{"title":"Non-invasive markers of hepatic fibrosis in chronic Hepatitis B: A review","authors":"M. Al‐Mahtab, S. Rahman, Mobin Khan","doi":"10.4103/0972-9747.45090","DOIUrl":"https://doi.org/10.4103/0972-9747.45090","url":null,"abstract":"Assessment of fibrosis is important in chronic hepatitis B for a number of reasons including decision-making regarding treatment and predicting prognosis.Currently liver biopsy is considered the gold standard for assessing liver histology. However, since liver biopsy has significant limitations,the quest for a non-invasive alternative to assess hepatic fibrosis continues. A review of published literature reveals that extensive research has been carried out in this field, and several simple to complicated alternatives to liver biopsy for assessing hepatic fibrosis have been evaluated. A few have shown promise too, but we are still short of an ideal alternative to liver biopsy. Despite the fact that much has been done, we still have a long way to go before we can finally say farewell to liver biopsy.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122613011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Bijay Misra, C. Panda, H. Das, Kinshuk C. Nayak, S. Singh
{"title":"Study on awareness about hepatitis B viral infection in coastal Eastern India.","authors":"Bijay Misra, C. Panda, H. Das, Kinshuk C. Nayak, S. Singh","doi":"10.4103/0972-9747.76902","DOIUrl":"https://doi.org/10.4103/0972-9747.76902","url":null,"abstract":"Background: Hepatitis B is a major health problem in India. To prevent transmission and progression of the disease in the community, proper community awareness about the disease, including prevention, is necessary. Our objective was to study the awareness amongst the general population about hepatitis B virus, including knowledge regarding vaccine. Materials and Methods: The study was conducted in Department of Gastroenterology of SCB Medical College. The patients attending the OPD and their attendants were subjected to a questionnaire about different aspects of hepatitis B. Binary logistic regression analysis (SPSS 16) was employed to assess the statistical importance of the observations. Results: In all, 682 individuals (65% patients, 35% non-patients) were studied; 78% were males while 22% were females. Majority were in the age group of 31-40 years. 65% hailed from rural area; 65% were poor. About half of the subjects attended state run medical centers for medical attention; only 17% preferred medical colleges. Awareness about the disease and the vaccine among the subjects was 38% and 32%, respectively. 50% of those who were aware had no knowledge about route of transmission, infectivity, or importance of vaccination. Educated individuals were more aware about hepatitis B vaccine (P Conclusions: Only about one-third of the population in coastal Eastern India are aware about hepatitis B and its vaccine. Less than a third of the population are vaccinated for hepatitis B. The educated, especially those who read newspapers and listened to radio, were more aware about the disease/vaccine. The government health agencies and physicians should work together to educate the masses about hepatitis B and its vaccine.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128433603","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Perinatal transmission of Hepatitis B","authors":"S. Chowdhury, C. Eapen","doi":"10.4103/0972-9747.76906","DOIUrl":"https://doi.org/10.4103/0972-9747.76906","url":null,"abstract":"There is a high global prevalence of hepatitis B. Perinatal transmission of hepatitis B is the predominant mode of transmission in high prevalence areas. The risk of progression to chronic liver disease and development of hepatocellular carcinoma in individuals who acquire the infection at birth is high. Perinatal transmission of hepatitis B can be reduced by early identification of hepatitis B virus (HBV) carrier mothers. High maternal viral loads and maternal serum HBeAg positivity increase the risk of perinatal transmission of hepatitis B. Passive and active immunoprophylaxis at birth reduces the risk of perinatal transmission of hepatitis B in approximately 95%. Failure of immunoprophylaxis has been related to possible in utero transmission of HBV. Reducing maternal HBV DNA levels by treatment with lamivudine in the last trimester of pregnancy in high viremic mothers may help reduce the risk of perinatal transmission of hepatitis B.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"50 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129061270","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Flares on and off therapy during chronic HBV infection: Pathogenesis, significance and management","authors":"D. Amarapurkar","doi":"10.4103/0972-9747.58803","DOIUrl":"https://doi.org/10.4103/0972-9747.58803","url":null,"abstract":"Approximately 400 million people worldwide are chronically infected with the hepatitis B virus (HBV). Chronic infection with HBV can lead to progressive liver diseases including cirrhosis, liver failure, and hepatocellular carcinoma. During treatment of chronic hepatitis B (CHB) patients, flares of inflammatory activity are a well known phenomenon. Flares can be life threatening but have also been associated with virological response. While, interferon induced flares have been attributed to the stimulatory effect of IFN, and may precede HBeAg seroconversion, Lamivudine related flares are seen during treatment and after withdrawal of lamivudine, which are probably caused by reoccurrence of HBV replication, and have been associated with decompensation of liver disease. These flares play an important role in the treatment with Peg-IFN α-2b alone or in combination with lamivudine, and patients with pre-existing cirrhosis are at greater risk for experiencing a flare. Furthermore, host induced flares but not virus induced flares may herald a response to therapy. For optimisation of treatment, it is necessary to understand the virological and immunological mechanisms which induce the specific flare patterns. This article reviews the pathogenesis, significance and management of flares encountered during and after cessation of treatment of patients with chronic HBV infection.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"78 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127753567","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Comparison of different hepatitis B guidelines.","authors":"P. Sethy, M. Goenka","doi":"10.4103/0972-9747.76905","DOIUrl":"https://doi.org/10.4103/0972-9747.76905","url":null,"abstract":"Hepatitis B is a global healthcare problem. An estimated one third of the global population have been infected with the hepatitis B virus (HBV). Various guidelines have been proposed for management of chronic hepatitis B. These guidelines have similarities and differences and are changed from time to time. Here, we have reviewed the management guidelines of chronic hepatitis B published after 2007 and highlighted the similarities and differences between their different recommendations.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130949088","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Efficacy and safety of telbivudine during pregnancy in a patient with HBeAg-Negative chronic Hepatitis B","authors":"Arumugam Mohan, M. Hariharan","doi":"10.4103/0972-9747.76912","DOIUrl":"https://doi.org/10.4103/0972-9747.76912","url":null,"abstract":"Managing chronic hepatitis B (CHB) during pregnancy remains a challenging task as there is no information on the consequences to the fetus. Telbivudine, an oral nucleoside analog (NA), is a potential therapeutic option during pregnancy, but clinical experience is lacking. We report on the safety and efficacy of telbivudine 600 mg/day administered to a 20-year-old Indian woman with hepatitis B e antigen negative CHB, who became pregnant during treatment. Telbivudine was continued with monitoring of maternal hepatitis B virus (HBV) DNA and alanine aminotransferase (ALT) levels during pregnancy and after delivery. The patient maintained polymerase chain reaction (PCR) undetectable HBV DNA and normal ALT levels with telbivudine throughout pregnancy. At birth, HBV DNA was undetectable by PCR in the newborn. No congenital abnormalities were noted. In conclusion, telbivudine therapy during pregnancy was effective in maintaining undetectable viremia, and no safety concerns were noted in the mother and child. Additional clinical studies are warranted.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"28 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130994372","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Hepatitis B viral infection: Emerging issues","authors":"S. Singh, Y. Chawla","doi":"10.4103/0972-9747.45085","DOIUrl":"https://doi.org/10.4103/0972-9747.45085","url":null,"abstract":"","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"19 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124568327","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Screening for chronic hepatitis B.","authors":"K. Shenoy","doi":"10.4103/0972-9747.162105","DOIUrl":"https://doi.org/10.4103/0972-9747.162105","url":null,"abstract":"Hepatitis B virus (HBV) infection is a major public health problem worldwide. More than 2 billion people have been infected; more than 350 million present with chronic HBV infection. A significant proportion (15-40%) of chronic HBV infected patients develop liver cirrhosis, liver failure, and primary hepatocellular carcinoma (HCC), making chronic hepatitis B one of the 10 major causes of death worldwide. The practice of preventive medicine involves three primary tasks: Screening, counseling, and immunization or chemoprophylaxis. Screening healthy individuals incurs an ethical obligation on the clinician. Persons who are most likely to be actively infected with HBV should be tested for chronic HBV infection. Testing should include a serologic assay for HBsAg offered as a part of routine care and be accompanied by appropriate counseling and referral for recommended clinical evaluation and care. To determine susceptibility among persons who are at ongoing risk for infection and recommended for vaccination, total anti-HBc or anti-HBs also should be tested at the time of serologic testing for chronic HBV infection. Recommendations related to screening for chronic HBV infection have been summarized in this article.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"7 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129457731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Interferon for HBV infection: Plain or Pegylated? Alone or in combination? Concurrent or sequential?","authors":"A. Sood, V. Midha","doi":"10.4103/0972-9747.190081","DOIUrl":"https://doi.org/10.4103/0972-9747.190081","url":null,"abstract":"Hepatitis B Virus (HBV) infection is a significant global public health problem. Treatment options that have evolved rapidly over the last two decades have proven to be effective, but clear recommendations regarding the choice of first-line therapy are lacking. With the emergence of pegylated interferon (PEG IFN), conventional interferon has been relegated into the background and has a very limited role in the treatment of chronic Hepatitis B. Pegylated interferon α2a / 2b treatment has been documented to successfully achieve normalization of alanine aminotransferase (ALT) and viral suppression in nearly half of the patients. However, HBsAg loss can be achieved only rarely. Combination therapy, comprising of pegylated interferon plus nucleos(t)ide analogs theoretically appear attractive because of the synergistic anti-viral and immunomodulatory actions, but the available present literature does not provide sufficient evidence to recommend the combination therapy. Patient selection is important for tailoring the therapy for patients with chronic hepatitis B. Pegylated interferon seems suitable for young patients with raised ALTs, moderately high viral load, and having Genotype A / B; the advantage being finite duration of therapy and no risk of emergence of drug resistance.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"40 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127088763","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Incidentally detected asymptomatic HBsAg positive subjects","authors":"V. Dixit, S. Jena","doi":"10.4103/0972-9747.58808","DOIUrl":"https://doi.org/10.4103/0972-9747.58808","url":null,"abstract":"Hepatitis B virus [HBV] affects almost five per cent of the total population worldwide and majority of the affected population are detected incidentally without any symptoms. This mammoth pool of Hepatitis B virus infected population needs to be properly assessed and followed up to minimize morbidity and mortality in them. This article reviews literature related to this subset of HBV patients and attempts to provide a rational guideline to approach and manage them.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"9 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"1900-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124932159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}