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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...
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Pulmonary Tuberculosis I

Tuberculosis, often called TB, is a contagious illness primarily caused by Mycobacterium tuberculosis. It mainly affects the lung parenchyma but can also impact other body parts.
Causative Organism
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Inhibitors of Viral Protein Synthesis

Protein synthesis is indispensable for viral replication, as viruses lack the cellular machinery required for this process and must hijack the host's translational apparatus. In response, host cells deploy a critical innate immune defense involving interferons, specialized cytokines that play a central role in inhibiting viral propagation.Upon viral detection, infected cells release interferons that bind to receptors on adjacent uninfected cells, activating the JAK-STAT signaling pathway and...
Immunodeficiency Diseases01:25

Immunodeficiency Diseases

Immunodeficiency disorders are conditions in which the immune system's ability to fight infectious disease and cancer is compromised or entirely absent. The immune system comprises a complex network of cells, tissues, and organs that work together to protect the body from potentially harmful invaders. When this system is deficient or not functioning properly, it leaves the body susceptible to infections, diseases, or other complications.
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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...
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Stem Cell-Derived Viral Ag-Specific T Lymphocytes Suppress HBV Replication in Mice
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Stem Cell-Derived Viral Ag-Specific T Lymphocytes Suppress HBV Replication in Mice

Published on: September 25, 2019

Immunosuppression and HBV reactivation.

Daniel Shouval1, Oren Shibolet

  • 1Liver Unit, Hadassah-Hebrew University Hospital, Jerusalem, Israel. shouval@hadassah.org.il

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

Hepatitis B virus (HBV) reactivation can cause severe liver injury in immunosuppressed patients. Preemptive antiviral treatment and monitoring are crucial for preventing HBV reactivation in at-risk individuals.

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Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Hepatitis B virus (HBV) reactivation is a significant risk in immunosuppressed patients, particularly those with
  • silent
  • hepatitis B surface antigen (HBsAg) positivity or occult HBV infection.
  • Reactivation can manifest variably, from asymptomatic cases to severe hepatitis, liver failure, and death.
  • High-risk groups include patients with lymphoma, those undergoing transplantation, cancer patients, HIV-infected individuals, organ transplant recipients, and those with autoimmune diseases.

Purpose of the Study:

  • To define Hepatitis B virus (HBV) reactivation in immunosuppressed individuals.
  • To outline the clinical spectrum and risk factors associated with HBV reactivation.
  • To emphasize the importance of preemptive antiviral therapy and monitoring in preventing HBV reactivation.

Main Methods:

  • Review of clinical presentations and outcomes of HBV reactivation.
  • Identification of patient populations at increased risk for HBV reactivation.
  • Evaluation of current management strategies, including preemptive antiviral treatment and monitoring protocols.

Main Results:

  • HBV reactivation is characterized by increased HBV replication and hepatocellular injury in HBsAg carriers or those with occult HBV.
  • Rituximab, corticosteroids, stem cell/bone marrow transplantation, and chemotherapy are frequently associated with HBV reactivation.
  • Preemptive antiviral therapy (lamivudine, tenofovir, entecavir) is effective in preventing HBV reactivation in HBsAg-positive patients undergoing immunosuppression.
  • Monitoring of alanine aminotransferase and HBV DNA is recommended for patients with occult HBV during immunosuppression.

Conclusions:

  • HBV reactivation poses a serious threat to immunosuppressed patients, potentially leading to treatment interruption and adverse outcomes.
  • Preemptive antiviral treatment is a standard of care for HBsAg-positive patients undergoing chemotherapy or biologic therapy.
  • Vigilant monitoring and prompt antiviral intervention are critical for managing HBV reactivation, especially in patients with occult HBV infection, and can be lifesaving.