The Changing Face of Hepatitis B in Greater Glasgow: epidemiological trends 1993–2007

Barclay, Stephen T.; Cameron, S.; Mills, Peter R.; Priest, Marc; Ross, Frank; Fox, Rena K.; Goulding, CA; Forrest, Ewan; Morris, Allan J.; Neilson, Meredith; Stanley, Adrian J.

doi:10.1258/rsmsmj.55.3.4

Cited by 2 publications

(1 citation statement)

References 18 publications

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“…Overall, because of the vaccination success, most countries see declines in the reported incidences of acute hepatitis B . However, still acute hepatitis B is a cause of death, i.e.…”

Section: Spontaneous Hepatitis B Virus Clearance In Different Reportsmentioning

confidence: 99%

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Tillmann

Zachou

Dalekos

2011

Liver International

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Despite a decline in cases of acute hepatitis B and the low hepatitis B virus (HBV) chronicity rates in adults, still some patients progress to HBV‐related fulminant liver failure. In this review, we discuss treatment options that may prevent the progression of severe acute hepatitis B to fulminant liver failure and death. In severe acute HBV with prolonged prothrombin time and increased bilirubin, interferon failed to be effective while antiviral treatment, particularly with lamivudine, appears to improve survival (mean survival almost 80%). Outcome without antiviral therapy has remained considerably poor, whereas there is no convincing evidence of amelioration of HBV‐targeted immunity. Of note, most patients who died or required transplantation despite lamivudine therapy, were started on lamivudine at advanced stages compared with those survived. This suggests that prompt and timely antiviral therapy is crucial. Owing to the abovementioned results the design of randomized placebo‐control trials in the setting of severe acute hepatitis B seems unethical. On the contrary, the design of multicentre double‐blind randomized trials to compare the efficacy between lamivudine and entecavir or even tenofovir in acute severe HBV cases is ideally needed, but these studies appear to be very difficult to perform considering that these cases are not frequent and therefore, it is almost impossible to have two arms adequately numerous and homogenous for statistical evaluation. Thus, in the absence of solid evidence based data, the hepatologists could treat their patients with severe acute hepatitis B with lamivudine or the most potent antivirals entecavir or tenofovir.

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“…Overall, because of the vaccination success, most countries see declines in the reported incidences of acute hepatitis B . However, still acute hepatitis B is a cause of death, i.e.…”

Section: Spontaneous Hepatitis B Virus Clearance In Different Reportsmentioning

confidence: 99%

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Tillmann

Zachou

Dalekos

2011

Liver International

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Hepatitis B escape mutants in Scottish blood donors

Larralde

Dow

Jarvis

et al. 2012

Med Microbiol Immunol

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Hepatitis B virus (HBV) remains as the viral infection with the highest risk of transmission by transfusion. This risk is associated with window period donations, occult HBV infection (OBI) and the emergence of escape mutants, which render blood donations false negative for hepatitis B surface antigen (HBsAg) serological testing. A retrospective study was conducted to gain insights into the molecular epidemiology of HBV escape mutants in Scottish blood donors. The criterion for selection was HBV positivity either by serology or nucleic acid testing (NAT). HBsAg detection was compared across several commercial immunoassays. The full length S gene from plasma samples was PCR amplified, cloned and expressed in HepG2 cells. Eight samples showed HBsAg discordant results, while 5 OBI samples were found. Four escape mutants, containing missense mutations in the S gene, are described here. These mutations impaired HBsAg detection both from HBV infected plasma samples and from recombinant proteins derived from its infected donors. Phylogenetic analysis showed that most of the mutants were clustered in the genotype D and were closely related to strains from Asia and the Middle East. We report here a proline substitution, outside the major hydrophilic region, that impaired HBsAg detection in vivo and in vitro, warning about the risk for the emergence of vaccine escape mutants with mutations outside the major neutralisation site.

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The Changing Face of Hepatitis B in Greater Glasgow: epidemiological trends 1993–2007

Abstract: Chronic HBV trebled in Glasgow between 2000 and 2007. Most patients were not assessed in secondary care. Improved levels of clinic referral and attendance are required to ensure best care for HBV patients in Glasgow.

Cited by 2 publications

References 18 publications

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Management of severe acute to fulminant hepatitis B: to treat or not to treat or when to treat?

Hepatitis B escape mutants in Scottish blood donors

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