CON: All Patients With Immune‐Tolerated Hepatitis B Virus Do Not Need to Be Treated

Attar, Bashar M.

doi:10.1002/cld.893

Cited by 5 publications

(3 citation statements)

References 35 publications

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“…13,20,21 HBV goes undetected in a considerable number of pregnancies, which leads to mother-to-child transmission (MTCT) of the virus through various ways. 22 Hence, undetected hepatitis B among adults might be significantly responsible for disease burden leading to chronic HBV or even hepatocellular carcinoma (HCC). 14,[23][24][25] A majority of the transmission of hepatitis B in India and other developing countries occurs by vertical transmission from an infected carrier mother to the neonate, intrapartum or through antenatal route.…”

Section: Discussionmentioning

confidence: 99%

“…Despite universal vaccination against it, the prevalence of HBV infection still remains high in India 13,20,21 . HBV goes undetected in a considerable number of pregnancies, which leads to mother‐to‐child transmission (MTCT) of the virus through various ways 22 . Hence, undetected hepatitis B among adults might be significantly responsible for disease burden leading to chronic HBV or even hepatocellular carcinoma (HCC) 14,23–25 .…”

Section: Discussionmentioning

confidence: 99%

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Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Kalita

Hazarika

et al. 2023

American J Rep Immunol

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Problem Hepatitis B is one of the leading causes of mortality in India. Despite the mass vaccination programme, the burden of the infection is still increasing due to its vertical transmission. Asymptomatic nature of hepatitis B virus (HBV) infection owing to immune tolerance among pregnant women is a major issue in this regard. Method of study As such, this study aims to investigate the potential role of altered Toll‐like receptor (TLR) expression (TLR‐3, 7 and 9) along with peripheral blood HBeAg status in attaining differential cord blood (CB) HBV DNA status. Result Expression analysis reveals an overall downregulation of expression with mean ± SD value 1.14 ± 1.05, 0.86 ± 0.5 and 0.71 ± 0.4 (TLR 3, 7 and 9, respectively) upon comparison with healthy women. Further stratification based on CB HBV DNA status; the downregulation of expression was found to be significantly (p < .05) associated with positive CB HBV DNA status apart from peripheral HBeAg status. One hundred percent HBeAg positive parturiting women exhibit positive CB HBV DNA. Pearson's correlation analysis reveals a positive correlation between CB HBV DNA status and altered TLR expression, HBeAg status and mother HBV DNA status and as such can be associated with the potential risk of HBV vertical transmission. Conclusion This study suggests that the downregulation of TLR 3, 7 and 9 may be a risk factor for potential vertical transmission of HBV.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Kalita

Hazarika

et al. 2023

American J Rep Immunol

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“…The immune-tolerant phase is characterized by a higher HBV load without obvious liver histopathological changes, indicating a "peaceful coexistence" of HBV and the host [ 107 , 108 ]. Most HBV-related guidelines recommend to not treat these patients with antiviral therapy [ 2 , 4 , 10 , 100 , 109 , 110 ]. Different guidelines have distinct diagnostic values of serum indicators for staging CHB patients.…”

Section: Epidemiologymentioning

confidence: 99%

Latest insights into the epidemiology, characteristics, and therapeutic strategies of chronic hepatitis B patients in indeterminate phase

Liu,

Yu,

Zhao

et al. 2024

Eur J Med Res

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As a hepatotropic virus, hepatitis B virus (HBV) can establish a persistent chronic infection in the liver, termed, chronic hepatitis B (CHB), which causes a series of liver-related complications, including fibrosis, cirrhosis, and hepatocellular carcinoma (HCC). HCC with HBV infection has a significantly increased morbidity and mortality, whereas it could be preventable. The current goal of antiviral therapy for HBV infection is to decrease CHB-related morbidity and mortality, and achieve sustained suppression of virus replication, which is known as a functional or immunological cure. The natural history of chronic HBV infection includes four immune phases: the immune-tolerant phase, immune-active phase, inactive phase, and reactivation phase. However, many CHB patients do not fit into any of these defined phases and are regarded as indeterminate. A large proportion of indeterminate patients are only treated with dynamic monitoring rather than recommended antiviral therapy, mainly due to the lack of definite guidelines. However, many of these patients may gradually have significant liver histopathological changes during disease progression. Recent studies have focused on the prevalence, progression, and carcinogenicity of indeterminate CHB, and more attention has been given to the prevention, detection, and treatment for these patients. Herein, we discuss the latest understanding of the epidemiology, clinical characteristics, and therapeutic strategies of indeterminate CHB, to provide avenues for the management of these patients.

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The Epidemiology, Transmission, Genotypes, Replication, Serologic and Nucleic Acid Testing, Immunotolerance, and Reactivation of Hepatitis B Virus

Patel,

Dossaji,

Gupta

et al. 2024

Gastro Hep Advances

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CON: All Patients With Immune‐Tolerated Hepatitis B Virus Do Not Need to Be Treated

Abstract: http://aasldpubs.onlinelibrary.wiley.com/hub/journal/10.1002/(ISSN)2046-2484/video/15-1-reading-attar a video presentation of this article

Cited by 5 publications

References 35 publications

Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Altered expression of endosomal Toll‐like receptors and HBeAg seropositivity may act synergistically towards the vertical transmission of HBV

Latest insights into the epidemiology, characteristics, and therapeutic strategies of chronic hepatitis B patients in indeterminate phase

The Epidemiology, Transmission, Genotypes, Replication, Serologic and Nucleic Acid Testing, Immunotolerance, and Reactivation of Hepatitis B Virus

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