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Chronic Hepatitis B, C, and D

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  • Authors: Bryan R. Cobb1, Alexandra Valsamakis2
  • Editors: Randall T. Hayden3, Donna M. Wolk4, Karen C. Carroll5, Yi-Wei Tang6
  • VIEW AFFILIATIONS HIDE AFFILIATIONS
    Affiliations: 1: Roche Diagnostics Corporation, Indianapolis, IN 46250; 2: Johns Hopkins Hospital, Baltimore, MD 21287; 3: St. Jude Children’s Research Hospital, Memphis, TN; 4: Geisinger Clinic, Danville, PA; 5: Johns Hopkins University Hospital, Baltimore, MD; 6: Memorial Sloan-Kettering Institute, New York, NY
  • Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
  • Received 21 December 2015 Accepted 06 April 2016 Published 22 July 2016
  • Bryan R. Cobb, bryan.cobb@roche.com
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  • Abstract:

    Chronic hepatitis B, C, and D virus infections contribute significantly to the morbidity and mortality of immunocompromised individuals. To contextualize discussion of these infections in immunocompromised patients, this paper provides an overview of aspects of infection in normal hosts. It then describes differences in disease, diagnostic testing, and therapeutic management observed in immunocompromised patients.

  • Citation: Cobb B, Valsamakis A. 2016. Chronic Hepatitis B, C, and D. Microbiol Spectrum 4(4):DMIH2-0025-2015. doi:10.1128/microbiolspec.DMIH2-0025-2015.

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/content/journal/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015
2016-07-22
2017-08-17

Abstract:

Chronic hepatitis B, C, and D virus infections contribute significantly to the morbidity and mortality of immunocompromised individuals. To contextualize discussion of these infections in immunocompromised patients, this paper provides an overview of aspects of infection in normal hosts. It then describes differences in disease, diagnostic testing, and therapeutic management observed in immunocompromised patients.

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Figures

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FIGURE 1

Key HBV virion components.

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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FIGURE 2

Phases and associated markers of CHB ( 23 , 25 , 187 , 188 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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Image of FIGURE 3
FIGURE 3

HBV exacerbation/reactivation risk associated with pharmacologic immunosuppression ( 37 , 44 , 52 , 189 208 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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FIGURE 4

CDC testing algorithm for the identification of patients with CHC. Adapted from reference ( 13 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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FIGURE 5

SVR rates with various regimens over the last 30 years ( 112 , 113 , 116 , 123 , 166 168 , 170 , 172 , 209 220 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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FIGURE 6

Regimens currently recommended for treatment of CHC ( 7 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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FIGURE 7

Current recommendations for viral load monitoring during treatment for CHC ( 7 ).

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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Tables

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TABLE 1

Characteristics of hepatitis B (HBV), C (HCV), and D (HDV) viruses

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 2

Serologic markers of hepatitis B virus infection

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 3

Serologic and molecular test results in typical acute, resolved, and chronic hepatitis B

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 4

CHB phases, associated serologic and molecular test results, and HBV disease risk during pharmacologic immunocompromise

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 5

HBV genotype distribution worldwide

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 6

Current treatments for CHB

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 7

HBV-infected individuals at risk of HBV reactivation/exacerbation after pharmacologic immunosuppression and associated laboratory results during reactivation/exacerbation

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 8

Testing for hepatitis C virus: types of assays (specimens), indications, result interpretations

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 9

FDA-approved DAA-containing therapies for HCV

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 10

Definitions used in assessing quantitative HCV RNA test results

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015
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TABLE 11

Interpretations of quantitative HCV RNA test results

Source: microbiolspec July 2016 vol. 4 no. 4 doi:10.1128/microbiolspec.DMIH2-0025-2015

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