Modifications of immunosuppression in hepatitis B virus infection

Flores, Patricia A.; Vierling, John M.

doi:10.1097/00075200-200112000-00011

Cited by 3 publications

(2 citation statements)

References 36 publications

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“…In addition, the HBV genome contains a glucocorticoid-responsive element that enhances replication [29]. Azathioprine may stimulate intracellular HBV synthesis, and calcineurin inhibitors may have direct effects on HBV replication [30][31][32]. Reactivation of HBV infection even in HBsAg-seronegative individuals whose serological profile indicates remote, resolved HBV infection is recognized post-transplantation with reappearance of HBsAg in serum.…”

Section: Natural History Of Hbv Infection After Renal Transplantmentioning

confidence: 99%

Management of Chronic Hepatitis B in Special Populations: Immunosuppressed Patients and Chronic Kidney Disease

2011

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Hepatitis B virus (HBV) infection remains an important cause of liver disease in the population with chronic kidney disease, including patients on long-term dialysis and renal transplant (RT) recipients. Diminished survival due to hepatitis B has been observed after RT. A thorough evaluation, including liver biopsy as well as assessment of serum markers of HBV replication (ie, hepatitis B e antigen and/or HBV DNA) is required before transplantation. Tolerance to interferon is poor both in dialysis patients and after renal transplant. Oral antiviral therapy now permits safe and potent antiviral treatment of HBV-related liver disease in chronic kidney disease patients with prevention of progressive liver disease. Preliminary evidence shows an improved survival of HBsAg positive renal allograft recipients on antiviral therapy. However, numerous issues concerning the treatment of hepatitis B in the population with chronic kidney disease remain unclear and further clinical trials are needed.

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Section: Natural History Of Hbv Infection After Renal Transplantmentioning

confidence: 99%

Management of Chronic Hepatitis B in Special Populations: Immunosuppressed Patients and Chronic Kidney Disease

2011

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“…Immunosuppression after transplantation plays a significant role in the progression and outcome of the HBV and HCV infection in transplant recipients. Numerous studies support the concept that suppression of the cellular immune response against HBV infection may diminish acute hepatic injury, while ultimately worsening the clinical course of infection by preventing viral clearance [4].…”

Section: Introductionmentioning

confidence: 99%

Hepatitis B and C Virus Variants in Long-Term Immunosuppressed Renal Transplant Patients in Latvia

et al. 2005

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The incidence of genome variants of hepatitis B and hepatitis C viruses among 38 long-term (2–15 years) immunosuppressed patients after renal transplantation and 10 patients undergoing dialysis was investigated. Twelve patients had only HBV infection, 9 had only HCV infection and 14 were co-infected. Regions corresponding to the HBV X/EnII/BCP, preC/C, preS/S and to the HCV core were sequenced for molecular characterization of the HBV and HCV genomes. Fifty-seven percent of HBV DNA isolates belonged to genotype D and 42% to genotype A, whereas 77% of HCV RNA isolates belonged to genotype 1b and only 17% to genotype 3a. One sample (6%) was of genotype 2c. Detailed analysis of the above-mentioned HBV genome regions revealed the presence of nucleotide point mutations, which, in some cases, resulted in amino acid substitutions. The clinical significance of such mutations is discussed.

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