Infectious Source Factors Affecting the Severity of Sexually Transmitted Acute Hepatitis due to Hepatitis B Virus Genotype C

Michitaka, Kojiro; Horiike, Norio; Yan, Chen‐Hua; Yatsuhashi, Hiroshi; Yano, Michitami; Kojima, Naohiko; Ohkubo, Keiji; Tanaka, Yukimi; Yamamoto, Kazuhisa; Ohno, Naofumi; Onji, Morikazu

doi:10.1159/000081737

Cited by 12 publications

(10 citation statements)

References 92 publications

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“…Similar to our data , very good survival rates (mean survival rate almost 80%) in patients receiving lamivudine have been reported by others , whereas outcome without antiviral therapy has remained poor (see also Table ).…”

Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 92%

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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Section: Antivirals In the Setting Of Severe Acute To Fulminant Hepatsupporting

confidence: 92%

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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“…Thus, discussion of the association of fulminant hepatic failure with the T1762, A1764, and A1896 BCP/PC mutations should also consider HBV subgenotypes. 27 In the present study, of the 9 patients who progressed to fulminant hepatic failure, 8 were infected with subgenotype C2 carrying a T1762, A1764, or A1896 mutation, while 1 lacked the T1762, A1764, and A1896 mutations and was infected with the Okinawa variant of genotype C. It is possible that this minor variant of subgenotype C could affect the clinical course independent of the BCP and PC variants. The contributions of the subgenotype variants to the clinical features of acute hepatitis patients need to be clarifi ed.…”

Section: Discussionmentioning

confidence: 59%

Association of hepatitis B virus subgenotypes and basal core promoter/precore region variants with the clinical features of patients with acute hepatitis

et al. 2008

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“…Precore mutation at nt position 1986 and core promoter mutations at nt 1862 and nt 1864 are known to be related to severe hepatitis and the HBV in the present case did not have these mutations. The absence of these mutations might be related to chronicity because HBV without these mutations may relate to mild immune response and low levels of elevation of ALT in acutely infected patient (11). Nucleotide sequences of HBV relating to chronicity of acute infection should be further investigated in the future.…”

Section: Discussionmentioning

confidence: 99%

An Adult Patient with Acute Infection with Hepatitis B Virus Genotype C that Progressed to Chronic Infection

et al. 2012

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In 2008, a 28-year-old woman consulted our hospital due to general fatigue. Her ALT level was within normal range but she was positive for hepatitis B surface antigen (HBsAg). Her ALT level was nearly within normal range thereafter and she was consistently positive for HBeAg. Later, it was proven that she was negative for HBsAg in 1999. She had been a sex worker in [2007][2008]. Complete genome sequencing revealed that her HBV was genotype C. The present case may indicate that it is possible for acute infection with HBV genotype C to progress to chronic infection in adults.

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Infectious Source Factors Affecting the Severity of Sexually Transmitted Acute Hepatitis due to Hepatitis B Virus Genotype C

Cited by 12 publications

References 92 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?

Association of hepatitis B virus subgenotypes and basal core promoter/precore region variants with the clinical features of patients with acute hepatitis

An Adult Patient with Acute Infection with Hepatitis B Virus Genotype C that Progressed to Chronic Infection

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