Hepatitis B as an Immune Complex Disease

Dienstag, Jules L.

doi:10.1055/s-2008-1063929

Cited by 42 publications

(12 citation statements)

References 57 publications

(117 reference statements)

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“…Extrahepatic manifestations of HBV infection occur in 1% to 10% of patients, and include serum-sickness-like syndrome, acute necrotizing vasculitis (polyarteritis nodosa), membranous glomerulonephritis (MGN)85, and papular acrodermatitis of childhood (Gianotti-Crosti syndrome) 8687. Serum-sickness-like syndrome occurs in the setting of acute hepatitis B, often preceding the onset of jaundice 88.…”

Section: Pathophysiology / Serology / Signs and Symptomsmentioning

confidence: 99%

Hepatitis B virus and its sexually transmitted infection – an update

Inoue

Tanaka

2016

MIC

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Epidemiology: incidence and prevalence: About 5% of the world’s population has chronic hepatitis B virus (HBV) infection, and nearly 25% of carriers develop chronic hepatitis, cirrhosis, and hepatocellular carcinoma (HCC). The prevalence of chronic HBV infection in human immunodeficiency virus (HIV)-infected individuals is 5%-15%; HIV/HBV coinfected individuals have a higher level of HBV replication, with higher rates of chronicity, reactivation, occult infection, and HCC than individuals with HBV only. The prevalence of HBV genotype A is significantly higher among men who have sex with men (MSM), compared with the rest of the population. Molecular mechanisms of infection, pathology, and symptomatology: HBV replication begins with entry into the hepatocyte. Sodium taurocholate cotransporting polypeptide was identified in 2012 as the entry receptor of HBV. Although chronic hepatitis B develops slowly, HIV/HBV coinfected individuals show more rapid progression to cirrhosis and HCC. Transmission and protection: The most common sources of HBV infection are body fluids. Hepatitis B (HB) vaccination is recommended for all children and adolescents, and all unvaccinated adults at risk for HBV infection (sexually active individuals such as MSM, individuals with occupational risk, and immunosuppressed individuals). Although HB vaccination can prevent clinical infections (hepatitis), it cannot prevent 100% of subclinical infections. Treatment and curability: The goal of treatment is reducing the risk of complications (cirrhosis and HCC). Pegylated interferon alfa and nucleos(t)ide analogues (NAs) are the current treatments for chronic HBV infection. NAs have improved the outcomes of patients with cirrhosis and HCC, and decreased the incidence of acute liver failure.

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Section: Pathophysiology / Serology / Signs and Symptomsmentioning

confidence: 99%

Hepatitis B virus and its sexually transmitted infection – an update

Inoue

Tanaka

2016

MIC

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“…Mixed cryoglobulinemia type I1 associated with HBV infection is a rare but known complication accompanied by immune complex vasculitis or by membranoproliferative glomerulonephritis [Dienstag, 1981;Ozawa et al, 19761. In chronic hepatitis B cryoglobulinemia is associated with disease activity [Lisker-Melman et al, 1989;Lev0 et al, 19771.…”

Section: Discussionmentioning

confidence: 99%

Mixed cryoglobulinemia type II in chronic hepatitis B associated with HBe‐minus HBV mutant: Cellular immune reactions and response to interferon treatment

Löhr

Goergen

Weber

et al. 1994

Journal of Medical Virology

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The case of a young female patient with chronic active hepatitis B, vasculitic purpura, edema, and circulating immune complexes due to mixed cryoglobulinemia is described. Serum transaminases were elevated. Serological assays showed hepatitis B surface antigen (HBsAg), antibody to hepatitis B e antigen (anti-HBe), and antibody to hepatitis B core antigen (anti-HBc) antibodies but no antibody to hepatitis C virus (anti-HCV) or antibody to hepatitis delta virus (anti-HDV) antibodies. Using hepatitis B virus-polymerase chain reaction (HBV-PCR) and direct sequencing a precore/core (preC/C) mutant unable to synthesize HBeAg was detected in serum. HBV antigens were demonstrated in the circulating immune complexes. Following 1 month of treatment with interferon-alpha 2b3 miu three times weekly, alanine aminotransferases returned to normal levels while cryoglobulins and immune complexes disappeared from serum. In addition, 2 months after the onset of treatment serum HBV-DNA was no longer detectable by PCR. Prior to treatment the analysis of cellular immune reactions of peripheral blood mononuclear cells showed a major proliferative response to HBcAg, preS1Ag and HBxAg and a minor response to HBeAg and HBsAg. One month after conclusion of treatment a decline in T-cell reactivity against all HBV antigens was observed. During clinical response to the therapy, however, a strong proliferative response of T cells to HBcAg and HBeAg was demonstrated. In conclusion, immune complex disease may complicate chronic hepatitis B in patients expressing HBe-minus HBV mutants. Treatment with interferon-alpha was found to be effective in mixed cryoglobulinemia even in the presence of HBe-minus HBV mutants.(ABSTRACT TRUNCATED AT 250 WORDS)

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“…Although cardiac manifestations due to hepatitis have been recognized for a long time, there are few reports of myocarditis associated with HBV (10, 11). There are two hypotheses regarding HBV related myocarditis; one proposes an indirect mechanism with immune complexes (12), whereas the other proposes a direct myocardial cell injury by HBV. Some authors have reported that HBV proteins and nucleic acids were found in a number of non-hepatic tissues, including the myocardium (11,13).…”

Section: Discussionmentioning

confidence: 99%

Acute Liver Failure Complicated with Severe Heart Failure

et al. 2015

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A young pregnant woman was hospitalized due to hepatitis B virus (HBV)-related acute liver failure (ALF). The cardiac function was normal on admission. However, she developed ALF concurrently with a coma and severe cardiac failure. The patient was diagnosed with severe acute cardiomyopathy due to diffuse hypokinesis of the left ventricle wall on ultrasound cardiography. Following intensive treatment, both the liver and cardiac function dramatically recovered. Although some factors, such as HBV, pregnancy and systemic inflammatory response syndrome, are possible causes of acute cardiomyopathy in the present case, ALF itself may be a risk factor for heart failure.

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Hepatitis B as an Immune Complex Disease

Cited by 42 publications

References 57 publications

Hepatitis B virus and its sexually transmitted infection – an update

Hepatitis B virus and its sexually transmitted infection – an update

Mixed cryoglobulinemia type II in chronic hepatitis B associated with HBe‐minus HBV mutant: Cellular immune reactions and response to interferon treatment

Acute Liver Failure Complicated with Severe Heart Failure

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