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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, [email protected]
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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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2016-07-22
2020-08-10

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

Chronic Hepatitis B, C, and D
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Citation: Cobb B, Valsamakis A. 2016. Chronic hepatitis b, c, and d. microbiolspec 4(4): doi:10.1128/microbiolspec.DMIH2-0025-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.fig1
FIGURE 1
Key HBV virion components.
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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 ).
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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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FIGURE 3
HBV exacerbation/reactivation risk associated with pharmacologic immunosuppression ( 37 , 44 , 52 , 189 – 208 ).
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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 ).
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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 ).
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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 ).
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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 ).
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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

Chronic Hepatitis B, C, and D
[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-1,webId=/content/author/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-1,properties={foaf_givenname=Bryan R., foaf_name=Bryan R. Cobb, foaf_surname=Cobb, pub_isAffiliatedWith=[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/affiliation/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-aff1]]}], com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/author/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-2,webId=/content/author/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-2,properties={foaf_givenname=Alexandra, foaf_name=Alexandra Valsamakis, foaf_surname=Valsamakis, pub_isAffiliatedWith=[com.pub2web.rdf.cci.facet.ContentItem[id=http://asm.metastore.ingenta.com/content/affiliation/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015-aff2]]}]]
Citation: Cobb B, Valsamakis A. 2016. Chronic hepatitis b, c, and d. microbiolspec 4(4): doi:10.1128/microbiolspec.DMIH2-0025-2015
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T1
TABLE 1
Characteristics of hepatitis B (HBV), C (HCV), and D (HDV) viruses
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T2
TABLE 2
Serologic markers of hepatitis B virus infection
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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
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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
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T5
TABLE 5
HBV genotype distribution worldwide
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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
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T7
TABLE 7
HBV-infected individuals at risk of HBV reactivation/exacerbation after pharmacologic immunosuppression and associated laboratory results during reactivation/exacerbation
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T8
TABLE 8
Testing for hepatitis C virus: types of assays (specimens), indications, result interpretations
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T9
TABLE 9
FDA-approved DAA-containing therapies for HCV
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T10
TABLE 10
Definitions used in assessing quantitative HCV RNA test results
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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
/content/microbiolspec/10.1128/microbiolspec.DMIH2-0025-2015.T11
TABLE 11
Interpretations of quantitative HCV RNA test results
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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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