Pharmacological interventions for acute hepatitis B infection

Kalafateli, Maria; Buzzetti, Elena; Thorburn, Douglas; Davidson, Brian R; Tsochatzis, Emmanuel; Gurusamy, Kurinchi Selvan

doi:10.1002/14651858.cd011645.pub2

Cited by 22 publications

(27 citation statements)

References 78 publications

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“…In previous research, these markers at first HBsAg‐positive serology were associated with reduced risk of delayed HBsAg seroclearance and developing chronic infection . Second, anti‐HBV containing ART was infrequently given to HBV‐infected individuals during the study period and the treatments provided (mostly lamivudine) were unlikely to provide a major prophylactic effect on either HBV acquisition or HBsAg seroclearance during the acute phase . As such, we were unable to provide any assessment on the role of anti‐HBV‐containing ART in our study.…”

Section: Discussionmentioning

confidence: 77%

“…5,10 Second, anti-HBV containing ART was infrequently given to HBV-infected individuals during the study period and the treatments provided (mostly lamivudine) were unlikely to provide a major prophylactic effect on either HBV acquisition 17 or HBsAg seroclearance during the acute phase. 23 As such, we were unable to provide any assessment on the role of anti-HBV-containing ART in our study. Third, individuals with established chronic infection had a shorter follow-up than those with standard HBsAg Finally, we had a small sample size which did not allow us to study determinants of delayed HBsAg seroclearance in multivariable analysis.…”

Section: Discussionmentioning

confidence: 92%

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Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

Santen

Boyd

Bruisten

et al. 2019

Journal of Viral Hepatitis

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High rates (~25%) of developing chronic hepatitis B virus (HBV) infection (hepatitis B surface antigen (HBsAg)‐positive for > 6 months following infection) have been observed in people who use drugs (PWUD) and men who have sex with men (MSM). We aimed to estimate the frequency of delayed HBsAg seroclearance, along with its determinants, and time to delayed HBsAg seroclearance. Data were used from MSM and PWUD enrolled in the Amsterdam Cohort Studies (1985‐2002) who had anti‐hepatitis B core antibody seroconversion. Potential determinants for standard HBsAg seroclearance, delayed HBsAg seroclearance and chronic HBV were examined using multinominal logistic regression. Time to HBsAg seroclearance was estimated using Kaplan‐Meier curves. A total of 147 incident HBV infections occurred during follow‐up. On initial HBsAg testing after infection (6‐12 months), 42 (29%) were HBsAg‐positive and 105 (71%) were HBsAg‐negative (‘standard HBsAg seroclearance’). Of the 42 initially HBsAg‐positive individuals, 22 subsequently tested HBsAg‐negative (of whom 7 (31.8%) were HBV DNA positive at last visit, suggesting occult HBV). Overall, 15 became HBsAg‐negative and HBV DNA‐negative (‘delayed HBsAg seroclearance’), while 27 remained HBsAg and/or HBV DNA‐positive (‘chronic HBV’). The 5‐year cumulative probability of delayed HBsAg seroclearance was 41.6% for initially HBsAg‐positive individuals. Delayed HBsAg seroclearance and remaining chronically infected were associated with younger age and HIV/hepatitis C virus (HCV)‐co‐infection. In conclusion, delayed HBsAg seroclearance is common in these key adult populations at‐risk for HBV, while proportion developing HBV chronicity (18%) is still higher compared to the general population (~5%). Given the proportion of individuals with occult HBV infection and that HCV direct‐acting antivirals can lead to HBV reactivation, HBV DNA testing in HCV co‐infected MSM/PWUD are warranted prior to treatment initiation.

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Section: Discussionmentioning

confidence: 77%

Section: Discussionmentioning

confidence: 92%

Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

Santen

Boyd

Bruisten

et al. 2019

Journal of Viral Hepatitis

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“…Most commonly, biomarkers of liver damage with a PT(INR) !1.6, bilirubin !170 lM (10 mg/dL) or clinical signs of impaired liver function, such as ascites or encephalopathy are used. A meta-analysis from Cochrane 2017, found that studies of treatment of acute hepatitis B are of low quality and that evidence to recommend such treatment is lacking [43]. However, with regards to the potentially serious consequences and the lack of severe side-effects, it is reasonable to recommend treatment as described below in cases where a severe disease progression is suspected, as outlined in the recently published guideline from the British Transplantation Society [44].…”

Section: Treatment Of Hepatitis B Virus Infectionmentioning

confidence: 99%

Management of hepatitis B virus infection, updated Swedish guidelines

Westin

Aleman

Castedal

et al. 2019

Infectious Diseases

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Despite access to effective antiviral drugs and vaccines, hepatitis B virus (HBV) infection remains a major health issue worldwide. HBV is highly infectious and may cause chronic infection, progressive liver damage, hepatocellular cancer (HCC) and death. Early diagnosis, proper management and timing of treatment are crucial. The Swedish Reference group for Antiviral Treatment (RAV) here provides updated evidence-based guidelines for treatment and management of HBV infection which may be applicable also in other countries. Tenofovir alafenamide (TAF) has been introduced as a novel treatment option and new principles regarding indication and duration of treatment and characterization of hepatitis B have been gradually introduced which justifies an update of the previous guidelines from 2007. Updated guidelines on HCC surveillance in HBV-infected patients, treatment and prophylaxis for patients undergoing liver transplantation as well as management of pregnant women and children with HBV infection are also provided.

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“…Pored napora, pokušaj pronalaska optimalne terapije analizom nekoliko različitih studija ostaje kontroverzan. U jednoj takvoj studiji, objavljenoj 2017. godine, autori nisu mogli da utvrde relevantne razlike između ishoda simptomatske i antivirusne terapije, ali ni sa sigurnošću da tvrde da one ne postoje, usled pristrasnih i podataka slabijeg kvaliteta u studijama koje su analizirali (16).…”

Section: Diskusijaunclassified

Epidemiological characteristics of acute HBV infection

Perić¹,

Bojović²

2019

Medicinski podmladak

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Introduction: Despite the existing vaccines and mandatory immunization, the number of patients with acute HBV infection is substantial. According to some authors, almost 30% of world population has a serological confirmation of acute HBV infection or has recovered from it. Aim: The aim of this study was to show the most common clinical course of acute HBV infection. Our goal was also to evaluate risky forms of behaviour that would most likely lead to infection and which age groups are the most vulnerable. Material and methods: The study has been conducted based on the medical charts and case records of 243 patients hospitalised at the Clinic for Infective and Tropical Diseases in Belgrade and diagnosed with acute hepatitis B infection. Selected demographic characteristics were analyzed: sex, age, occupation, vaccination status and risk factors. Transaminase activity (ALT, AST) was spectrophotometrically measured; PV was determined by using photo-optic coagulometry, while ELISA was used to get the serological parameters (HBsAg, anti-HBc IgM, anti-HBs antibodies). Results: Results have shown that acute HBV occurs more often in the age group between 21 and 40. Infection occurs more often among men (72%). Only 24% of the participants in the study mentions sexual contact as risk. At the moment of their admission, the values of transaminases were mostly increased > 20 x, compared to standard values. Most patients recovered (negative HBsAg among 72%), but anti-HBs antibodies were developed only among 18%. There was no statistically significant difference between patients who were on the casual therapy and those symptomatically treated. Conclusion: Awareness of the HBV infection, the way it is transmitted and the importance of regular checkups is not high enough among already infected people. The future of prevention of the HBV infection lies in the immunization and education of the population about this infection.

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Pharmacological interventions for acute hepatitis B infection

Cited by 22 publications

References 78 publications

Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

Frequent delayed spontaneous seroclearance of hepatitis B virus after incident HBV infection among adult high‐risk groups

Management of hepatitis B virus infection, updated Swedish guidelines

Epidemiological characteristics of acute HBV infection

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