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Related Concept Videos

Hepatitis01:25

Hepatitis

Hepatitis is an inflammatory condition of the liver most commonly caused by hepatotropic viruses (A–E), though non-infectious causes such as alcohol and drugs also exist.Hepatitis AHepatitis A virus (HAV) is a non-enveloped RNA virus of the Picornaviridae family. It is primarily transmitted via the fecal-oral route, typically through ingestion of contaminated food or water. After ingestion, HAV enters the bloodstream through the oropharynx or intestinal epithelium and reaches the liver. The...
Viral Hepatitis I: Introduction01:28

Viral Hepatitis I: Introduction

Viral hepatitis is an inflammatory condition of the liver caused by infection with hepatotropic viruses, most commonly hepatitis A, B, C, D, and E. Despite variations in structure and transmission, all viruses mentioned infect hepatocytes and provoke immune responses that can hinder liver function. Additionally, some non-hepatotropic viruses can also lead to hepatic inflammation.Hepatitis A VirusHepatitis A virus (HAV) is transmitted through the fecal–oral route, typically by ingestion of food...
Cirrhosis I: Introduction01:23

Cirrhosis I: Introduction

Cirrhosis is a chronic, irreversible liver disease characterized by the widespread replacement of healthy liver tissue with fibrotic scar tissue and the formation of regenerative nodules.Etiology of cirrhosisCirrhosis results from sustained liver injury that triggers progressive fibrosis and structural remodeling. The underlying causes are diverse, encompassing common and less frequent clinical conditions. Regardless of the origin, all causes lead to chronic inflammation, hepatocyte loss, and...
Chronic Bowel Disorders: Introduction01:17

Chronic Bowel Disorders: Introduction

Chronic bowel diseases are a group of long-term conditions affecting the digestive tract, characterized by inflammation and damage to the gut lining. These conditions primarily include irritable bowel syndrome and inflammatory bowel disease.
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Chronic Pancreatitis II: Collaborative Care01:29

Chronic Pancreatitis II: Collaborative Care

The management of chronic pancreatitis is multifaceted, involving a comprehensive approach that includes thorough assessment, diagnostic testing, and a variety of management strategies.
Assessment:
Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test01:22

Effect of Hepatic Disease on Pharmacokinetics: Pathophysiologic Assessment and Liver Function Test

In clinical practice, the direct measurement of hepatic blood flow to evaluate liver function presents significant challenges due to the intricate and specialized nature of the necessary techniques. Consequently, healthcare professionals often rely on empirical estimates derived from thorough patient examinations and liver function tests to gauge liver health. Among the tools at their disposal, the Child–Pugh and MELD scoring systems stand out for their ability to categorize and assess the...

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Stem Cell-Derived Viral Ag-Specific T Lymphocytes Suppress HBV Replication in Mice
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Chronic hepatitis B: a treatment update.

Vincent Wai-Sun Wong1, Vincent Wong1, Henry Lik-Yuen Chan

  • 1Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Hong Kong.

Seminars in Liver Disease
|June 11, 2013
PubMed
Summary
This summary is machine-generated.

Recent advances in chronic hepatitis B treatment include peginterferon and nucleos(t)ide analogs. While effective, challenges remain with side effects, durability, and relapse, necessitating ongoing research into combination therapies.

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Area of Science:

  • Hepatology
  • Virology
  • Pharmacology

Background:

  • Chronic hepatitis B treatment has evolved significantly over the last 20 years.
  • Peginterferon offers durable seroconversion but has side effects and limited efficacy (30-40%).
  • Oral nucleos(t)ide analogs like entecavir and tenofovir suppress HBV effectively with low resistance but often lead to relapse upon cessation.

Purpose of the Study:

  • To review recent developments in chronic hepatitis B treatment.
  • To discuss the efficacy and limitations of current therapies.
  • To highlight the need for further research into combination treatments and long-term outcomes.

Main Methods:

  • Review of current literature on hepatitis B therapeutics.
  • Analysis of treatment outcomes for peginterferon and nucleos(t)ide analogs.
  • Discussion of monitoring strategies and emerging treatment combinations.

Main Results:

  • Peginterferon provides durable hepatitis B e antigen seroconversion but has significant side effects and moderate success rates.
  • Hepatitis B surface antigen levels may predict peginterferon response.
  • Oral agents like entecavir and tenofovir offer potent viral suppression but require long-term treatment due to relapse risk.
  • Tenofovir shows promise in multi-agent experienced and lamivudine-resistant patients.

Conclusions:

  • Current hepatitis B treatments present a trade-off between side effects, efficacy, and long-term management.
  • Monitoring viral markers like HBV DNA and HBsAg is crucial during therapy.
  • Combination therapies and long-term efficacy studies, particularly for tenofovir, are essential for optimizing chronic hepatitis B management.