SERUM LEVELS OF HEPATITIS B SURFACE AND CORE ANTIGENS DURING IMMUNOSUPPRESSIVE TREATMENT OF HBsAg-POSITIVE CHRONIC ACTIVE HEPATITIS

Hepatitis B virus DNA contains a glucocorticoid-responsive element.

“…In addition, corticosteroids increase expression of HBV gene products in two human hepatocellular carcinoma cell lines, PLC/PRF/5 (3) and Mahlavu (4). These findings are consistent with the observations that glucocorticoid therapy in patients with HBV-related chronic hepatitis causes activation of latent infection (5,6), increased levels of HBV markers (7), and increased severity of liver disease (8).…”

Age‐Specific Prevalence of Hepatitis B e Antigen (HBeAg) and Antibody to HBeAg (Anti‐HBe) among Asymptomatic Hepatitis B Surface Antigen (HBsAg) Carriers in Okinawa and Kyushu, Japan

“…Factors other than age influence the virus replication in chronic HBV carriers, including the duration of illness (6) and immunosuppression induced by either drugs (28) or underlying diseases such as lymphoproliferative disorders and uremia (8). In the present study, patients with liver diseases were excluded according to abnormal levels of serum transaminases, but there might have been patients with normal levels of serum transaminases.…”

Withdrawal of Azathioprine in Renal Transplant Patients with Chronic Active Hepatitis: Is It Wise or Not?

“…They failed to seroconvert and to develop HBsAB while on reduced immunosuppression. This is not surprising since minimal immunosuppression was continued with corticosteroids which are known to decrease HBsAB titers in the serum [3], Immunosuppressive treatment favors virus replication in liver cells [3], Some authors have proposed, therefore, to reduce immunosuppression in order to improve the chance for virus elimination by minimizing the rate of virus replica tion [13,14]. However, following reduction of immuno suppression and recuperation of immunocompétence, necrosis of all infected liver cells may ensue [15,16].…”

“…The life expectancy of kidney transplant recipients may be limited by chronic active hepatitis [1], It has been sug gested that azathioprine might adversely affect liver disease and, therefore, should be withdrawn in order to protect the liver [2], Without azathioprine, the rate of virus replication in the liver cells might be expected to decrease [3] and a potential hepatotoxic effect of the drug could be avoided [4].…”