Hepatitis B virus (HBV) infects approximately more than 350 million people worldwide, especially in Asia, Africa, southern Europe and Latin America. Except for interferon-α, most anti-HBV drugs are derived from the anti-herpes and anti-HIV drugs. Because of the high cost of hepatitis B medications, herbs-also called 'complementary and alternative therapies' in modern Western science-are widely used for treatment of chronic hepatitis B in developing countries. Herbals confer their activities not only by inhibiting HBV secretion but also by building up immunity against viruses. After studying the anti-HBV mechanism of herbs, scientists were encouraged to find that novel anti-HBV drugs target viral secretion, whereas nucleoside analogues target viral polymerase. The complementary and alternative anti-HBV therapies published in scientific peer-reviewed journals are reviewed and discussed in this article.
{"title":"Complementary and alternative therapies in the treatment of chronic hepatitis B","authors":"Jia-Ming Chang, Kai-Ling Huang","doi":"10.4103/0972-9747.45091","DOIUrl":"https://doi.org/10.4103/0972-9747.45091","url":null,"abstract":"Hepatitis B virus (HBV) infects approximately more than 350 million people worldwide, especially in Asia, Africa, southern Europe and Latin America. Except for interferon-α, most anti-HBV drugs are derived from the anti-herpes and anti-HIV drugs. Because of the high cost of hepatitis B medications, herbs-also called 'complementary and alternative therapies' in modern Western science-are widely used for treatment of chronic hepatitis B in developing countries. Herbals confer their activities not only by inhibiting HBV secretion but also by building up immunity against viruses. After studying the anti-HBV mechanism of herbs, scientists were encouraged to find that novel anti-HBV drugs target viral secretion, whereas nucleoside analogues target viral polymerase. The complementary and alternative anti-HBV therapies published in scientific peer-reviewed journals are reviewed and discussed in this article.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"94 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":"132290972","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}
Despite the development of an effective vaccine, hepatitis B is still the leading cause of chronic viral hepatitis across the world, especially in developing countries, with over 400 million people across the world estimated to be harboring the infection. This section of the journal highlights a few important articles on hepatitis B viral infection published recently and discusses the significance of their results and conclusions. We do hope that this review would enable treating hepatologists, physicians and students to comprehend the significance of these specially selected articles better, which would result in better comprehension and management of different aspects of chronic hepatitis B viral infection encountered in clinical practice.
{"title":"Hepatitis B: News from the research world","authors":"P. Piramanayagam, G. Choudhuri, S. Singh","doi":"10.4103/0972-9747.76911","DOIUrl":"https://doi.org/10.4103/0972-9747.76911","url":null,"abstract":"Despite the development of an effective vaccine, hepatitis B is still the leading cause of chronic viral hepatitis across the world, especially in developing countries, with over 400 million people across the world estimated to be harboring the infection. This section of the journal highlights a few important articles on hepatitis B viral infection published recently and discusses the significance of their results and conclusions. We do hope that this review would enable treating hepatologists, physicians and students to comprehend the significance of these specially selected articles better, which would result in better comprehension and management of different aspects of chronic hepatitis B viral infection encountered in clinical practice.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"52 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":"133533738","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}
Healthcare personnel, especially medical students, represent a high risk population for Hepatitis B Virus (HBV) infection. Hepatitis B is the most important infectious occupational hazard which Indian medical students and healthcare workers (HCWs) encounter. The medical students and HCWs all over the world do not practice universal precautions on a routine basis and there exists the widely prevalent problem of under reporting of percutaneous and mucocutaneous exposures and a lack of awareness about the disease transmission, its consequences and the importance of adhering to universal precautions at all times. This further compounds the issue of safety of student HCWs. This article highlights the dismal scenario vis-ΰ-vis awareness about these risks and HBV prophylaxis amongst medical students from a student's perspective and suggests how to tackle the situation to protect the unfortunate medical students from an unwarranted predicament.
{"title":"Hepatitis B prophylaxis practice among medical students : An overview","authors":"S. Chouhan","doi":"10.4103/0972-9747.58809","DOIUrl":"https://doi.org/10.4103/0972-9747.58809","url":null,"abstract":"Healthcare personnel, especially medical students, represent a high risk population for Hepatitis B Virus (HBV) infection. Hepatitis B is the most important infectious occupational hazard which Indian medical students and healthcare workers (HCWs) encounter. The medical students and HCWs all over the world do not practice universal precautions on a routine basis and there exists the widely prevalent problem of under reporting of percutaneous and mucocutaneous exposures and a lack of awareness about the disease transmission, its consequences and the importance of adhering to universal precautions at all times. This further compounds the issue of safety of student HCWs. This article highlights the dismal scenario vis-ΰ-vis awareness about these risks and HBV prophylaxis amongst medical students from a student's perspective and suggests how to tackle the situation to protect the unfortunate medical students from an unwarranted predicament.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"70 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":"129801728","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}
In the nineties, lamivudine (LMV) was the first nucleoside analog to be marketed for the treatment of patients with chronic hepatitis B virus (HBV). Following the advent of LMV, the management of patients with chronic hepatitis B, particularly those with advanced liver disease was markedly improved, with a substantial reduction in the rates of liver-related complications and mortality. In the face of excellent safety profile records of the drug, hepatologists had to face for the first time the issue of high rates of HBV resistance to therapy as the result of years of treatment of large cohorts of patients in the West and East. Initially considered no more than a virological problem, LMV resistance was later recognized to be a relevant clinical issue whose management requires specific therapeutic strategies. New, more active oral analogs have been marketed since, and new agents are to appear in the market scenario in the near future; however, LMV is still the number one prescribed anti-HBV agent worldwide for the treatment of chronic HBV patients, due to its limited cost, excellent safety and well predicted resistance profile.
{"title":"Management of lamivudine resistance: An overview","authors":"P. Lampertico, M. Viganò, M. Colombo","doi":"10.4103/0972-9747.58806","DOIUrl":"https://doi.org/10.4103/0972-9747.58806","url":null,"abstract":"In the nineties, lamivudine (LMV) was the first nucleoside analog to be marketed for the treatment of patients with chronic hepatitis B virus (HBV). Following the advent of LMV, the management of patients with chronic hepatitis B, particularly those with advanced liver disease was markedly improved, with a substantial reduction in the rates of liver-related complications and mortality. In the face of excellent safety profile records of the drug, hepatologists had to face for the first time the issue of high rates of HBV resistance to therapy as the result of years of treatment of large cohorts of patients in the West and East. Initially considered no more than a virological problem, LMV resistance was later recognized to be a relevant clinical issue whose management requires specific therapeutic strategies. New, more active oral analogs have been marketed since, and new agents are to appear in the market scenario in the near future; however, LMV is still the number one prescribed anti-HBV agent worldwide for the treatment of chronic HBV patients, due to its limited cost, excellent safety and well predicted resistance profile.","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":"116015189","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}
Pub Date : 1900-01-01DOI: 10.4103/0972-9747.162125
D. Amarapurkar
There has been considerable progress in the treatment of hepatitis B in the past two decades. However, currently approved treatments have significant limitations, and the long-term management of patients with chronic HBV infection is as much an art as a science. Selection of the optimal treatment option is very important in the treatment of chronic hepatitis B. In this review, the focus is on current treatment strategies of chronic hepatitis B
{"title":"Selection of treatment options in the management of chronic Hepatitis B","authors":"D. Amarapurkar","doi":"10.4103/0972-9747.162125","DOIUrl":"https://doi.org/10.4103/0972-9747.162125","url":null,"abstract":"There has been considerable progress in the treatment of hepatitis B in the past two decades. However, currently approved treatments have significant limitations, and the long-term management of patients with chronic HBV infection is as much an art as a science. Selection of the optimal treatment option is very important in the treatment of chronic hepatitis B. In this review, the focus is on current treatment strategies of chronic hepatitis B","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"171 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":"132191622","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}
Hepatitis B vaccine can induce transient hepatitis B surface antigen positivity not only in adult hemodialysis patients but also in normal adults and children. Hence hepatitis B vaccinees may be mistaken for confirmed hepatitis B surface antigen-positive carrier. Hence blood donors should not donate blood in this early post-vaccination period and renal dialysis patients should not be screened for hepatitis B surface antigen for at least 21 to 28 days after hepatitis B vaccination. These guidelines could prevent individuals in the early post-inoculation period from being erroneously labeled as having hepatitis B viral infection.
{"title":"Hepatitis B vaccine induced HBsAg positivity","authors":"S. Singh","doi":"10.4103/0972-9747.45089","DOIUrl":"https://doi.org/10.4103/0972-9747.45089","url":null,"abstract":"Hepatitis B vaccine can induce transient hepatitis B surface antigen positivity not only in adult hemodialysis patients but also in normal adults and children. Hence hepatitis B vaccinees may be mistaken for confirmed hepatitis B surface antigen-positive carrier. Hence blood donors should not donate blood in this early post-vaccination period and renal dialysis patients should not be screened for hepatitis B surface antigen for at least 21 to 28 days after hepatitis B vaccination. These guidelines could prevent individuals in the early post-inoculation period from being erroneously labeled as having hepatitis B viral infection.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"2 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":"128745037","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}
Pub Date : 1900-01-01DOI: 10.4103/0972-9747.190083
S. Singh, P. Lawate
The last five years have emerged as a new era in the treatment of chronic hepatitis B (CHB). Advances in therapeutics and the approval of new drugs have been accompanied by a better understanding of the natural history and pathogenesis, as well as better diagnostics. In the treatment of CHB, no therapy has been proven to eradicate the virus completely from the human body due to the persistence of the covalently closed circular hepatitis B virus (HBV) DNA in the hepatocytes. Long-term maximal viral suppression is of utmost importance for the prevention of disease progression and hepatocellular cirrhosis development. Telbivudine is one of the more potent options, with phase III studies indicating its antiviral potency with 6- to 6.5-log 10 copies / mL reductions in HBV DNA levels at year one, comparable to other potent agents such as entecavir or tenofovir. The increasing rates of hepatitis B e antigen (HBeAg) seroconversion were achieved in HBeAg-positive patients during periods of up to four years of continuous telbivudine treatment, and seroconversion was durable in most patients throughout a two-year, off-treatment follow-up, indicating the potential for a finite treatment period in this group of patients. Long-term telbivudine treatment offers effective viral suppression to CHB patients, with certain baseline characteristics and on-treatment virological response. It is also one of the few drugs in the treatment of CHB under FDA pregnancy Category B. Telbivudine is well-tolerated, with elevations in creatine phosphokinase being the most common abnormality observed in the clinical trials. Most often, elevations have been asymptomatic. There are few new drugs for hepatitis B in the pipeline, with the agent farthest along in development, clevudine, halted for problems with muscle toxicity. Future research in hepatitis B will focus on the best ways to use the existing therapies, including telbivudine, sequentially or in combination, in order to maximize viral suppression and minimize the development of antiviral resistance.
{"title":"Telbivudine: A valuable treatment option in chronic hepatitis B","authors":"S. Singh, P. Lawate","doi":"10.4103/0972-9747.190083","DOIUrl":"https://doi.org/10.4103/0972-9747.190083","url":null,"abstract":"The last five years have emerged as a new era in the treatment of chronic hepatitis B (CHB). Advances in therapeutics and the approval of new drugs have been accompanied by a better understanding of the natural history and pathogenesis, as well as better diagnostics. In the treatment of CHB, no therapy has been proven to eradicate the virus completely from the human body due to the persistence of the covalently closed circular hepatitis B virus (HBV) DNA in the hepatocytes. Long-term maximal viral suppression is of utmost importance for the prevention of disease progression and hepatocellular cirrhosis development. Telbivudine is one of the more potent options, with phase III studies indicating its antiviral potency with 6- to 6.5-log 10 copies / mL reductions in HBV DNA levels at year one, comparable to other potent agents such as entecavir or tenofovir. The increasing rates of hepatitis B e antigen (HBeAg) seroconversion were achieved in HBeAg-positive patients during periods of up to four years of continuous telbivudine treatment, and seroconversion was durable in most patients throughout a two-year, off-treatment follow-up, indicating the potential for a finite treatment period in this group of patients. Long-term telbivudine treatment offers effective viral suppression to CHB patients, with certain baseline characteristics and on-treatment virological response. It is also one of the few drugs in the treatment of CHB under FDA pregnancy Category B. Telbivudine is well-tolerated, with elevations in creatine phosphokinase being the most common abnormality observed in the clinical trials. Most often, elevations have been asymptomatic. There are few new drugs for hepatitis B in the pipeline, with the agent farthest along in development, clevudine, halted for problems with muscle toxicity. Future research in hepatitis B will focus on the best ways to use the existing therapies, including telbivudine, sequentially or in combination, in order to maximize viral suppression and minimize the development of antiviral resistance.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"66 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":"116680749","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}
Pub Date : 1900-01-01DOI: 10.4103/0972-9747.193290
Bijay Misra, S. Singh
Nonalcoholic fatty liver disease [NAFLD] has rapidly emerged as the most common liver disorder not only in developed countries, but also in the developing countries. This entity encompasses a wide variety of liver abnormalities ranging from plain hepatic steatosis through nonalcoholic steatohepatitis [NASH] to cirrhosis of the liver and hepatocellular carcinoma [HCC]. NAFLD is now recognized as the hepatic manifestation of insulin resistance [IR], and an important marker of the metabolic syndrome [MS]. Although a number of advances have been made in elucidating the pathogenetic mechanisms involved in the causation and perpetuation of NAFLD, a great many unanswered questions remain unresolved yet. In view of the involvement of so many different pathways in the pathogenesis, there has always been a speculation regarding the interaction between NAFLD and other liver diseases especially chronic hepatitis C [CHC] and chronic hepatitis B [CHB], because of theubiquitous distribution of NAFLD and its common association with other liver diseases.
{"title":"Nonalcoholic fatty liver disease and hepatitis B virus infection","authors":"Bijay Misra, S. Singh","doi":"10.4103/0972-9747.193290","DOIUrl":"https://doi.org/10.4103/0972-9747.193290","url":null,"abstract":"Nonalcoholic fatty liver disease [NAFLD] has rapidly emerged as the most common liver disorder not only in developed countries, but also in the developing countries. This entity encompasses a wide variety of liver abnormalities ranging from plain hepatic steatosis through nonalcoholic steatohepatitis [NASH] to cirrhosis of the liver and hepatocellular carcinoma [HCC]. NAFLD is now recognized as the hepatic manifestation of insulin resistance [IR], and an important marker of the metabolic syndrome [MS]. Although a number of advances have been made in elucidating the pathogenetic mechanisms involved in the causation and perpetuation of NAFLD, a great many unanswered questions remain unresolved yet. In view of the involvement of so many different pathways in the pathogenesis, there has always been a speculation regarding the interaction between NAFLD and other liver diseases especially chronic hepatitis C [CHC] and chronic hepatitis B [CHB], because of theubiquitous distribution of NAFLD and its common association with other liver diseases.","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":"127710283","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}
Pub Date : 1900-01-01DOI: 10.4103/0972-9747.193286
S. Singh, Sudha Singh
{"title":"The South Asian cauldron: Hepatitis B, NAFLD, tuberculosis and ..…..","authors":"S. Singh, Sudha Singh","doi":"10.4103/0972-9747.193286","DOIUrl":"https://doi.org/10.4103/0972-9747.193286","url":null,"abstract":"","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":"131360203","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}
Pub Date : 1900-01-01DOI: 10.4103/0972-9747.162141
A. Seth
The treatment for Hepatitis B viral infection without any co-morbidities is relatively simpler, although the outcome remains suboptimal. However in a large number of these patients, the matter is complicated by co-morbid conditions which exist in these patients and the treatment in such patients has to be tailored to individual settings and demands. All patients of chronic hepatitis B [CHB] must be evaluated for co-morbidities especially those which can complicate treatment. This overview attempts to provide clinicians with guidance for treatment of CHB patients who have coexisting co-morbidities.
{"title":"Treatment options for HBV with co-morbid conditions","authors":"A. Seth","doi":"10.4103/0972-9747.162141","DOIUrl":"https://doi.org/10.4103/0972-9747.162141","url":null,"abstract":"The treatment for Hepatitis B viral infection without any co-morbidities is relatively simpler, although the outcome remains suboptimal. However in a large number of these patients, the matter is complicated by co-morbid conditions which exist in these patients and the treatment in such patients has to be tailored to individual settings and demands. All patients of chronic hepatitis B [CHB] must be evaluated for co-morbidities especially those which can complicate treatment. This overview attempts to provide clinicians with guidance for treatment of CHB patients who have coexisting co-morbidities.","PeriodicalId":345516,"journal":{"name":"Hepatitis B Annual","volume":"34 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":"123355199","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：