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Causes of acute exacerbations of chronic hepatitis B.
- Source :
-
Sbornik lekarsky [Sb Lek] 1995; Vol. 96 (2), pp. 75-83. - Publication Year :
- 1995
-
Abstract
- The authors analyzed acute exacerbations of chronic hepatitis B in 24 chronic HBsAg carriers (20 with positive HBeAg, 4 with anti-HBe), more than half of whom were treated with glucocorticoids, by examining specific antigens and antibodies of the hepatitis A virus (HAV), hepatitis B virus (HBV), hepatitis delta virus (HDV), Epstein-Barr virus (EBV) and cytomegalovirus (CMV). Of 38 observed exacerbations of the disease they found in 7 (18%) deterioration after discontinuation of glucocorticoids, in 7 (18%) seroconversion of HBeAg to anti-HBe, in 9 (24%) spontaneous exacerbation of chronic hepatitis B, in 11 (29%) chronic activation, reactivation of EBV superinfection, in 3 (8%) CMV reactivation or superinfection and in one (3%) HDV superinfection. In no instance HAV superinfection was observed. Exacerbations were found five times more frequently in subjects in the stage of active viral replication (in HBeAg+ subjects) than in subjects with anti-HBe. In eight patients EBV reactivation was found after glucocorticoids withdrawal: in five patients after an average period of 5 months (range 3-7) and in three patients after an average period of 33 months (range 22-48). The results provide evidence that in addition to already known causes of acute exacerbations of chronic hepatitis B in our geographical area probably an important cause of deterioration of hepatitis is reactivation or superinfection with EBV and CMV in some patients in conjunction with previous glucocorticoid treatment.
- Subjects :
- Acute Disease
Adolescent
Adult
Aged
Antibodies, Viral analysis
Chronic Disease
Cytomegalovirus immunology
Female
Hepatitis Antibodies analysis
Hepatitis B Surface Antigens analysis
Hepatitis C immunology
Hepatitis C virology
Herpesvirus 4, Human immunology
Humans
Male
Middle Aged
Hepatitis C physiopathology
Subjects
Details
- Language :
- English
- ISSN :
- 0036-5327
- Volume :
- 96
- Issue :
- 2
- Database :
- MEDLINE
- Journal :
- Sbornik lekarsky
- Publication Type :
- Academic Journal
- Accession number :
- 8718791