Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation from Acute Viral Hepatitis B

Puri, Pankaj

doi:10.1016/j.jceh.2013.08.014

Cited by 27 publications

(27 citation statements)

References 89 publications

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“…Low HBeAg titer, other tests such as increased alpha-fetoprotein titer may be useful in diagnosis. Biopsy may not help at early stage, it is recommended to perform after acute phase (12). One of our patients was admitted with very high serum ALT (2800 IU) and bilirubin (total bilirubin 17 mg/dL) levels.…”

Section: Discussionmentioning

confidence: 99%

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

C¹,

Tülek²,

Aktepe³

et al. 2015

vhd

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ÖZETObjective: In the course of chronic hepatitis B infection, acute exacerbations characterized by high ALT and HBV DNA levels may occur. Sometimes icterus and hepatic decompensation may develop in severe cases. In this study, we evaluated characteristics of patients who were diagnosed as having acute exacerbation of chronic hepatitis B and the reasons that lead to exacerbation. Materials and Methods:Patients with acute exacerbation of chronic hepatitis B followed up in a training and research hospital clinic between 2010 and 2014, were retrospectively evaluated. Acute exacerbation was diagnosed by detection of 5-fold increase or more than twice of the previous values in ALT levels and elevation of HBV DNA (>10 5 I.U) in patients with chronic hepatitis. Age, gender, known duration of hepatitis B infection, medication, HBeAg positivity and anti-HBc IgM, ALT, AST, albumin, prothrombin time and HBV DNA levels of patients were recorded.

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Section: Discussionmentioning

confidence: 99%

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

C¹,

Tülek²,

Aktepe³

et al. 2015

vhd

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“…HBV DNA'nın negatifken, pozitifleş-mesi veya >1 log artışıyla nitelenir. Önce HBV DNA artışı, ardından karaciğerde inflamasyon bulguları ve ALT yükselmesi gelişir (94)…”

Section: Akut Hepatit B'nin Kronik Hepatit B Akut Alevlenmesinden Ayıunclassified

“…İkter akut hepatitte, splenomegali de kronik hepatitin akut alevlenmesinde daha yaygındır. Bununla birlikte klinik olarak ayırt etmek her zaman mümkün değildir (92)(93)(94)(97)(98)(99).…”

Section: Akut Hepatit B'nin Kronik Hepatit B Akut Alevlenmesinden Ayıunclassified

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Management of Chronic Hepatitis B Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Akhan¹,

Aynıoğlu²,

Çağatay³

et al. 2015

Klimik Dergisi

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ÖzetTürk Klinik Mikrobiyoloji ve İnfeksiyon Hastalıkları Derneği Viral Hepatit Çalışma Grubu, dünyada 400 milyonun üzerinde kişide bulunan kronik hepatit B virusu (HBV) infeksiyonunun yönetimi-ne ilişkin bir uzlaşı raporu hazırlamak üzere bir toplantı düzenle-miştir. Raporda konuyla ilgili literatür ve uluslararası kılavuzlar, hepatit B virusu (HBV) infeksiyonunun epidemiyolojisi ve doğal seyri, kronik hepatit B (KHB)'nin ülke ekonomisine maliyeti, akut hepatit B (AHB) ve KHB'de tanı, AHB'nin KHB akut alevlenmesinden ayırt edilmesi, KHB tedavisi, HBeAg-pozitif ve negatif hastalarda tedaviye yanıtın değerlendirilmesi ve uzun dönem sonuçları, nükleoz(t)id analoglarına karşı viral direnç ve direncin izlemi ve hepatit B'den korunma gibi bölümler halinde gözden geçirilmiş ve üzerinde uzlaşılan öneriler her bölümün sonunda sunulmuştur. Bu önerilerden seçilmiş birkaçı aşağıda sıralan-mıştır: [1] İlk basamak tedavisi olarak entekavir ya da tenofovir gibi dirence karşı genetik bariyeri yüksek çok güçlü ilaçların seçilmesi, uzun süreli tedavi hedeflerine ulaşmak için en uygun AbstractStudy Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases convened a meeting to develop a consensus report on management of chronic hepatitis B virus (HBV) infection, a global public health problem, affecting more than 400 million people worldwide. Relevant literature and international guidelines were reviewed, and recommendations agreed are presented at the end of each section such as epidemiology and natural history of HBV infection, economic burden of chronic hepatitis B (CHB), diagnosis of acute hepatitis B (AHB) and CHB, differentiation of AHB from acute exacerbation of CHB, treatment of CHB, evaluation of response to treatment and longterm outcomes in HBeAg-positive and negative patients, antiviral resistance and its follow-up, and prevention of HBV infection. Examples of some selected recommendations are as follows: [1] The selection of a highly potent drug such as entecavir or tenofovir with a high genetic barrier to resistance as a first line therapy provides the best approach of achieving the goals of long-term

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“…Hepatitis B virus (HBV) is one of the most challenging infections of liver which caused acute and chronic liver disease (4)(5)(6)(7). Although an effective preventive vaccine against HBV has been used globally, still this infection is considered as a leading cause of death worldwide.…”

Section: Introductionmentioning

confidence: 99%

Immune Responses of Mice Immunized with HBsAg Formulated in Naloxone/Alum Mixture: Comparison to Fendrix Vaccine

et al. 2017

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Background: Hepatitis B virus (HBV) can cause cirrhosis of the liver and hepatocellular carcinoma. Due to the lack of sufficient immune response in whole population, several studies have been conducted to improve the efficacy of alum-based HBV vaccine. Here, naloxone/alum mixture as adjuvant was used for the hepatitis B surface antigen HBsAg vaccine and immune parameters evaluated in immunized mice. Objectives: The present study aimed at investigating the effect of naloxone/alum mixture for the HBsAg vaccine and comparing to Fendrix vaccine. Methods: Female Balb/c mice were vaccinated at day 0, 14, and 28 with alum-based vaccine or naloxone/alum mixture vaccine in different doses. Naloxone/alum vaccine groups received a dose of 3, 6, or 10 mg/kg of naloxone (NLX) in the vaccine formulation. One group received routine HBsAg alum vaccine and another group received Fendrix vaccine. Some groups received naloxone plus HBsAg without alum and a group received HBsAg without adjuvant. Phosphate buffered saline (PBS), naloxone, and alum were also injected into the control groups separately. Finally, the naloxone/alum formulated vaccine was compared with the Fendrix and routine alum-based vaccine with respect to the levels of total anti-HBS antibody, IFN-γ, IL-4, IgG1, IgG2a, and the level of lymphocyte proliferation. Results:The level of total anti-HBS antibody in naloxone formulated vaccine was comparable with Fendrix. Meanwhile, IFN-γ/IL-4 ratio level was significantly higher in naloxone formulated vaccine groups versus mere vaccine group. IgG2a was also higher in the naloxone formulated vaccine groups. Conclusions: Based on the data presented in the present study, it was found that naloxone/alum mixture has the ability to shift the immune response towards Th1 pattern and potentially increase immunity against infections.

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Acute Exacerbation of Chronic Hepatitis B: The Dilemma of Differentiation from Acute Viral Hepatitis B

Cited by 27 publications

References 89 publications

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

Causes of Acute Exacerbation of Chronic Hepatitis B Infection: A Report of Case Series

Management of Chronic Hepatitis B Virus Infection: A Consensus Report of the Study Group for Viral Hepatitis of the Turkish Society of Clinical Microbiology and Infectious Diseases

Immune Responses of Mice Immunized with HBsAg Formulated in Naloxone/Alum Mixture: Comparison to Fendrix Vaccine

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