https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1053/jhep.2001.29401

Chronic hepatitis B

https://aasldpubs.onlinelibrary.wiley.com/doi/epdf/10.1002/hep.23190

Chronic hepatitis B: Update 2009

Worldwide, some 240 million people have chronic hepatitis B virus (HBV), with the highest rates of infection in Africa and Asia. Our understanding of the natural history of HBV infection and the potential for therapy of the resultant disease is continuously improving. New data have become available since the previous APASL guidelines for management of HBV infection were published in 2012. The objective of this manuscript is to update the recommendations for the optimal management of chronic HBV infection. The 2015 guidelines were developed by a panel of Asian experts chosen by the APASL. The clinical practice guidelines are based on evidence from existing publications or, if evidence was unavailable, on the experts' personal experience and opinion after deliberations. Manuscripts and abstracts of important meetings published through January 2015 have been evaluated. This guideline covers the full spectrum of care of patients infected with hepatitis B, including new terminology, natural history, screening, vaccination, counseling, diagnosis, assessment of the stage of liver disease, the indications, timing, choice and duration of single or combination of antiviral drugs, screening for HCC, management in special situations like childhood, pregnancy, coinfections, renal impairment and pre- and post-liver transplant, and policy guidelines. However, areas of uncertainty still exist, and clinicians, patients, and public health authorities must therefore continue to make choices on the basis of the evolving evidence. The final clinical practice guidelines and recommendations are presented here, along with the relevant background information.

/pdf/asian-pacific-clinical-practice-guidelines-on-the-management-za5qxgu5i6.pdf

Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update.

More than 500 million people worldwide are persistently infected with the hepatitis B virus (HBV) and/or hepatitis C virus (HCV) and are at risk of developing chronic liver disease, cirrhosis and hepatocellular carcinoma. Despite many common features in the pathogenesis of HBV- and HCV-related liver disease, these viruses markedly differ in their virological properties and in their immune escape and survival strategies. This review assesses recent advances in our understanding of viral hepatitis, contrasts mechanisms of virus-host interaction in acute hepatitis B and hepatitis C, and outlines areas for future studies. NECROINFLAMMATORY A state in which there is morphological evidence of infiltration of inflammatory cells and necrosis of parenchymal

Immunology of hepatitis B virus and hepatitis C virus infection.

https://aasldpubs.onlinelibrary.wiley.com/doi/pdf/10.1002/hep.1840360704

Course and outcome of hepatitis C.

Hepatitis C virus in multiple episodes of acute hepatitis in polytransfused thalassaemic children

Long-term benefit of interferon α therapy of chronic hepatitis D: regression of advanced hepatic fibrosis

https://www.journal-of-hepatology.eu/article/S0168-8278(05)80149-7/pdf

The role of pre-core hepatitis B virus mutants on the long-term outcome of chronic hepatitis B virus hepatitis. A longitudinal study

Sequence analysis of hepatitis B virus genome of a new mutant of ayw subtype isolated in Sardinia.

Serum samples from 1,765 consecutive Sardinian blood donors, negative for hepatitis B surface antigen (HBsAg) and for antibodies to human immunodeficiency virus (HIV) (anti-HIV), were evaluated for the presence of antibodies to hepatitis C virus (anti-HCV) by second-generation ELISA. Anti-HCV was detected in 25 (1.45%) of the 1,765 donors examined. Anti-HCV was found in 15 of the 1,690 (0.9%) donors with normal alanine aminotransferase (ALT) and in 10 of the 75 (13%) donors with elevated ALT (P < 0.0001). Of the 15 anti-HCV-positive donors with normal ALT, only five (33%) were confirmed to be positive by second-generation RIBA, six (40%) were indeterminate, while four (27%) were RIBA negative. HCV RNA, as detected by polymerase chain reaction (PCR) using a set of primers from the 5′-noncoding region, was found in six of the 15 (40%) donors with normal ALT, including five RIBA, positive and one indeterminant. Of the 10 anti-HCV-positive donors with elevated ALT, all were RIBA positive and eight (80%) had detectable HCV RNA. Thus, among ELISA-reactive donors, those with elevated ALT had a significantly higher probability of being positive for secondgeneration RIBA and HCV RNA compared to those with normal ALT levels (P = 0.028). None of the 65 donors with elevated ALT but negative for anti-HCV by ELISA had detectable serum HCV RNA, as compared to eight of 10 anti-HCV ELISApositive donors (P < 0.0001). However, although negative for HBsAg, 12 of the 65 (18%) had serum HBV DNA by PCR. This study demonstrates that the combined use of second-generation ELISA and RIBA anti-HCV assays is highly effective in identifying HCV infection, whereas the specificity of ELISA alone for the screening of blood donors with normal ALT values appears to be limited. In contrast, in donors with elevated ALT levels, there is a positive correlation between second-generation assays (ELISA and RIBA) and HCV viremia. The high proportion of inapparent HBV infection in blood donors with elevated ALT levels underlines the importance of this test for the prevention of transfusion-associated viral hepatitis.

Anna Paola Mazzoleni

Papers

Hepatitis C virus in multiple episodes of acute hepatitis in polytransfused thalassaemic children

Long-term benefit of interferon α therapy of chronic hepatitis D: regression of advanced hepatic fibrosis

The role of pre-core hepatitis B virus mutants on the long-term outcome of chronic hepatitis B virus hepatitis. A longitudinal study

Sequence analysis of hepatitis B virus genome of a new mutant of ayw subtype isolated in Sardinia.

Markers of hepatitis C virus infection in Sardinian blood donors: relationship with alanine aminotransferase levels.