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Chapter 108 : Hepatitis B and D Viruses*

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Hepatitis B and D Viruses*, Page 1 of 2

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Abstract:

Hepatitis B virus (HBV) is a DNA virus in the Hepadnaviridae family that is transmitted by percutaneous, sexual, and perinatal transmission. Currently, approximately 1.25 million individuals in the United States and approximately 400 million persons worldwide are infected with HBV. Detection of HBV-specific proteins, antibodies, and nucleic acid is used as key diagnostic tests to detect infection and determine the stage of disease. These include the HBV surface antigen (HBsAg) and a soluble nucleocapsid protein, HBV e antigen (HBeAg), as well as the detection and quantitation of HBV DNA. Additionally, there are specific tests for detection of antibodies to HBsAg and the HB core antigen. Several effective vaccines are available for preventing infection with HBV, and the Centers for Disease Control and Prevention recommend that all infants receive the HBV vaccine at birth. A variety of effective antiviral therapies are available for treatment of chronic HBV. These drugs are antiviral agents which target and prevent HBV replication. With the effective vaccine and therapy, HBV infections can be controlled and prevented.

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 1
FIGURE 1

(A) The intact infectious HBV virion and the empty particles are shown. The two HBV particles (right) comprised of HBsAg are shown as elongated or tubular particle and as spherical particles. These particles vastly outnumber the virions. (Designed by the University of Kansas Graphic Design Department, 2009.) (B) Electron micrograph of serum showing the presence of three distinct morphologic entities: 17- to 25-nm-diameter pleomorphic, spherical particles (a); tubular or filamentous forms with diameters similar to those of the small particles (b); and 42- to 47-nm-diameter double-shelled spherical particles representing the HBV virion (Dane particle) (c). Magnification, ×10. (C) Diagrammatic representation of HBV coding regions. The functioning genome is a double-stranded circular DNA molecule, shown in the middle. RNA transcripts (arrows) are generated using both the plus-strand [(+)Strand] and minus-strand [(−)Strand] DNA templates. The largest transcript codes for the viral polymerase shown around the genome as the P transcript. The transcript for surface antigen (S) is produced as three separate transcripts, pre-S1, pre-S2, and S. The core protein is translated from the C transcript. HBeAg is encoded within the HB core gene. The transactivating protein is coded by the X transcript. (Designed by the University of Kansas Graphic Design Department, 2009.) doi:10.1128/9781555817381.ch108.f1

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 2
FIGURE 2

Worldwide distribution of chronic hepatitis B (CDC). doi:10.1128/9781555817381.ch108.f2

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 3
FIGURE 3

Typical sequence of serologic markers in patients with acute HBV infection with resolution of symptoms. doi:10.1128/9781555817381.ch108.f3

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 4
FIGURE 4

Typical sequence of serologic markers in patients with HBV infection that progresses to chronicity. In patients with chronic HBV infection, both HBsAg and IgG anti-HBc remain persistently detectable, generally for life. HBeAg is variably present in these patients. doi:10.1128/9781555817381.ch108.f4

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 5
FIGURE 5

Serologic course of HDV infection, with resolution when the virus is acquired as a coinfection with HBV. doi:10.1128/9781555817381.ch108.f5

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Image of FIGURE 6
FIGURE 6

Serologic course of HDV infection when the virus is acquired as a superinfection with HBV. Symptoms and alanine aminotransferase (ALT) levels are shown to indicate the intermittent nature of symptoms and liver involvement. doi:10.1128/9781555817381.ch108.f6

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
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Tables

Generic image for table
TABLE 1

HBV markers in different stages of infection and convalescence

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
Generic image for table
TABLE 2

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
Generic image for table
TABLE 3

Molecular assays used to detect HBV nucleic acid

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
Generic image for table
TABLE 4

HBV genotypes and geographic circulation

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108
Generic image for table
TABLE 5

Antiviral agents and HBV mutations associated with resistance

Citation: Horvat R, Taylor R. 2015. Hepatitis B and D Viruses*, p 1841-1858. In Jorgensen J, Pfaller M, Carroll K, Funke G, Landry M, Richter S, Warnock D (ed), Manual of Clinical Microbiology, Eleventh Edition. ASM Press, Washington, DC. doi: 10.1128/9781555817381.ch108

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