Chapter 9 : Hepatitis B Virus Infection and Immunity

MyBook is a cheap paperback edition of the original book and will be sold at uniform, low price.

Preview this chapter:
Zoom in

Hepatitis B Virus Infection and Immunity, Page 1 of 2

| /docserver/preview/fulltext/10.1128/9781555818289/9781555811303_Chap09-1.gif /docserver/preview/fulltext/10.1128/9781555818289/9781555811303_Chap09-2.gif


Hepatitis B virus (HBV) infection is a major public health problem, there being approximately 300 million people infected worldwide, and is a major cause of chronic liver disease and hepatocellular carcinoma. The majority of adults infected have a transient, acute hepatitis from which they completely recover and clear the virus. Infection with HBV in adults usually results in an acute, self-limiting, inflammatory disease. It is likely that there are many different reasons why the chronic carrier state develops after adult infection, and the liver pathology in chronic disease is probably the result of a dynamic equilibrium between the replication of the virus and the host's immune response. HBV is not thought to be directly cytopathic; the liver damage in both the acute and the chronic disease is probably caused by the host immune response. Apoptosis is an active process involving autolysis of cells that are damaged or redundant. One of the crucial issues in HBV infection is identification of the factors which determine the outcome of infection. A number of groups have looked for HBV disease associations with MHC class II, and the results are summarized this chapter. HBsAg vaccines are now in widespread use throughout the world. When these vaccines are used to prevent neonatal transmission from HBeAg-positive infected mothers, the best protection is achieved when given with hyperimmune globulin. Important developments in control of replication by antiviral agents and/or modulation of the immune response are needed, along with improvements in the vaccine and the level of delivery.

Citation: Waters J, Foster G, Thursz M, Thomas H. 1998. Hepatitis B Virus Infection and Immunity, p 283-299. In McCance D (ed), Human Tumor Viruses. ASM Press, Washington, DC. doi: 10.1128/9781555818289.ch9
Highlighted Text: Show | Hide
Loading full text...

Full text loading...


Image of Figure 1
Figure 1

HBV. The virion is a 45-nm enveloped virus. Excess envelope protein is found in the serum as 22-nm lipoprotein particles. HBeAg is secreted by the infected cell as a soluble antigen.

Citation: Waters J, Foster G, Thursz M, Thomas H. 1998. Hepatitis B Virus Infection and Immunity, p 283-299. In McCance D (ed), Human Tumor Viruses. ASM Press, Washington, DC. doi: 10.1128/9781555818289.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 2
Figure 2

The natural history of acute HBV infection. HBsAg and HBeAg can be detected early in the serum, prior to the onset of clinical hepatitis. Antibody to preS1 can sometimes be detected during this early phase. AST (aspartate aminotransferase) is an indication of lysis of infected hepatocytes.

Citation: Waters J, Foster G, Thursz M, Thomas H. 1998. Hepatitis B Virus Infection and Immunity, p 283-299. In McCance D (ed), Human Tumor Viruses. ASM Press, Washington, DC. doi: 10.1128/9781555818289.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint
Image of Figure 3
Figure 3

Natural history of persistent HBV infection after neonatal or adult exposure. During conversion from HBe antigenemia to the presence of anti-HBe, viremia ceases. The hepatitis associated with this seroconversion is the result of immune lysis of hepatocytes supporting HBV replication. This immune pressure may select an HBe-negative strain of HBV which causes viremia in the absence of HBeAg. AST, aspartate aminotransferase (an indication of lysis of hepatocytes).

Citation: Waters J, Foster G, Thursz M, Thomas H. 1998. Hepatitis B Virus Infection and Immunity, p 283-299. In McCance D (ed), Human Tumor Viruses. ASM Press, Washington, DC. doi: 10.1128/9781555818289.ch9
Permissions and Reprints Request Permissions
Download as Powerpoint


1. Akbar, S. M. F.,, M. Onji,, K. Inaba,, K. Yamamura,, and Y. Ohta. 1993. Low responsiveness of hepatitis B virus-transgenic mice in antibody response to T-cell-dependent antigen: defect in antigen presenting activity of dendritic cell. Immunology 78: 468 475.
2. Almarri, A.,, and J. R. Batchelor. 1994. HLA and infection. Lancet 344: 1194 1195.
3. Ando, K.,, L. G. Guidotti,, S. Wirth,, T. Ishikawa,, G. Missale,, T. Moriyama,, R. D. Schreiber,, H.-J. Schlict,, S. Huang,, and F. V. Chisari. 1994. Class I restricted cytotoxic T lymphocytes are directly cytopathic for their target cells in vivo. J. Immunol. 152: 3245 3255.
4. Ashton-Rickardt, P. G.,, and K. Murray. 1989. Mutants of the hepatitis B virus surface antigen that define some antigenically essential residues in the immunodominant a region. J. Med. Virol. 29: 196 203.
5. Askonas, B. A., 1994. Immunopathology and virus infections, p. 1 9. In H. C. Thomas, and J. A. Waters (ed.), Immunology of Liver Disease, vol. 21. Immunology and Medicine. Kluwer Academic Publishers, Dordrecht, The Netherlands.
6. Beasley, R. P.,, and L. Hwang. 1983. Postnatal infectivity of hepatitis B surface antigen-carrier mothers. J. Infect. Dis. 147: 185 190.
7. Bertoletti, A.,, A. Sette,, F. V. Chisari,, A. Penna,, M. Levrero,, M. De Carli,, F. Fiaccadori,, and C. Ferrari. 1994. Natural variants of cytotoxic epitopes are T-cell receptor antagonists for antiviral cytotoxic T cells. Nature 369: 407 410.
8. Blackman, M.,, and A. Morris. 1985. The effect of interferon treatment of targets on susceptibility to cytotoxic T cell killing: augmentation of allogeneic killing and virus specific killing relative to virus antigen expression. Immunology 56: 451 457.
9. Brook, M. G.,, G. Chan,, I. Yap,, P. Karayiannis,, A. M. Leuer,, H. Jacyna,, J. Main,, and H. C. Thomas. 1989. Randomised controlled trial of lymphoblastoid interferon alpha in Europid men with chronic hepatitis B infection. Br. Med. J. 299: 652 656.
10. Carman, W. F.,, M. R. Jacyna,, S. Hadziyannis,, P. Karayiannis,, M. J. McGarvey,, A. Makris,, and H. C. Thomas. 1989. Mutation preventing formation of hepatitis B e antigen in patients with chronic hepatitis B infection. Lancet ii: 588 591.
11. Carman, W. F.,, A. R. Zanetti,, P. Karayiannis,, J. Waters,, G. Manzillo,, E. Tanzi,, A. J. Zuckerman,, and H. C. Thomas. 1990. Vaccine-induced escape mutant of hepatitis B virus. Lancet 326: 325 329.
12. Dudley, F. J.,, R. A. Fox,, and S. Sherlock. 1972. Cellular immunity and hepatitis associated (Australia antigen) liver disease. Lancet i: 723 725.
13. Dreesman, G. R.,, F. B. Hollinger,, R. M. McCombs,, and J. L. Melnick. 1973. Alteration of hepatitis B antigen (HBAg) determinants by reduction and alkylation. J. Gen. Virol. 19: 129 134.
14. Ehata, T.,, M. Omata,, O. Yokosuka,, K. Hosoda,, and M. Ohto. 1992. Variations in codons 84-101 in the core nucleotide sequence correlate with hepatocellular injury in chronic hepatitis B virus infection. J. Clin. Invest. 89: 332 338.
15. Ferrari, C.,, A. Bertoletti,, A. Penna,, A. Cavalli,, A. Valli,, G. Missale,, M. Pilli,, P. Fowler,, T. Gluberti,, F. V. Chisari,, and F. Fiaccadori. 1991. Identification of immunodominant T cell epitopes of the hepatitis B virus nucleocapsid antigen. J. Clin. Invest. 88: 214 222.
16. Ferrari, C.,, A. Penna,, A. Bertoletti,, A. Valli,, A. D. Antoni,, T. Guiberti,, A. Cavalli,, M.-A. Petit,, and F. Fiaccadori. 1990. Cellular immune response to hepatitis B virus-encoded antigens in acute and chronic hepatitis B virus infection. J. Immunol. 145: 3442 3449.
17. Foster, G.,, M. Jacyna,, and H. Thomas,. 1994. Interferon treatment of hepatitis, p. 145 150. In G. Griffon (ed.), Cytokines in Infection. Baillieres, London.
18. Gilles, P. N.,, G. Fey,, and F. V. Chisari. 1992. Tumor necrosis factor-alpha negatively regulates hepatitis B virus gene expression in transgenic mice. J. Virol. 66: 3955 3960.
19. Greenfield, C.,, P. Karayiannis,, B. M. Wankya,, M. V. Shah,, P. Tukei,, S. Galpin,, T. P. Jowett,, and H. C. Thomas. 1984. Aetiology of acute sporadic hepatitis in adults in Kenya. J. Med. Virol. 14: 357 362.
20. Guidotti, L. G.,, S. Guilhot,, and F. V. Chisari. 1994. Interleukin 2 and interferon alpha/beta down-regulate hepatitis B virus gene expression in vivo by tumor necrosis factor-dependent and independent pathways. J. Virol. 68: 1265 1270.
21. Guidotti, L. G.,, B. Matzke,, C. Pasquinelli,, J. M. Shoenberger,, C. Rogler,, and F. V. Chisari. 1996. The hepatitis B virus (HBV) precore protein inhibits HBV replication in transgenic mice. J. Virol. 70: 7056 7061.
22. Hadziyannis, S. J. 1995. Hepatitis B e antigen negative chronic hepatitis B: from clinical recognition to pathogenesis and treatment. Viral Hepatitis Rev. 1: 7 36.
23. Hadziyannis, S. J.,, H. M. Lieberman,, G. G. Karvountzis,, and D. Shafritz. 1983. Analysis of liver disease, nuclear HBsAg, viral replication, and hepatitis B virus DNA in liver and serum of HBeAg vs. anti-HBe positive carriers of hepatitis B virus. Hepatology 3: 656 662.
24. Harris, H.,, and T. Gill. 1986. Expression of class I transplantation antigens. Transplantation 42: 109 117.
25. Harrison, T. J.,, C.-J. Oon,, and A. J. Zuckerman,. 1994. A novel antibody escape variant (Ala 144) of hepatitis B virus in an identical twin before selection in the mother, p. 248 251. In K. Nishioka,, H. Suzuki,, S. Mishiro,, and T. Oda (ed.), Viral Hepatitis and Liver Disease. Springer, Tokyo.
26. Hata, K.,, D. H. Van Theil,, R. B. Heberman,, and T. Whiteside. 1991. Natural killer activity of human liver-derived lymphocytes in various hepatic diseases. Hepatology 14: 495 503.
27. Hauptman, R.,, and P. Sweetly. 1985. A novel class of human Type I interferons. Nucleic Acids Res. 13: 4739 4749.
28. Hernandez-Frontera, E.,, and D. N. McMurray. 1993. Dietary vitamin D affects cell-mediated hypersensitivity but not resistance to experimental pulmonary tuberculosis in guinea pigs. Infect. Immun. 61: 2116 2121.
29. Hertogs, K.,, W. P. Leenders,, E. Depla,, W. C. C. De Bruin,, L. Meheus,, J. Raymackers,, H. Moshage,, and S. M. Yap. 1993. Endonexin II, present on human liver plasma membranes, is a specific binding protein of small hepatitis B virus (HBV) envelope protein. Virology 197: 549 557.
30. Hill, A. V. S.,, C. E. Allsopp,, D. Kwiatkowski,, N. Anstey,, P. Twumasi,, P. Rowe,, S. Bennett,, D. Brewster,, A. McMichael,, and B. Greenwood. 1991. Common West African HLA antigens are associated with protection from severe malaria. Nature 352: 595 600.
31. Hinshaw, V. S.,, C. W. Olsen,, N. Dybdahl-Sissoko,, and D. Evans. 1994. Apoptosis: a mechanism of cell killing by influenza A and B viruses. J. Virol. 69: 3667 3673.
32. Hiscott, J.,, K. Cantell,, and C. Weissman. 1984. Differential expression of human interferon genes. Nucleic Acids Res. 12: 3727 3746.
33. Hsu, H.-Y.,, M.-H., Chang,, K.-H. Hsieh,, C.-Y. Lee,, H.-H. Lee,, L.-H. Hwang,, P.-J. Chen,, and D.-S. Chen. 1992. Cellular immune response to HBcAg in mother-infant transmission of hepatitis B virus. Hepatology 15: 770 776.
34. Iwarson, S.,, E. Tabor,, H. C. Thomas,, A. Goodall,, J. Waters,, P. Snoy,, J. W.-K. Shih,, and R. C. Gerety. 1985. Neutralization of hepatitis B virus infectivity by a murine monoclonal antibody: an experimental study in the chimpanzee. J. Med. Virol. 16: 89 96.
34a.. Jeannet, M.,, and J. J. Farquet. 1974. HLA antigens in asymptomatic chronic HBsAg carriers. Lancet ii: 13831384..
35. Jung, M. C.,, H. M. Diepolder,, U. Spengler,, E. A. Wierenga,, R. Zachoval,, R. M. Hoffmann,, D. Eichenlaub,, G. Frosner,, H. Will,, and G. R. Pape. 1995. Activation of a heterogeneous hepatitis B (HB) core and e antigen-specific CD4+ T-cell population during seroconversion to anti-HBe and anti-HBs in hepatitis B virus infection. J. Virol. 69: 3358 3368.
36. Jung, M. C.,, U. Spengler,, W. Schraut,, R. Hoffman,, R. Zachoval,, J. Eisenburg,, D. Eichenlaub,, G. Riethmuller,, G. Paumgartner,, H. W. L. Zeigler-Heitbrock,, H. Will,, and G. R. Pape. 1991. Hepatitis B virus antigen-specific T-cell activation in patients with acute and chronic hepatitis B. J. Hepatol. 13: 310 317.
37. Karthigesu, V.,, L. M. C. Allison,, M. Fortuin,, M. Mendy,, H. C. Whittle,, and C. R. Howard. 1994. A novel hepatitis B virus variant in the sera of immunized children. J. Gen. Virol. 75: 443 448.
38. Kelly, A.,, S. Powis,, R. Glynne,, E. Radley,, S. Beck,, and J. Trowsdale. 1991. Second proteosome related gene in the human MHC class II region. Nature 353: 667 668.
39. Lamberts, C.,, M. Nassal,, I. Velhagen,, H. Zentgraf,, and C. H. Schroder. 1993. Precore-mediated inhibition of hepatitis B virus progeny DNA synthesis. J. Virol. 67: 3756 3762.
40. Lohr, H. F.,, G. Gerken,, H.-J. Schliet,, K. H. Meyer zumBuschenfelde,, and B. Fleischer. 1993. Low frequency of cytotoxic liver-infiltrating T lymphocytes specific for endogenous processed surface and core proteins in chronic hepatitis B. J. Infect. Dis. 168: 1133 1139.
41. Lok, A. 1993. Treatment of hepatitis B. J. Viral Hepatitis. 1: 91 102.
42. Mangold, C. M.,, F. Unckell,, M. Werr,, and R. Streck. 1995. Secretion and antigenicity of hepatitis B virus small envelope proteins lacking cysteines in the major antigenic region. Virology 211: 535 543.
43. Maruyama, T.,, S. lino,, K. Koike,, K. Yasuda,, and D. R. Milich. 1993. Serology of acute exacerbation in chronic hepatitis B virus infection. Gastroenterology 105: 1141 1151.
44. Maruyama, T.,, A. McLachlan,, S. lino,, K. Koike,, K. Kurokawa,, and D. R. Milich. 1993. The serology of chronic hepatitis B infection revisited. J. Clin. Invest. 91: 2586 2595.
45. McMahon, G.,, P. H. Ehlich,, Z. A. Moustafa,, L. A. McCarthy,, D. Dottovio,, M. D. Tolpin,, P. I. Nadler,, and L. Ostberg. 1992. Genetic alterations in the gene encoding the major HBsAg: DNA and immunological analysis of recurrent HBsAg derive from monoclonal antibody-treated liver transplant patients. Hepatology 15: 757 766.
46. Milich, D. R.,, J. Jones,, J. Hughes,, and T. Maruyama. 1993. Role of T-cell tolerance in the persistence of hepatitis B virus infection. J. Immunother. 14: 226 233.
47. Milich, D. R.,, A. McLachlan,, F. V. Chisari,, S. B. H. Kent,, and G. B. Thornton. 1986. Immune response to the pre-S(1) region of the hepatitis B surface antigen (HBsAg): a pre-S(1)-specific T cell response can bypass nonresponsiveness to the pre-S(2) and S regions of HBsAg. J. Immunol. 137: 315 322.
48. Montano, L.,, F. Aranguibel,, M. Boffil,, A. H. Goodall,, G. Janossy,, and H. C. Thomas. 1983. An analysis of the composition of the inflammatory infiltrate in autoimmune and hepatitis B virus induced chronic liver disease. Hepatology 3: 292 296.
49. Moriyama, T.,, S. Guilhot,, K. Klopchin,, B. Moss,, C. A. Pinkert,, R. D. Palmiter,, R. L. Brinster,, O. Kanagawa,, and F. V. Chisari. 1990. Immunobiology and pathogenesis of hepatocellular injury in hepatitis B virus transgenic mice. Science 248: 361 364.
50. Morrison, N. A.,, J. C. Qi,, A. Tokita,, P. J. Kelly,, L. Crofts,, T. V. Nguyen,, P. N. Sambrook,, and J. A. Eisman. 1994. Prediction of bone density from vitamin D receptor allelles. Nature 367: 284 287.
51. Munoz, L. A. 1987. Serum opsonic activity and polymorphonuclear cell function in patients with chronic liver disease. Ph.D. thesis. University of London, London.
52. Nainan, O. V.,, C. E. Stevens,, and H. S. Margolis,. 1996. Hepatitis B virus (HBV) antibody resistant mutants: frequency and significance, abstr. 98. In M. Rizzetto,, R. H. Purcell,, J. L. Gerin,, and G. Verme (ed.), IX Triennial International Symposium on Viral Hepatitis and Liver Disease, Rome, April, 1996. Edizioni Minerva Medica, Turin.
53. Nayersina, R.,, P. Fowler,, S. Guilhot,, G. Missale,, A. Cerny,, H.-J. Schlict,, A. Vitiello,, R. Chesnut,, J. L. Person,, A. G. Redeker,, and F. V. Chisari. 1993. HLA-A2 restricted cytotoxic T lymphocyte response to multiple hepatitis B surface antigen epitopes during hepatitis B virus infection. J. Immunol. 150: 4659 4671.
54. Neurath, A. R.,, S. B. H. Kent,, N. Strick,, and K. Parker. 1986. Identification and chemical synthesis of a host cell receptor binding site on hepatitis B virus. Cell 46: 429 436.
55. Ogata, N.,, R. H. Miller,, K. G. Ishak,, A. R. Zanetti,, and R. H. Purcell,. 1994. Genetic and biological characterisation of two hepatitis B virus variants: a precore mutant implicated in fulminant hepatitis and a surface mutant resistant to immunoprophylaxis, p. 238 242. In K. Nishioka,, H. Suzuki,, S. Mishiro,, and T. Oda (ed.), Viral Hepatitis and Liver Disease. Springer, Tokyo.
56. Oon, C.-J.,, G.-K. Lim,, Z. Ye,, K.-T. Goh,, K.-L. Tan,, S.-L. Yo,, E. Hopes,, T. Harrison,, and A. J. Zuckerman. 1995. Molecular epidemiology of hepatitis B virus vaccine variants in Singapore. Vaccine 13: 699 702.
57. Ortaldo, J. R.,, B. Hebermann,, C. Harvey,, P. Osheroff,, Y.-C. E. Pan,, B. Kelder,, and S. Petska. 1984. A species of human interferon that lacks the ability to boost natural killer cell activity. Proc. Natl. Acad. Sci. USA 81: 4926 4929.
58. Ou, J.-H.,, O. Lamb,, and W. J. Rutter. 1986. Hepatitis B virus gene function: the precore region targets the core antigen to cellular membranes and causes the secretion of the e antigen. Proc. Natl. Acad. Sci. USA 83: 1578 1582.
58a.. Patterson, M. J.,, M. R. Hourani,, and G. H. Mayor. 1977. HLA antigens and hepatitis B. N. Engl. J. Med. 297: 1124.
59. Penna, A.,, F. V. Chisari,, A. Bertoletti,, G. Missale,, P. Fowler,, T. Giuberti,, F. Fiaccadori,, and C. Ferrari. 1991. Cytotoxic T lymphocytes recognise an HLA-A2 restricted epitope within the hepatitis B virus nucleocapsid antigen. J. Exp. Med. 174: 1565 1570.
60. Pestka, S.,, J. Langer,, K. Zoon,, and C. Samuel. 1987. Interferons and their actions. Annu. Rev. Biochem. 56: 727 777.
61. Pignatelli, M.,, J. Waters,, D. Brown,, A. Lever,, S. Iwarson,, Z. Schaff,, R. Gerety,, and H. C. Thomas. 1986. HLA class I antigens on the hepatocyte membrane during recovery from acute hepatitis B virus infection and during interferon therapy in chronic hepatitis B virus infection. Hepatology 6: 349 353.
62. Rehermann, B.,, C. Ferrari,, C. Pasquinelli,, and F. V. Chisari. 1996. The hepatitis B virus persists for decades after patients' recovery from acute viral hepatitis despite active maintenance of a cytotoxic T-lymphocyte response. Nat. Med. 2: 1104 1108.
63. Rehermann, B.,, P. Fowler,, J. Sidney,, J. Person,, A. Redeker,, M. Brown,, B. Moss,, A. Sette,, and F. V. Chisari. 1995. The cytotoxic T lymphocyte response to multiple hepatitis B virus polymerase epitopes during and after acute viral hepatitis. J. Exp. Med. 181: 1047 1058.
64. Rehermann, B.,, D. Lau,, J. H. Hoofnagle,, and F. V. Chisari. 1996. Cytotoxic T lymphocyte responsiveness after resolution of chronic hepatitis B virus infection. J. Clin. Invest. 97: 1655 1665.
65. Rhodes, J.,, J. Ivanyi,, and P. Cozens. 1986. Antigen presentation by human monocytes: effects of modifying major histocompatibility complex class II antigen expression and interleukin I production using recombinant interferons and corticosteroids. Eur. J. Immunol. 16: 370 375.
66. Rook, G. A.,, J. Taverne,, C. Leveton,, and J. Steele. 1987. The role of gamma-interferon, vitamin D3 metabolites and tumour necrosis factor in the pathogenesis of tuberculosis. Immunology 62: 229 234.
67. Salfeld, J.,, E. Pfaff,, M. Noah,, and H. Schaller. 1989. Antigenic determinants and functional domains in core antigen and e antigen from hepatitis B virus. J. Virol. 63: 798 808.
68. Scaglioni, P. P.,, M. Melegari,, and J. R. Wands. 1997. Posttranscriptional regulation of hepatitis B virus replication by the precore protein. J. Virol. 71: 345 353.
69. Stellar, H. 1995. Mechanisms and genes of cellular suicide. Science 267: 1445 1449.
70. Stevens, C. E.,, R. P. Beasley,, and J. W. C. Tsu. 1975. Vertical transmission of hepatitis B antigen in Taiwan. N. Engl. J. Med. 292: 771 780.
71. Sumiya, M.,, M. Super,, P. Tabona,, R. J. Levinski,, T. Arai,, M. W. Turner,, and J. A. Summerfield. 1992. Molecular basis of opsonic defect in immunodeficient children. Lancet 337: 1569 1570.
72. Summerfield, J. A.,, S. Ryder,, M. Sumiya,, M. R. Thusz,, A. Gorchein,, M. A. Monteil,, and M. W. Turner. 1995. Mannose binding protein gene mutations associated with unusual and severe infections in adults. Lancet 345: 886 889.
73. Szmuness, W.,, C. Stevens,, E. Harley,, M. S. E. Zang,, W. R. Oleszko,, D. C. William,, R. Sadovsky,, J. Morrison,, and A. Kellner. 1980. Hepatitis B vaccine. Demonstration of efficacy in a controlled clinical trial in a high-risk population. N. Engl. J. Med. 303: 833 841.
74. Takizawa, T.,, R. Fukuda,, T. Miyawaki,, K. Ohashi,, and Y. Nakanishi. 1995. Activation of the apoptotic FAS antigen encoding gene upon influenza virus infection involving spontaneously produced interferon beta. Virology 209: 288 296.
75. Thomas, H. C.,, G. R. Foster,, M. Sumiya,, D. Mcintosh,, M. W. Turner,, and J. A. Summerfield. A mannose binding protein gene mutation is associated with hepatitis B viral infections. Lancet 348: 1417 1419.
76. Thursz, M.,, D. Kwiatkowski,, C. E. M. Allsopp,, B. M. Greenwood,, H. C. Thomas,, and A. V. S. Hill. 1995. Association between an MHC class II allele and clearance of hepatitis B virus in the Gambia. N. Engl. J. Med. 332: 1065 1069.
77. Trowsdale, J.,, I. Hanson,, I. Mockbridge,, S. Beck,, A. Townsend,, and A. Kelly. 1990. Sequences encoded in the class II region of the MHC relate to the ABC family of transporters. Nature 348: 741 744.
78. Tsai, S. L.,, P. J. Chen,, M. Y. Lai,, P. M. Yang,, J. L. Sung,, J. H. Huang,, L. H. Hwang,, T. H. Chang,, and D. S. Chen. 1992. Acute exacerbations of chronic type B hepatitis are accompanied by increased T cell responses to hepatitis B core and e antigens. J. Clin. Invest. 89: 87 96.
79. Van Hattum, J.,, G. M. Schreuder,, and S. W. Schalm. 1987. HLA antigens in patients with various courses after hepatitis B virus infection. Hepatology 7: 11 14.
80. Van Hecke, E.,, J. Paradijs,, C. Molitor,, C. Bastin,, P. Pala,, M. Slaoui,, and G. Leroux-Roels. 1994. Hepatitis B virus-specific cytotoxic T lymphocyte responses in patients with acute and chronic hepatitis B virus infection. J. Hepatol. 20: 514 523.
81. von Hoegan, P. 1995. Synergistic role of type I interferons in the induction of protective cytotoxic T lymphocytes. Immunol. Lett. 47: 157 162.
82. Waters, J. A.,, S. E. Brown,, M. W. Steward,, C. R. Howard,, and H. C. Thomas. 1992. Analysis of the antigenic epitopes of hepatitis B surface antigen involved in the induction of a protective antibody response. Virus Res. 221: 1 12.
83. Waters, J. A.,, M. Kennedy,, P. Voet,, P. Hauser,, J. Petre,, W. F. Carman,, and H. C. Thomas. 1992. Loss of the common 'a' determinant of hepatitis B surface antigen by a vaccine-induced escape mutant. J. Clin. Invest. 90: 2543 2547.
84. Waters, J. A.,, S. M. O'Rourke,, S. C. Richardson,, G. Papaevangelou,, and H. C. Thomas. 1987. Qualitative analysis of the humoral immune response to the 'a' determinant of HBs antigen after inoculation with plasma derived or recombinant vaccine. J. Med. Virol. 21: 155 160.
85. Waters, J. A.,, S. O'Rourke,, H.-J. Schlict,, and H. C. Thomas. 1995. Cytotoxic T cell responses in patients with chronic hepatitis B virus infection undergoing HBe antigen/antibody seroconversion. Clin. Exp. Immunol. 102: 314 319.
86. Wilson, A. G.,, N. deVries,, F. Pociot,, F. S. di Giovine,, L. B. A. van der Putte,, and G. W. Duff. 1993. An allelic polymorphism within the tumour necrosis alpha promoter region is strongly associated with HLA Al, B8,DR3 alleles. J. Exp. Med. 177: 557 559.
87. Yamamoto, K.,, M. Horikita,, F. Tsuda,, K. Itoh,, Y. Akhane,, S. Yotsumoto,, H. Okamoto,, and Y. Miyakawa. 1994. Naturally occurring escape mutants of hepatitis B virus with various mutations in the S gene in carriers seropositive for antibody to hepatitis B surface antigen. J. Virol. 68: 2671 2676.
88. Yoo, Y.,, B. Gavaler,, K. Chen,, T. L. Whiteside,, and D. H. van Thiel. 1990. The effect of recombinant interferon alfa on lymphocyte subpopulations and HLA DR expression on liver tissue of HBV positive individuals. Clin. Exp. Immunol. 82: 338 343.


Generic image for table
Table 1

MHC class II and HBsAg persistence

Citation: Waters J, Foster G, Thursz M, Thomas H. 1998. Hepatitis B Virus Infection and Immunity, p 283-299. In McCance D (ed), Human Tumor Viruses. ASM Press, Washington, DC. doi: 10.1128/9781555818289.ch9

This is a required field
Please enter a valid email address
Please check the format of the address you have entered.
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error