. Therefore, several studies will be needed to determine suitable antioxidant therapies. We propose the “2-step Combined Antioxidant Adjuvant Therapy for hepatitis B (2CAAT Hep B)” as a new strategy for antioxidant adjuvant therapy. We also suggest developing an international platform and database for antioxidant adjuvant therapy in hepatitis B (IPAATH and IDAATH) to canalize this field of research in a standardized direction, especially when complexity is a problem.

Oxidative Stress and First-Line Antituberculosis Drug-Induced Hepatotoxicity

“…Taken together, the information underscores extremely important awareness regarding the enhanced predisposition to hepatotoxicity incurred by chronic hepatitis C disease and antituberculosis therapy. In chronic hepatitis B infection, there is also some evidence for the occurrence of oxidative stress (52). As in chronic hepatitis C infection, sometimes the studies regarding antioxidant status have yielded rather conflicting results in patients with chronic hepatitis B infection (49,52).…”

“…In chronic hepatitis B infection, there is also some evidence for the occurrence of oxidative stress (52). As in chronic hepatitis C infection, sometimes the studies regarding antioxidant status have yielded rather conflicting results in patients with chronic hepatitis B infection (49,52). This notwithstanding, great vigilance has to be exercised regarding the impact of an ROS-based pathogenetic mechanism in causing antituberculosis drug-associated hepatotoxicity in patients with chronic hepatitis B infection.…”

“…In chronic viral hepatitis, the use of antioxidants has not been shown to be definitely beneficial for the liver disease per se and indeed might prove to be the contrary in some patients. It has been suggested that patients with chronic hepatitis B infection might harvest therapeutic results with antioxidants, only if appropriate selection of candidates is undergone; thus, more pertinent research is mandatory (52). On the other hand, since the severity of hepatotoxicity has been shown to be related to the viral loads of chronic hepatitis B and hepatitis C infection at the time of commencement of antituberculosis therapy, antiviral therapy would likely have greater value.…”

Evaluation of thiol-disulphide homeostasis in patients with chronic hepatitis B

“…As far as we know, this study is the first that investigates the thiol / disulfide homeostasis balance in CHB patients with respect to HBV DNA levels and healthy controls. Studies exist that reveal oxidant-antioxidant imbalance in CHB patients and relate the oxidant-antioxidant state to the ethiopathogenesis and severity of CHB [22]. Various indicators of oxidative stress have been studied in various clinical forms of hepatitis B.…”

Soluble E‐cadherin is associated with oxidative stress in patients with chronic HBV infection

“…Hepatitis B virus (HBV) infection is one of the most common infectious disease in humans. Despite the success of prophylactic HBV vaccination program and antiviral therapy in decreasing the prevalence of HBV infection, there are still more than 350 million people who suffered from chronic hepatitis B (CHB) virus infection in the world . Remarkably, it has been reported that approximately 1 million people die annually because of HBV‐related disorders, such as HBV‐associated cancer and end‐stage liver diseases .…”