Immune tolerant hepatitis B: a clinical dilemma.
نویسنده
چکیده
Chronic hepatitis B virus infection remains a global health concern, with perinatal transmission still a problem in many countries. Several new therapies for chronic hepatitis B virus infection have recently been introduced that can safely and effectively suppress viral replication with a low risk of resistance; thus, it has become increasingly tempting for many clinicians to treat patients in the immune tolerant stage of infection who have high levels of viremia yet persistently normal levels of transaminases. However, understanding the natural history of hepatitis B virus infection and how it pertains to disease progression, as well as how current therapies alter or do not alter this natural history, is important when deciding whether to treat these patients. This article will review the definition and natural history of immune tolerance, the current world guidelines and recommendations for treatment of immune tolerant patients, and data on the effectiveness of current therapies in this patient population.
منابع مشابه
Study of Immune Response in Infants of Non-Gestational Diabetic Mothers
Background Infants of diabetic mothers (IDMs) have significantly greater risk for spontaneous abortion, stillbirth, congenital malformations and perinatal mortality and morbidity but whether maternal DM affects the neonatal innate immune system is unknown. We aimed to assess the immune response of infants of diabetic mothers (IDMs) with non-gestational DM for Hepatitis B vaccine and to compare ...
متن کاملCurrent progress in the development of therapeutic vaccines for chronic hepatitis B virus infection
Chronic hepatitis B is still a major public health issue despite the successful prophylactic vaccination attempts. Chronicity of hepatitis B virus(HBV) is mainly due to its ability to debilitate host's immune system. Therefore, major measures have been taken to stop this process and help patients with chronic hepatitis B infection recover from their illness. While satisfactory results have been...
متن کاملImmune Response to Standard Hepatitis B Vaccination in HIV-Infected Patients
Background: Due to their similar routes of transmission, human immunodeficiency virus (HIV) and hepatitis B virus (HBV) co-infection occurs considerably. HBV infection progresses more rapidly in HIV-infected patients. Therefore, HBV vaccination of all non-immune HIV infected patients is recommended. On the other hand, HIV-infected subjects have suboptimal responses to HBV vaccine. In this study...
متن کاملNoninvasive predictive models of liver fibrosis in patients with chronic hepatitis B.
OBJECTIVE The aim of the present study was to establish noninvasive diagnostic models for liver fibrosis and assess their predictive accuracy (AC). METHODS A total of 349 patients with chronic hepatitis B virus infection were evaluated, who underwent liver biopsy and pathologic examination at Beijing Ditan Hospital affiliated to Capital Medical University. Patients were subdivided in disease-...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
عنوان ژورنال:
- Gastroenterology & hepatology
دوره 7 8 شماره
صفحات -
تاریخ انتشار 2011