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Management of acute hepatitis B and reactivation of hepatitis B

Ankur Jindal,
Manoj Kumar,
Shiv K. Sarin^*

Article first published online: 3 JAN 2013

DOI: 10.1111/liv.12081

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Liver International

Special Issue: Proceedings of the 6th Paris Hepatitis Conference, International Conference on the Management of Patients with Viral Hepatitis

Volume 33, Issue Supplement s1, pages 164–175, February 2013

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Jindal, A., Kumar, M. and Sarin, S. K. (2013), Management of acute hepatitis B and reactivation of hepatitis B. Liver International, 33: 164–175. doi: 10.1111/liv.12081

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Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India

^* Correspondence
Dr S K Sarin, MD, DM, Senior Professor, Hepatology, Institute of Liver & Biliary Sciences (ILBS), New Delhi, India
Tel: +91 11 4630 0000
Fax: +91 11 2612 3504
e-mail: shivsarin@gmail.com

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Issue published online: 3 JAN 2013
Article first published online: 3 JAN 2013

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References

1
Hepatitis B: Fact sheets WHO. Available at [http://www.who.int/mediacentre/factsheets/fs204/en]. Accessed: 20 October 2012.
2
Lok AS, McMahon BJ. Chronic hepatits B. Hepatology 2007; 45: 507–39.
Direct Link:
3
Gupta S, Govindarajan S, Fong TL, Redeker AG. Spontaneous reactivation in chronic hepatitis B: patterns and natural history. J Clin Gastroenterol 1990; 12: 562–7.
4
Lok AS, Lai CL, Wu PC, et al. Spontaneous hepatitis B e antigen to antibody seroconversion and reversion in Chinese patients with chronic hepatitis B virus infection. Gastroenterology 1987; 92: 1839–46.
5
Lok AS, Ward JW, Perrillo RP, McMahon BJ, Liang TJ. Reactivation of hepatitis B during immunosuppressive therapy: potentially fatal yet preventable. Ann Intern Med 2012; 156: 743–5.
- Web of Science®
6
Wieland S, Thimme R, Purcell RH, et al. Genomic analysis of the host response to hepatitis B virus infection. Proc Natl Acad Sci USA 2004; 101: 6669–74.
7
Murray JM, Wieland SF, Purcell RH, et al. Dynamics of hepatitis B virus clearance in chimpanzees. Proc Natl Acad Sci USA 2005; 102: 17780–5.
8
Sandalova E, Laccabue D, Boni C, et al. Increased levels of arginase in patients with acute hepatitis B suppress antiviral T cells. Gastroenterology 2012; 143: 78–87. e3.
9
Fletcher SP, Chin DJ, Cheng DT, et al. Identification of an intrahepatic transcriptional signature associated with self-limiting infection in the woodchuck model of hepatitis B. Hepatology 2012. doi: 10.1002/hep.25954
Direct Link:
10
Stross L, Günther J, Gasteiger G, et al. Foxp3 + regulatory T cells protect the liver from immune damage and compromise virus control during acute experimental hepatitis B virus infection in mice. Hepatology 2012; 56: 873–83.
Direct Link:
11
TrehanPati N, Geffers R. Sukriti, Hissar S, Riese P, Toepfer T, Buer J, Kumar M, Guzman CA, Sarin SK. Gene expression signatures of peripheral CD4 + T cells clearly discriminate between patients with acute and chronic hepatitis B infection. Hepatology 2009 ; 49: 781–90.
Direct Link:
12
Rehermann B, Ferrari C, Pasquinelli C, et al. The hepatitis B virus persists for decades after patients’ recovery from acute viral hepatitis despite active maintenance of a cytotoxic T-lymphocyte response. Nat Med 1996; 2: 1104–8.
13
Whalley SA, Murray JM, Brown D, et al. Kinetics of acute hepatitis B virus infection in humans. J Exp Med 2001; 193: 847–54.
14
Chulanov VP, Shipulin GA, Schaefer S, et al. Kinetics of HBV DNA and HBsAg in acute hepatitis B patients with and without coinfection by other hepatitis viruses. J Med Virol 2000; 69: 313–23.
Direct Link:
15
Gerlich W, Stamm B. Prognostic significance of quantitative HBsAg determination in acute hepatitis B. Partial report of a cooperative clinical study of the DFG-focus of “virus hepatitis”. Verh Dtsch Ges Inn Med 1977; 83: 554–7.
- CAS
16
Maruyama T, McLauchlan A, lino S, et al. The serology of chronic hepatitis infection revisited. J Clin Invest 1993; 91: 2586–95.
17
Maruyama T, Iino S, Koike K, Yasuda S, Milish DR. Serology of acute exacerbation in chronic hepatitis B virus infection. Gastroenterology 1993; 105: 1141–51.
18
Gerlich WH, Uy A, Lambrecht F, et al. Cutoff levels of immunoglobulin M antibody against viral core antigen for differentiation of acute, chronic, and past hepatitis B virus infections. J Clin Microbiol 1986; 24: 288–93.
19
Kumar M, Jain S, Sharma BC, Sarin SK. Differentiating acute hepatitis B from the first episode of symptomatic exacerbation of chronic hepatitis B. Dig Dis Sci 2006; 51: 594–9.
20
Tassopoulos NC, Sjogren MH, Purcell RH. 19S and 7–8S forms of IgM antibody to hepatitis B core antigen in acute icteric hepatitis superimposed on hepatitis B surface antigen carriage. Infection 1990; 18: 376–80.
21
Garfein RS, Bower WA, Loney CM, et al. Factors associated with fulminant liver failure during an outbreak among injection drug users with acute hepatitis B. Hepatology 2004; 40: 865–72.
- PubMed,
- Web of Science® Times Cited: 27
22
Wai CT, Fontana RJ, Polson J, et al. Clinical outcome and virological characteristics of hepatitis B-related acute liver failure in the United States. J Viral Hepat 2005; 12: 192–8.
Direct Link:
23
Hasegawa K, Huang J, Rogers SA, et al. Enhanced replication of a hepatitis B virus mutant associated with an epidemic of fulminant hepatitis. J Virol 1994; 68: 1651–7.
24
Sato S, Suzuki K, Akahane Y, et al. Hepatitis B virus strains with mutations in the core promoter in patients with fulminant hepatitis. Ann Intern Med 1995; 122: 241–9.
25
Chu CM, Liaw YF. Predictive factors for reactivation of hepatitis B following hepatitis B e antigen seroconversion in chronic hepatitis B. Gastroenterology 2007; 133: 1458–67.
26
Kusakabe A, Tanaka Y, Mochida S, et al. Case-control study for the identification of virological factors associated with fulminant hepatitis B. Hepatol Res 2009; 39: 648–56.
Direct Link:
27
Inoue J, Ueno Y, Kawamura K, et al. Association between S21 substitution in the core protein of hepatitis B virus and fulminant hepatitis. J Clin Virol 2012; 55: 147–52.
28
Wakil SM, Kazim SN, Khan LA, Raisuddin S, Parvez MK, Guptan RC, Thakur V, Hasnain SE, Sarin SK. Prevalence and profile of mutations associated with lamivudine therapy in Indian patients with chronic hepatitis B in the surface and polymerase genes of hepatitis B virus. J Med Virol 2002; 68: 311–8.
Direct Link:
29
Luo Q, Zhong Y, Yang Y, et al. Clinical characteristics and chronicity of acute hepatitis B induced by lamivudine-resistant strains. J Med Virol 2012; 84: 1558–61.
Direct Link:
30
Yuki N, Nagaoka T, Yamashiro M, et al. Long-term histologic and virologic outcomes of acute self-limited hepatitis B. Hepatology 2003; 37: 1172–9.
Direct Link:
31
Schmilovitz-Weiss H, Ben-Ari Z, Sikuler E, et al. Lamivudine treatment for acute severe hepatitis B: a pilot study. Liver Int 2004; 24: 547–51.
Direct Link:
32
Tillmann HL, Hadem J, Leifeld L, et al. Safety and efficacy of lamivudine in patients with severe acute or fulminant hepatitis B, a multicenter experience. J Viral Hepat 2006; 13: 256–63.
Direct Link:
33
Kumar M, Satapathy S, Monga R, et al. A randomized controlled trial of lamivudine to treat acute hepatitis B. Hepatology 2007; 45: 97–101.
Direct Link:
34
Miyake Y, Iwasaki Y, Takaki A, et al. Lamivudine treatment improves the prognosis of fulminant hepatitis B. Intern Med 2008; 47: 1293–9.
35
Yu JW, Sun LJ, Zhao YH, Kang P, Li SC. The study of efficacy of lamivudine in patients with severe acute hepatitis B. Dig Dis Sci 2010; 55: 775–83.
36
Kumar M, Sarin SK, Sharma BC. Treating acute hepatitis B. Author reply. Hepatology 2007; 46: 608–15.
Direct Link:
37
Liaw YF, Yang SS, Chen TJ, Chu CM. Acute exacerbation in hepatitis B e antigen positive chronic type B hepatitis. A clinicopathological study. J Hepatol 1985; 1: 227–33.
38
Perrillo RP, Campbell CR, Sanders GE, Regenstein FG, Bodicky CJ. Spontaneous clearance and reactivation of chronic hepatitis B virus infection among male homosexuals with chronic type B hepatitis. Ann Intern Med 1984; 100: 43–6.
39
Chan HL, Hui Y, Leung NW, et al. Risk factors for active liver disease in HBeAg-negative chronic hepatitis B virus-infected patients. Am J Gastroenterol 2000; 95: 3547–51.
40
Sung JJ, Chan HL, Wong ML, et al. Relationship of clinical and virological factors with hepatitis activity in hepatitis B e antigen-negative chronic hepatitis B virus-infected patients. J Viral Hepat 2002; 9: 229–34.
Direct Link:
41
Gupta S, Govindarajan S, Fong TL, Redeker AG. Spontaneous reactivation in chronic hepatitis B: patterns and natural history. J Clin Gastroenterol 1990; 12: 562–8.
42
Levy P, Marcellin P, Martinot-Peignoux M, et al. Clinical course of spontaneous reactivation of hepatitis B virus infection in patients with chronic hepatitis B. Hepatology 1990; 12: 570–4.
Direct Link:
43
Sheen IS, Liaw YF, Tai DI, Chu CM. Hepatic decompensation associated with hepatitis B e antigen clearance in chronic type B hepatitis. Gastroenterology 1985; 89: 732–5.
44
Lok AS, Lai CL. Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology. J Hepatol 1990; 10: 29–34.
45
Chien RN, Lin CH, Liaw YF. The effect of lamivudine therapy in hepatic decompensation during acute exacerbation of chronic hepatitis B. J Hepatol 2003; 38: 322–7.
46
Lok AS, Lai CL. Acute exacerbations in Chinese patients with chronic hepatitis B virus (HBV) infection. Incidence, predisposing factors and etiology. J. Hepatol. 1990; 10: 29–34.
47
Yuen MF, Sablon E, Wong DK, et al. Role of hepatitis B virus genotypes in chronic hepatitis B exacerbation. Clin. Infect. Dis. 2003; 37: 593–7.
48
Imamura T, Yokosuka O, Kurihara T, et al. Distribution of hepatitis B viral genotypes and mutations in the core promoter and precore regions in acute forms of liver disease in patients from Chiba, Japan. Gut 2003; 52: 1630–7.
49
Chauhan R, Kazim SN, Bhattacharjee J, Sakhuja P, Sarin SK. Basal core promoter, precore region mutations of HBV and their association with e antigen, genotype, and severity of liver disease in patients with chronic hepatitis B in India. J Med Virol 2006; 78: 1047–54.
Direct Link:
50
Milich D, Liang TJ. Exploring the biological basis of hepatitis B e antigen in hepatitis B virus infection. Hepatology 2003; 38: 1075–86.
Direct Link:
51
Brunetto MR, Giarin MM, Oliveri F, et al. Wild-type and e antigen-minus hepatitis B viruses and course of chronic hepatitis. Proc Natl Acad Sci USA 1991; 88: 4186–90.
52
Milich DR, Jones JE, Hughes JL, et al. Is a function of the secreted hepatitis B e antigen to induce immunologic tolerance in utero? Proc Natl Acad Sci USA 1990; 87: 6599–603.
53
Oketani M, Oketani K, Xiaohong C, Arima T. Low level wild-type and pre-core mutant hepatitis B viruses and HBeAg negative reactivation of chronic hepatitis B. J Med Virol 1999; 58: 332–7.
Direct Link:
54
Inoue K, Yoshiba M, Sekiyama K, Okamoto H, Mayumi M. Clinical and molecular virological differences between fulminant hepatic failures following acute and chronic infection with hepatitis B virus. J Med Virol 1998; 55: 35–41.
Direct Link:
55
Perrillo RP, Campbell CR, Sanders GE, Regenstein FG, Bodicky CJ. Spontaneous clearance and reactivation of chronic hepatitis B virus infection among male homosexuals with chronic type B hepatitis. Ann Intern Med 1984; 100: 43–46.
56
Sarin SK, Kumar M, Shrivastava S, Sinha S, Pati NT. Influence of chronic HBV infection on pregnancy: a human model of maternofetal virus host interactions. Gastroenterology 2011; 141: 1522–5.
- CrossRef
57
Tsai SL, Chen PJ, Lai MY, et al. Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. Implications for hepatitis B e antigen seroconversion. J Clin Invest 1992; 89: 87–96.
58
Yang PM,Su I J,Lai MY, et al. Immunohistochemical studies on intrahepatic lymphocyte infiltrates in chronic type B hepatitis, with special emphasis on the activation status of the lymphocytes. Am J Gastroenterol 1988; 83: 948–53.
59
Wasmuth HE, Kunz D, Yagmur E, et al. Patients with acute on chronic liver failure display “sepsis-like” immune paralysis. J Hepatol 2005; 42: 195–201.
60
Chen Z, Cheng Y, Xu Y, et al. Expression profiles and function of Toll-like receptors 2 and 4 in peripheral blood mononuclear cells of chronic hepatitis B patients. Clin Immunol 2008; 128: 400–8.
61
Wang K, Liu H, He Y, et al. Correlation of TLR1-10 expression in peripheral blood mononuclear cells with chronic hepatitis B and chronic hepatitis B-related liver failure. Hum Immunol 2010; 71: 950–6.
62
Zhang J-Y, Zhang Z, Lin F, et al. Interleukin-17–producing CD4+ T cells increase with severity of liver damage in patients with chronic hepatitis B. Hepatology 2010; 51: 81–91.
Direct Link:
63
Farci P, Diaz G, Chen Z, et al. B cell gene signature with massive intrahepatic production of antibodies to hepatitis B core antigen in hepatitis B virus-associated acute liver failure. Proc Natl Acad Sci USA 2010; 107: 8766–71.
64
Gao L, Wang J-F, Xiang M, et al. Expression of human glucocorticoid receptor in T lymphocytes in acute-on-chronic hepatitis B liver failure. Dig Dis Sci 2011; 56: 2605–12.
65
Chu CM, Sheen IS, Liaw YF. The etiology of acute hepatitis in Taiwan: acute hepatitis superimposed upon HBsAg carrier state as the main etiology of acute hepatitis in areas with high HBsAg carrier rate. Infection 1988; 16: 233–7.
66
Kusumoto K, Yatsuhashi H, Nakao R, et al. Detection of HBV core promoter and precore mutations helps distinguish flares of chronic hepatitis from acute hepatitis B. J Gastroenterol Hepatol 2008; 23: 790–3.
Direct Link:
67
Chan HL, Tsang SW, Hui Y, et al. The role of lamivudine and predictors of mortality in severe flare-up of chronic hepatitis B with jaundice. J Viral Hepat 2002; 9: 424–8.
Direct Link:
68
Chien RN, Lin CH, Liaw YF. The effect of lamivudine therapy in hepatic decompensation during acute exacerbation of chronic hepatitis B. J Hepatol 2003; 38: 322–7.
69
Tsubota A, Arase Y, Suzuki Y, et al. Lamivudine monotherapy for spontaneous severe acute exacerbation of chronic hepatitis B. J Gastroenterol Hepatol 2005; 20: 426–32.
Direct Link:
70
Mori N, Suzuki F, Kawamura Y, et al. Determinants of the clinical outcome of patients with severe acute exacerbation of chronic hepatitis B virus infection. J Gastroenterol 2012; 47: 1022–9.
71
Jeng WJ, Sheen IS, Liaw YF. Hepatitis B virus DNA level predicts hepatic decompensation in patients with acute exacerbation of chronic hepatitis B. Clin Gastroenterol Hepatol 2010; 8: 541–5.
72
Sun QF, Ding JG, Xu DZ, et al. Prediction of the prognosis of patients with acute-on-chronic hepatitis B liver failure using the model for end-stage liver disease scoring system and a novel logistic regression model. J Viral Hepat 2009; 16: 464–70.
Direct Link:
73
Yu JW, Sun LJ, Zhao YH, Li SC. Prediction value of model for end-stage liver disease scoring system on prognosis in patients with acute-on-chronic hepatitis B liver failure after plasma exchange and lamivudine treatment. J Gastroenterol Hepatol 2008; 23: 1242–9.
Direct Link:
74
Lee WC, Chou HS, Wu TJ, et al. Indicators and outcome of liver transplantation in acute liver decompensation after flares of hepatitis B. J Viral Hepat 2011; 18: 193–9.
Direct Link:
75
Zheng MH, Shi KQ, Fan YC, et al. A model to determine 3-month mortality risk in patients with acute-on-chronic hepatitis B liver failure. Clin Gastroenterol Hepatol 2011; 9: 351–6.
- CrossRef,
- Web of Science® Times Cited: 5
76
Tsubota A, Arase Y, Saitoh S, et al. Lamivudine therapy for spontaneously occurring severe acute exacerbation in chronic hepatitis B virus infection: a preliminary study. Am J Gastroenterol 2001; 96: 557–62.
Direct Link:
77
Tsang SW, Chan HL, Leung NW, et al. Lamivudine treatment for fulminant hepatic failure due to acute exacerbation of chronic hepatitis B infection. Aliment Pharmacol Ther 2001; 15: 1737–44.
Direct Link:
78
Wong VW, Chan HL. Severe acute exacerbation of chronic hepatitis B: a unique presentation of a common disease. J Gastroenterol Hepatol 2009; 24: 1179–86.
Direct Link:
79
Sun LJ, Yu JW, Zhao YH, Kang P, Li SC. Influential factors of prognosis in lamivudine treatment for patients with acute-on-chronic hepatitis B liver failure. J Gastroenterol Hepatol 2010; 25: 583–90.
Direct Link:
80
Cui Y-L, Yan F, Wang Y-B, et al. Nucleoside analogue can improve the long-term prognosis of patients with hepatitis B virus infection-associated acute on chronic liver failure. Dig Dis Sci 2010; 55: 2373–8.
81
Kanda T, Shinozaki M, Kamezaki H, et al. Efficacy of lamivudine or entecavir on acute exacerbation of chronic hepatitis B. Int J Med Sci 2012; 9: 27–32.
82
Wong VW, Wong GL, Yiu KK, et al. Entecavir treatment in patients with severe acute exacerbation of chronic hepatitis B. J Hepatol 2011; 54: 236–42.
83
Lange CM, Bojunga J, Hofmann WP, et al. Severe lactic acidosis during treatment of chronic hepatitis B with entecavir in patients with impaired liver function. Hepatology 2009; 50: 2001–6.
Direct Link:
84
Garg H, Sarin SK, Kumar M, et al. Tenofovir improves the outcome in patients with spontaneous reactivation of hepatitis B presenting as acute-on-chronic liver failure. Hepatology 2011; 53: 774–80.
Direct Link:
85
Chan A, Fan S, Lo C, et al. Liver transplantation for acute-on-chronic liver failure. Hepatol Int 2009; 3: 571–81.
- CrossRef,
- Web of Science® Times Cited: 11
86
Garg V, Garg H, Khan A, et al. Granulocyte colony-stimulating factor mobilizes CD34(+) cells and improves survival of patients with acute-on-chronic liver failure. Gastroenterology 2012; 142: 505–12.
87
Kribben A, Gergen G, Haag S, Herget-Rosenthal S, Treichel U,et al. HELIOS Study Group. Effects of fractionated plasma separation and adsorption on survival in patients with acute-on-chronic liver failure. Gastroenterology 2012; 142: 782–9.
88
Zhang XQ, Jiang L, You JP, et al. Efficacy of short-term dexamethasone therapy in acute-on-chronic pre-liver failure. Hepatol Res 2011; 41: 46–53.
Direct Link:
89
Zachoval R, Roggendorf M, Deinhardt F. Hepatitis A infection in chronic carriers of hepatitis B virus. Hepatology 1983; 3: 528–31.
Direct Link:
90
Kumar M, Sharma BC, Sarin SK. Hepatitis E virus as an etiology of acute exacerbation of previously unrecognized asymptomatic patients with hepatitis B virus-related chronic liver disease. J Gastroenterol Hepatol 2008; 23: 883–7.
Direct Link:
91
Smedile A, Farci P, Verme G, et al. Influence of delta infection on severity of hepatitis B. Lancet 1982; 2: 945–7.
92
Chu CM, Yeh CT, Liaw YF. Fulminant hepatic failure in acute hepatitis C: increased risk in chronic carriers of hepatitis B virus. Gut 1999; 45: 613–7.
93
Liaw YF, Tsai SL, Chang JJ, et al. Displacement of hepatitis B virus by hepatitis C virus as the cause of continuing chronic hepatitis. Gastroenterology 1994; 106: 1048–53.
94
Chu CM, Liaw YF, Pao CC, Huang MJ. The etiology of acute hepatitis superimposed upon previously unrecognized asymptomatic HBsAg carriers. Hepatology 1989; 9: 452–6.
Direct Link:
95
Dulbecco R, Ginsberg HS. Interference with viral multiplication. In: Davis BD, Dulbecco R, Eisen HN, Ginsberg HS, Wood WB Jr, eds. Microbiology. New York: Harper & Row, 1973; 1172–87.
96
Sheen IS, Liaw YF, Chu CM, Pao CC. Role of hepatitis C virus infection in spontaneous hepatitis B surface antigen clearance during chronic hepatitis B virus infection. J Infect Dis 1992; 165: 831–4.

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