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Hepatitis B today: clinical and diagnostic overview
1University of Massachusetts Medical School, Worcester.
The Pediatric Infectious Disease Journal
|May 1, 1993
Summary
Hepatitis B virus (HBV) infection diagnosis relies on detecting specific antigens and antibodies. Persistent HBV infection can lead to severe liver disease, but some adults achieve remission with interferon treatment.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Hepatitis B virus (HBV) is a hepatotropic DNA virus belonging to the hepadnavirus family.
- HBV possesses a lipoprotein coat (hepatitis B surface antigen) enclosing a nucleocapsid with circular DNA.
- The HBV genome encodes seven proteins, including a DNA polymerase with reverse transcriptase activity.
Purpose of the Study:
- To elucidate the structure, replication, and diagnostic markers of Hepatitis B virus.
- To differentiate between acute and persistent HBV infections.
- To understand the long-term consequences and potential treatment outcomes of chronic HBV infection.
Main Methods:
- Analysis of HBV genome structure and encoded proteins.
- Description of HBV replication mechanisms, resembling retroviruses.
- Review of diagnostic testing for hepatitis B surface antigen and IgM/IgG antibodies to hepatitis B core antigen.
Main Results:
- HBV replication occurs primarily in hepatocytes.
- Genomic mutations lead to virus variants.
- Diagnosis of acute infection involves IgM antibodies to hepatitis B core antigen; antibody to hepatitis B surface antigen indicates immunity.
- Persistent infection is characterized by detectable hepatitis B surface antigen and low/undetectable antibody to hepatitis B surface antigen, with potential for active viral replication.
- Persistent infection is linked to chronic hepatitis, cirrhosis, and hepatocellular carcinoma.
Conclusions:
- Accurate diagnosis of acute and persistent Hepatitis B virus infections relies on specific serological markers.
- Persistent HBV infection poses significant risks for severe liver disease.
- Alpha-2b-interferon shows potential for achieving remission in approximately 50% of adults with chronic infection.