When it comes to crafting a literature review on the topic of HBV (Hepatitis B Virus), one cannot

underestimate the complexity of the task. Engaging with a vast array of academic articles, research
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relevant studies, theories, and findings, and then presenting them coherently within the context of
the broader research landscape. Additionally, the review must offer insights, critiques, and potential
avenues for future research.

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But it’s important to remember that an infected person can transmit HBV to other people even if he
or she has no symptoms. Recent advances in the research of hepatitis B virus-related hepatocellular
carcinoma: epidemiologic and molecular biological aspects. References to non-CDC sites on the
Internet are provided as a service to MMWR readers and do not constitute or imply endorsement of
these organizations or their programs by CDC or the U.S. Department of Health and Human
Services. Patients who are unable to achieve viral suppression progress to the HBeAg-negative CHB
phase (phase 3, previously known as inactive-carrier phase), lasting for many years or even a
lifetime. Immunology of hepatitis B virus and hepatitis C virus infection. If the drug is no longer
effective for this patient. So, these patients also need to be followed over time. They want you to
know the serum ALT, the HBV DNA level, and they. On the other hand, antiviral treatment is not
recommended for people without clinical symptoms of cirrhosis, persistently normal ALT levels ( 8,
33 The level of HBV DNA used to measure viral replication is the strongest single predictive
biomarker of disease progression. Reau, MD, has disclosed the following relevant financial
relationships: Served as an advisor or consultant for: Gilead Sciences, Inc.; Roche Dr. Reau does
intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved by
the FDA for use in the United States. This Review integrates the findings from research in HBsAg
kinetics and discusses how they might inform our understanding and management of HBeAg-
negative chronic HBV infection. Readers should verify all information and data before treating
patients or. Also known as occult HBV infection, patients in this phase have normal ALT values and
usually undetectable serum HBV DNA. Hepatitis B surface antigen level complements viral load in
predicting viral reactivation in spontaneous HBeAg seroconverters. Anyone with an adverse reaction
to a previous dose should not be given another dose of Hepatitis B vaccine. Approximately 0.5% of
patients with inactive CHB yearly achieve seroclearance, with the concomitant gain in anti-HBs. 8,
9, 33 Diagnosis The evaluation of CHB includes a complete history, physical examination,
assessment of liver disease, and markers of HBV infection. Previously resolved HBV infection is
defined by the presence of both anti-HBs and anti-HBc, whereas the presence of anti-HBs alone
indicates immunity to HBV infection following vaccination. Hepatitis B may cause acute hepatitis
(AHB) or chronic hepatitis (CHB) Patients with CHB have elevated complications involving
cirrhosis and liver cells carcinoma. Genetic susceptibility is thought to play a role in disease
progression, as the risk of HCC is higher in individuals with a family history of HCC. 36, 37 Viral-
related factors that affect disease prognosis include viral load, HBV genotypes and mutations, and
concurrent infections. In conclusion, accurate definition of the natural history of chronic HBV
infection not only sheds light on the pathogenesis of chronic hepatitis B but also helps determine the
optimal timing for antiviral therapy to cure HBV. High prevalence and mapping of pre-S deletion in
hepatitis B virus carriers with progressive liver diseases. Broth and fruit juices are also a good choice
when you have Hepatitis B. A well-balanced healthy diet that is low-fat and contains plenty of
vegetables is highly recommended for people with chronic Hepatitis B. However, more than 90% of
adults recover naturally within the first year without any special treatment. Well, there are multiple
guidelines, as you know, out there. There is no treatment available for acute infection. The most
severe complications occur in people with chronic Hepatitis B infection. Based on the virological and
clinical manifestations, the natural course of chronic hepatitis B can be divided into four classical
phases: immune tolerance, immune clearance, inactive carrier, and reactivation phases. Prognostic
determinants for chronic hepatitis B in Asians: therapeutic implications. Gut. That was a very nice
overview of the treatment indications for hepatitis B.
The majority of patients will undergo spontaneous HBeAg seroconversion and enter an inactive
carrier state. They may even remove the virus completely but it happens rarely. Summary of Natural
History, Diagnosis, Management, and Prognosis of HBV - Clinical Review Report: Tenofovir
Alafenamide (Vemlidy) Your browsing activity is empty. A small percentage (3% to 5%) of the HBV
primary infection cases in adults and up to 95% of children do not resolve and progress into
persistent infection, characterized by continual viral replication in the liver and varying degrees of
viremia. There are simple and effective ways to prevent the spread of Hepatitis B. Yang HC, Chen
CL, Shen YC, Peng CY, Liu CJ, Tseng TC, et al. HBV genotypes have a unique geographic
distribution, as discussed previously. These findings have shed new light on the natural course of
HBV infection and might lead to optimization of the management of HBeAg-negative chronic HBV
infection and contribute to the paradigm shift from indefinite to finite therapy for patients with HBV
infection. What we know from the interferon studies is that the benefits. The tests can be used to
distinguish chronic and acute infections. Sustained response of hepatitis B e antigen-negative
patients 3 years after treatment. The incubation period of HBV varies from 1 to 6 months. Dr. Jensen
does intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics approved
by the FDA for use in the United States. A number of effective tests are available to diagnose
hepatitis B and monitor the condition of infected people. Please confirm that you would like to log
out of Medscape. In fact, approximately 17,000 new cases of hepatocellular carcinoma, directly due
to hepatitis. We developed a conceptual model to evaluate patients' experience of CHB from pre-
diagnosis, through treatment, and living with a chronic condition, 8 by conducting 1) a qualitative
literature review and 2) patient interviews. When that occurs, transplantation is required to sustain
life. Historically, Chinese herbs have been used to treat chronic Hepatitis B and other liver diseases.
You can download the paper by clicking the button above. Precore stop mutant in HBeAg-positive
patients with chronic hepatitis B: clinical characteristics and correlation with the course of HBeAg-
to-Anti-HBe seroconversion. Immunology of hepatitis B virus and hepatitis C virus infection. So, the
aim of the present study was todetect the total markers of HBV (HBsAg, HBsAb, HBeAg, HBeAb,
Total anti-HBc and IgManti-HBc).A total of 126 cases with hepatitis B were recruited from different
medical centersin Basra. ELISA is used to detect HBV antigen and antibody and PCR is used to
detect HBV-DNA. Reau, MD, has disclosed the following relevant financial relationships: Served as
an advisor or consultant for: Gilead Sciences, Inc.; Roche Dr. Reau does intend to discuss off-label
uses of drugs, mechanical devices, biologics, or diagnostics approved by the FDA for use in the
United States. Moreover, not every person infected with chronic Hepatitis B is required to stay on
medication. Adults at high risk of acquiring the infection should also receive the Hepatitis B vaccine.
A qualified healthcare professional should be consulted. Unlike antiviral medicines, interferon may
show improvements that persist even after the treatment completion. It should be noted that ALT
levels often fluctuate over time; therefore, a minimum of one- to two-year follow-up post-treatment
at three-month intervals is recommended.
The loss of HBsAg is considered the optimal treatment end point, also termed “functional cure,”
since this indicates a suppression of viral replication and liver damage without complete eradication
of HBV DNA. An international multicenter cohort study. J Hepatol. 2010;52:S395. Poster 1020.
Source: WHO guidelines on hepatitis B and C testing. Gaiso, PhD, has disclosed no relevant
financial relationships. However, some people develop a rapid onset of the disease with symptoms
that last a few weeks, including extreme fatigue, yellowing of eyes and skin, dark urine, abdominal
pain, nausea and vomiting. Unlike antiviral medicines, interferon may show improvements that
persist even after the treatment completion. However, if cirrhosis develops before HBsAg loss, the
risk of HCC persists. They want you to know the serum ALT, the HBV DNA level, and they. Liver
transplantation can be used in people who develop cirrhosis or liver failure, with varying success.
Certainly, an adequate history and physical examination are. Infection can occur during dental and
surgical procedures, tattooing, or through the shared use of razors and other contaminated objects.
AJanssen Global Services, LLC, Raritan, NJ, USA; CDRG Abacus, Manchester, UK; NBarts and
The London School of Medicine and Dentistry, London, UK. In the case of inconclusive results
from biochemical and HBV markers, noninvasive tests or liver biopsy are performed. However, if
you are not treated, a chronic infection can develop into such serious diseases as liver cancer or
cirrhosis which can result in death. This treatment is the most effective when the number of viral
particles (viral load) is not very high. A small percentage of CHB patients may still develop HCC
despite spontaneous HBsAg loss (annual rate approximately 0.55%). However, as described
previously, the risk is lower if HBsAg loss is achieved at a younger age without significant fibrosis.
Some differences in vertical transmission, but certainly, for that individual's candidacy. Finally, the
severity of liver disease is assessed by a battery of biochemical parameters and physical examination.
Patients and Methods: This study was carried out on (8679) patients selected from Al-Karama
hospital in Baghdad from January 2001 to December 2002.The patients were divided into two
groups: outpatient and inpatient. However, the opposite finding has been reported in children and
young adults. Studies show that patients with genotype C are more susceptible to cirrhosis and HCC
than those with genotype B. Approximately 0.5% of patients with inactive CHB yearly achieve
seroclearance, with the concomitant gain in anti-HBs. 8, 9, 33 Diagnosis The evaluation of CHB
includes a complete history, physical examination, assessment of liver disease, and markers of HBV
infection. Dr. Poordad does intend to discuss off-label drugs, mechanical devices, biologics, or
diagnostics approved by the FDA for use in the United States. The risk of progression of cirrhosis to
decompensation and HCC is also higher among those with persistently elevated or repeated acute
exacerbations of ALT or HBV DNA levels without normalization or viral suppression. Perinatal or
vertical transmission is the major route of transmission in endemic areas. The treatment duration, as
we discussed, is potentially lifelong for the e antigen-negative. They were screened for Hepatitis B
surface antigen (HBs Ag) and anti Hepatitis C (Anti HCV) by Enzyme Linked Immunosorbent
Assay (ELISA). For more information about this message, please visit this page: About CDC.gov.
What we know from the interferon studies is that the benefits. One is the threshold of HBV DNA
that you use to consider the patient for therapy.
Dr. Jensen does not intend to discuss investigational drugs, mechanical devices, biologics, or
diagnostics not approved by the FDA for use in the United States. The HBV DNA level is very
important, as you pointed out. In these patients, concomitant liver injury is commonly found,
resulting from alcoholic or nonalcoholic fatty liver disease. Scudder, DNP, NP, has disclosed no
relevant financial relationships. Some differences in vertical transmission, but certainly, for that
individual's candidacy. If you log out, you will be required to enter your username and password the
next time you visit. Total of 50 HBV suspect patients were subjected to ELISA (Bioelisa HBsAg
Kit, spain) and then retested by HBsAg Rapid Test Cassette (OnSite HBsAg Rapid Test Cassette,
USA). To successfully earn credit, participants must complete the. Asymptomatic CHB carriers have
subclinical infection and normal or nearly normal liver function and histology. HBV infection is
easily preventable with a vaccine. HBV DNA level is used as a more direct and accurate measure of
viral replication. Serologic and clinical outcomes of 1536 Alaska Natives chronically infected with
hepatitis B virus. An abdominal ultrasound is routinely performed in most patients. A large cohort of
patients in a study from China, over 700 patients. So, I would say that resistance is not as big a
worry, but the corollary is that this is only true if the patient is compliant with the medication and
you have suppressed virus to undetectable levels. To date, the vaccine has effectively protected
millions against hepatitis B. Rights and permissions Reprints and permissions About this article Cite
this article Liaw, YF. Moreover, not every person infected with chronic Hepatitis B is required to
stay on medication. Therefore, they are often used in combination with different methods to assess
liver damage. 8, 33 Management A complete cure for CHB is yet to be discovered; therefore, current
treatment is targeted primarily to improve survival and quality of life by preventing viral replication
and disease progression and consequently HCC. This website also contains material copyrighted by
3rd parties. Some patients may replicate and yet never get clinical. A model of virus is built using
data of viral macromolecular structure furnished by Protein Data Bank (PDB 4G93). Dr. Poordad
does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not
approved by the FDA for use in the United States. Hence, continuing antiviral therapies, regardless
of HBeAg level, until HBsAg loss is an alternative treatment-stopping strategy. Incidence and
determinants of spontaneous hepatitis B surface antigen seroclearance: a community-based follow-
up study. Readers should verify all information and data before treating patients or. Host factors
associated with progression of CHB to cirrhosis and its complications include older age, male sex,
and disease expression. The biochemical and histological expression of fibrosis at diagnosis
correlates with the risk of cirrhosis; thus, the risk is higher for stage F3 compared with stage F1 or
F2. This Review integrates the findings from research in HBsAg kinetics and discusses how they
might inform our understanding and management of HBeAg-negative chronic HBV infection.
Gaiso, PhD, has disclosed no relevant financial relationships.
We get a little caught up in monitoring and assessing. Sometimes the Hepatitis B virus can end up in
a chronic infection that can develop such consequences as liver cancer or cirrhosis. The most severe
complications occur in people with chronic Hepatitis B infection. HBV poses a threat to those who
live with infected persons, to health care professionals, travelers to countries of high Hepatitis B
endemicity, and patients undergoing kidney dialysis. Accreditation of this program does not imply
endorsement by either Medscape, LLC or ANCC. This should include a family history of liver
disease, a family history. A number of effective tests are available to diagnose hepatitis B and
monitor the condition of infected people. Treatment can help to reduce the risk of cirrhosis and liver
cancer. An original paper copy of this issue can be obtained from the Superintendent of Documents,
U.S. Government Printing Office (GPO), Washington, DC 20402-9371; telephone: (202) 512-1800.
Prognosis of CHB patients with metabolic diseases, such as steatosis and nonalcoholic fatty liver
disease, has been studied. That was a very nice overview of the treatment indications for hepatitis B.
So, I think there is a little wiggle room, if you will, for clinicians to use their own judgment.
Quantitative hepatitis B core antibody levels in the natural history of hepatitis B virus infection.
These findings have shed new light on the natural course of HBV infection and might lead to
optimization of the management of HBeAg-negative chronic HBV infection and contribute to the
paradigm shift from indefinite to finite therapy for patients with HBV infection. The majority of
patients will undergo spontaneous HBeAg seroconversion and enter an inactive carrier state. To date,
the vaccine has effectively protected millions against hepatitis B. This paper demonstrates that,
compared to HBV DNA levels, HBsAg levels in patients with low viral load can further stratify
patients with high and low risks of HCC. An abdominal ultrasound is routinely performed in most
patients. Dr. Jensen does not intend to discuss investigational drugs, mechanical devices, biologics,
or diagnostics not approved by the FDA for use in the United States. Lin CL, Kao JH. Perspectives
and control of hepatitis B virus infection in Taiwan. To successfully earn credit, participants must
complete the. Total of 50 HBV suspect patients were subjected to ELISA (Bioelisa HBsAg Kit,
spain) and then retested by HBsAg Rapid Test Cassette (OnSite HBsAg Rapid Test Cassette, USA).
Unvaccinated men who have sex with other men as well as heterosexual persons with sex workers
or multiple sex partners are under particular risk of obtaining the disease. You may print the
certificate but you cannot alter it. However, HBeAg seroconversion can also be present during the
HBeAg-negative immune reactivation phase of CHB. Chronic infection is diagnosed if HBsAg
persists for 6 months. It is correlated with disease progression, as advanced stage and viral resistance
are associated with high viral load. Objective: To determine the prevalence of Hepatitis B and
Hepatitis C virus infection. Hepatocellular carcinoma in cirrhosis: incidence and risk factors.
Perinatal or vertical transmission is the major route of transmission in endemic areas.