Immunopathogenesis of the Extrahepatic Manifestations of Hepatitis B Virus Infection

Dienstag, Jules L.

doi:10.1007/978-3-642-68446-3_13

Cited by 4 publications

(4 citation statements)

References 50 publications

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“…These include the deposition of circulating hepatitis B antigen-antibody complexes in extrahepatic tissues (22); the local induction of immune complex formation in extrahepatic tissues; viral induction of host autoantibodies …”

Section: Discussionmentioning

confidence: 99%

Hepatitis B Virus Replication in Damaged Endothelial Tissues of Patients with Extrahepatic Disease

Mason

Theal²,

Bain³

et al. 2005

Am J Gastroenterology

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Hepatitis B virus (HBV) infection may be complicated by extrahepatic manifestations such as polyarteritis nodosa (PAN), glomerulonephritis, polymyositis, and dermatitis, but the etiology of these processes is not yet clear. HBV replication has been demonstrated in a variety of extrahepatic tissues and cell types, but the possible pathogenetic role of extrahepatic HBV replication has not been fully explored in patients with extrahepatic manifestations of HBV infection. In this case series, immunohistochemistry and in situ hybridization studies were performed on extrahepatic tissues from one HBsAg-positive patient with PAN and another HBsAg-positive patient with polymyositis, using HBsAg-seronegative control subjects with the same vasculitic disorders as controls. Tissue samples from the two study patients had detectable HBV RNA, replicative intermediates of HBV DNA, as well as HBsAg and HBcAg localized to vascular endothelium. In contrast, HBsAg-negative control patients had no tissue reactivity. Our results suggest that patients with HBV-related extrahepatic disease have evidence of viral replication in damaged extrahepatic endothelial tissues. While further studies would be required to support a hypothesis of causality, these findings suggest a role for both immune complex deposition and viral replication within diseased endothelial tissue in the pathogenesis of these poorly understood extrahepatic disorders.

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Section: Discussionmentioning

confidence: 99%

Hepatitis B Virus Replication in Damaged Endothelial Tissues of Patients with Extrahepatic Disease

Mason

Theal²,

Bain³

et al. 2005

Am J Gastroenterology

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“…Extrahepatic manifestations occur in up to 20% of HBVinfected individuals (30) and may involve the gastrointestinal, renal, and nervous systems (68). The mechanisms leading to extrahepatic manifestations of hepatitis B virus infection are poorly understood.…”

Section: Hbv Infection and Clinical Diseasementioning

confidence: 99%

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

2012

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SUMMARY Chronic hepatitis B virus (HBV) infection is a complex clinical entity frequently associated with cirrhosis and hepatocellular carcinoma (HCC). The persistence of HBV genomes in the absence of detectable surface antigenemia is termed occult HBV infection. Mutations in the surface gene rendering HBsAg undetectable by commercial assays and inhibition of HBV by suppression of viral replication and viral proteins represent two fundamentally different mechanisms that lead to occult HBV infections. The molecular mechanisms underlying occult HBV infections, including recently identified mechanisms associated with the suppression of HBV replication and inhibition of HBV proteins, are reviewed in detail. The availability of highly sensitive molecular methods has led to increased detection of occult HBV infections in various clinical settings. The clinical relevance of occult HBV infection and the utility of appropriate diagnostic methods to detect occult HBV infection are discussed. The need for specific guidelines on the diagnosis and management of occult HBV infection is being increasingly recognized; the aspects of mechanistic studies that warrant further investigation are discussed in the final section.

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“…Children less than 10 years of age are often asymptomatic, with acute illness being more common in adults (49). Signs and symptoms of acute HBV infection include anorexia, malaise, nausea, vomiting, abdominal pain, jaundice, elevated liver enzymes, rashes, and arthralgias (50). The mortality rate of acute HBV ranges from 0.5 to 1.5%, with the highest rates among the elderly (39).…”

Section: Hepatitis Bmentioning

confidence: 99%

Existing antiviral vaccines

Ravanfar

Satyaprakash

Creed

et al. 2009

Dermatologic Therapy

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The innovation of vaccines has allowed for one of the greatest advancements in the history of public health. The first of the vaccines have been the antiviral vaccines, in particular the smallpox vaccine that was first developed by Edward Jenner in 1796. This article will review vaccination for the following viral diseases: measles, mumps, rubella, polio, hepatitis A, hepatitis B, influenza, rotavirus, rabies, monkeypox, smallpox, Japanese encephalitis, and yellow fever.

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Immunopathogenesis of the Extrahepatic Manifestations of Hepatitis B Virus Infection

Cited by 4 publications

References 50 publications

Hepatitis B Virus Replication in Damaged Endothelial Tissues of Patients with Extrahepatic Disease

Hepatitis B Virus Replication in Damaged Endothelial Tissues of Patients with Extrahepatic Disease

Molecular Mechanisms Underlying Occult Hepatitis B Virus Infection

Existing antiviral vaccines

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