2567
Views & Citations1567
Likes & Shares
Hepatitis B virus (HBV) is a common cause of liver disease 9
cirrhosis, liver failure and hepatocellular carcinoma {HCC}) throughout the
world. The virus is transmitted through blood and other body fluids. Maximum
cases are diagnosed are during screening process of operative procedure,
foreign travel, etc., and are asymptomatic. These asymptomatic cases act as
reservoir of transmission of infection in the population. Many studies had been
conducted on various stages of the infection (acute, chronic, immunotolerant
phase, etc.) and HBV DNA levels. Most of the patients resolve the infection
when infected in the earlier or childhood stage of life. This stage is called
as acute stage. The patient may or may not develop significant symptoms. Those
who do not resolve within six months are chronic patients evidenced with the
presence of HBcIgG (IgG Hepatitis B core Ag) in there serum. The chronic phase
is the most important stage to be taken care of. The patients HBV DNA level and
other antigens-antibody against HBV virus parts in serum are continuously monitored
after every interval of 3-6 months. Serum liver enzymes level is also
considered. HBeAg (Hepatitis B envelope antigen) was initially considered for
treatment as it is sign of active HBV replication but later it was found core
mutants had evolved as a survival mechanism which terminates the translation of
HBeAg. The HBV DNA level if >10,000 copies/ml is considered for treatment.
There are few cases reported with reactivation of chronic cases. HBV Genotypes
(8 genotypes and recently new genotypes had been reported) are also somewhere
responsible for deciding the fate of infection. Vaccination and screening
programmes had been launched in developed and developing countries .Much care
must also be taken for completion of doses of vaccination and development of
protective level of anti Hbs level (antibody to HbsAg) because many are
non-responders. There are various techniques to diagnose the HBV like
immunochromatography, enzyme linked immunoassay, chemilluminiscence,
conventional PCR, real time PCR. Every technique has their advantages and
disadvantage. The technique with best sensitivity and specificity is selected.
The molecular diagnostic is the best approach but not done practically since
requires expensive instrumentation, set up, technically skilled individual and
costly reagents. The virus has also evolved with HBsAg mutants thus detection
system fails to detect. Thus HBsAg and HBc total antibody should be detected. If
the patient is Hbc Total Ab positive it may be due past infection or due to
current infection and those with HbsAg negative but Hbc Total Ab positive
patients should be detected for HBV DNA by molecular diagnostics for final
confirmation.
QUICK LINKS
- SUBMIT MANUSCRIPT
- RECOMMEND THE JOURNAL
-
SUBSCRIBE FOR ALERTS
RELATED JOURNALS
- International Journal of AIDS (ISSN: 2644-3023)
- Journal of Immunology Research and Therapy (ISSN:2472-727X)
- International Journal of Anaesthesia and Research (ISSN:2641-399X)
- Journal of Spine Diseases
- International Journal of Clinical Case Studies and Reports (ISSN:2641-5771)
- Ophthalmology Clinics and Research (ISSN:2638-115X)
- Journal of Renal Transplantation Science (ISSN:2640-0847)