Entecavir as specific antiviral therapy in selected cases of severe acute hepatitis B

Abstract

The role of specific antiviral treatment in severe acute hepatitis B has been subject to debate during the past few years. We present clinical findings in a series of three cases of severe acute hepatitis B and one case of acute hepatitis B treated with entecavir during 2007-2009, with interesting evolution. Entecavir appeared to improve the clinical evolution in the reported cases. Two of the patients displayed HBsAg to HBsAb seroconversion while another patient went into an inactive HBsAg carrier state. In the case of mild acute hepatitis B, the liver enzymes had returned to normal, symptomatology had receded but HBsAg had remained positive. Without data on viral load, we were unable to determine whether the patient had entered an inactive HBsAg carrier state or had continued into the services of another medical unit, for treatment of chronic HBV infection. We also discuss into detail a case which displayed transient initial HBe seroconversion at 1 week, followed by seroreversion to positive HBeAg and negative HBeAb at week 3, and a new seroconversion at week 7. We assess the possible roles of precore mutations, antibody-dependent cellular cytotoxicity, coinfection with Epstein Barr virus and the function of Kupffer cells.

Management of accidental exposure to HCV, HBV and HIV in healthcare workers in Romania

“…First, the prevalence of the infection in the general population and within the patient population served by the healthcare facility needs to be assessed. According to the CDC, 6 Romania is considered an intermediate-risk country for HBV, 7,8 with a 2-7% prevalence of chronic infection, 6 which is concordant with the results of a recent local epidemiologic study, pointing to a prevalence of 5.59%. 9 The same study found a 4.56% prevalence of HCV infection, 9 slightly higher than that recorded in another Romanian nationwide survey (3.23%).…”

Recent advances in the diagnosis of Mycobacterium tuberculosis

“…New methods that manage to overcome limitations and respond to challenges posed by special populations (including patients with concomitant infections such as hepatitis B, 64 hepatitis C, HIV, 65 or with hematologic malignancies) will definitely be well received.…”

Milk-borne infections. An analysis of their potential effect on the milk industry

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