Therapeutic strategies in the management of patients with chronic hepatitis B virus infection

Papatheodoridis, George V.; Manolakopoulos, Spilios; Dusheiko, Geoffrey; Archimandritis, Athanasios

doi:10.1016/s1473-3099(07)70264-5

Cited by 192 publications

(219 citation statements)

References 133 publications

Supporting

Mentioning

214

Contrasting

Unclassified

Order By: Relevance

“…In HBeAg(-) chronic hepatitis B, ALT levels can flare with an intervening period of normal values, can continue to increase without flare, or demonstrate intermittent flares superimposed on a continuous elevation [17,18] . The majority of our patients belonged to the first profile.…”

Section: Discussionmentioning

confidence: 99%

Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers

Assy¹,

Beniashvili²,

Djibre³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To determine whether new cut-off values for alanine aminotransferase (ALT) and baseline hepatitis B virus (HBV) DNA levels better differentiate HBeAg(-) chronic hepatitis B (CHB) patients from inactive chronic carriers. METHODS:Ninety-one patients [32 HBeAg(+) CHB, 19 inactive carriers and 40 HBeAg(-) CHB] were followed up for 2 years and were tested for HBV DNA levels by a PCR-based assay. ALT was tested twice during the last 6 mo using new cut-off values: ULN (upper limit of normal) 30 IU/L for males, 19 IU/L for females. Diagnostic accuracy, sensitivity, specificity, positive and negative predictive values were calculated by discriminant analysis. RESULTS:When using the revised ALT cut-off values, the lowest optimal HBV DNA level that differentiated HBeAg(-) CHB patients from inactive carriers was 50 000 copies/mL. The diagnostic accuracy of HBV DNA to determine inactive carriers with a cut-off of 50 000 copies/mL was similar to the previously recommended cut-off of 100 000 copies/mL (91%). HBV DNA levels were lower than the cut-off value in 95% of inactive carriers and in 28% of HBeAg(-) CHB patients. With ALT < 30 IU/L in men and < 19 IU/L in women and HBV DNA levels < 100 000 copies/mL, the risk of CHB is 5%. On the other hand, if ALT values were > 30 IU in men and > 19 IU in women and baseline HBV DNA levels were > 100 000 copies/mL, the risk is 86%. CONCLUSION:

show abstract

Section: Discussionmentioning

confidence: 99%

Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers

Assy¹,

Beniashvili²,

Djibre³

et al. 2009

WJG

View full text Add to dashboard Cite

show abstract

“…Preventive nucleoside analog against HBV is currently recommended for 4-6 mo after chemotherapy completion [46,50,52,61] . However, reports of HBV reactivation 4 to 6 mo after chemotherapy [62][63][64][65] suggest that this number should be revised. The current 6 mo value probably reflects our knowledge about the changes in B-cell numbers [60,64,[66][67][68] .…”

Section: Nucleoside Analog Treatment For the Prevention Of Hbv Reactimentioning

confidence: 99%

“…Telbivudine may also be used in the prophylaxis of HBV reactivation. Compared to lamivudine and telbivudine, entecavir is less likely to induce drug resistance in HBV, which has a treatment advantage and the preventive administration of HBV reactivation [65] . For this reason, entecavir administration is recommended for cases in which preventive administration against HBV will last 12 mo or more [50,52] .…”

Section: Nucleoside Analog Treatment For the Prevention Of Hbv Reactimentioning

confidence: 99%

Hepatitis B virus reactivation with rituximab-containing regimen

Tsutsumi¹,

Yamamoto²,

Shimono³

et al. 2013

WJH

View full text Add to dashboard Cite

Rituximab is recognized as a useful drug for the treatment of B-cell non-Hodgkin's lymphoma and its use has been extended to such diseases as idiopathic thrombocytopenic purpura, thrombotic thrombocytopenic purpura, chronic rheumatoid arthritis and AN-CA-associated vasculitides. One serious complication associated with its use is the reactivation of hepatitis B virus and the search for methods to prevent this occurrence has resulted in the rapid accumulation of knowledge. In this review, we discuss case analyses from our department and other groups and outline the current knowledge on the topic and the remaining issues.© 2013 Baishideng Publishing Group Co., Limited. All rights reserved.Key words: Rituximab; Hepatitis B virus; Reactivation; Chemotherapy; Lamivudine; Non-Hodgkin's lymphoma Core tip: The deleterious effects of hepatitis B virus (HBV) reactivation in rituximab-containing chemotherapy regimens have been reported and the effect of lamivudine treatment in the prevention of HBV reactivation is also well documented. Once reactivated, HBV may lead to death due to hepatitis. In this review, we discuss the factors of preventive lamivudine treatment (especially in the course of HBV antibody), including to whom and for how long the drug should be given, based on case studies and reports that span rituximab's debut in 2002 on the Japanese market to June 2013.

show abstract

“…An estimated 400 million people worldwide have chronic hepatitis B virus (HBV) infection, and more than 500 000 people die every year from complications of HBVrelated chronic liver disease [1] . In patients chronically infected with HBV, acute exacerbations are clinically important because they can have severe or even fatal consequences [2] .…”

Section: Introductionmentioning

confidence: 99%

A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B

Matsumoto

Miyake

Miyatake

et al. 2009

WJG

View full text Add to dashboard Cite

Of patients with severe exacerbation of chronic hepatitis B accompanied by jaundice and coagulopathy, 20%-30% have a fatal outcome. In this report, we describe 2 cases of severe exacerbation of chronic hepatitis B with jaundice and coagulopathy who were successfully treated with a combination of entecavir and corticosteroid. In both cases, rapid reductions in serum hepatitis B virus (HBV)-DNA levels were observed, and corticosteroid was stopped after serum HBV-DNA levels became undetectable. Entecavir treatment was continued. Generally, entecavir treatment reduced serum HBV-DNA levels rapidly, although the improvement in liver function was delayed by a few weeks. During this time lag, liver cell injury continued and the disease progressed. Corticosteroid suppressed the excessive host immune response and was useful for stopping progressive deterioration. A combination of entecavir and early-phase corticosteroid may be a useful treatment in severe exacerbation of chronic hepatitis B.

show abstract

Therapeutic strategies in the management of patients with chronic hepatitis B virus infection

Cited by 192 publications

References 133 publications

Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers

Lower baseline ALT cut-off values and HBV DNA levels better differentiate HBeAg(-) chronic hepatitis B patients from inactive chronic carriers

Hepatitis B virus reactivation with rituximab-containing regimen

A combination treatment of entecavir and early-phase corticosteroid in severe exacerbation of chronic hepatitis B

Contact Info

Product

Resources

About