Letter to the Editor
Antiviral therapy in acute viral hepatitis B: why and when
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* Corresponding author: Alessandro Perrella alexperrel@virgilio.it
1 VII Department of Infectious Diseases and Immunology, "D. Cotugno" Hospital, Naples, Italy
2 "Liver Unit," A. Cardarelli Hospital, Naples, Italy
Infectious Agents and Cancer 2009, 4:2 doi:10.1186/1750-9378-4-2
Published: 16 January 2009Abstract
Acute viral hepatitis B is cleared in more than 95% of patients, while the remainder ones may develop either chronic HBV infection or, rarely, fulminant hepatitis.
Therefore there are elderly patients with severe acute HBV hepatitis caractherized by high serum bilirubin levels >15 mmole/dl, international normalized ratio (INR) with value more than 1.6; these patients are caractherized by a severe outcome of HBV infection.
As known, outcome of infection and the pathogenesis of liver diseases are determined by viral and host factors, such as T reg lymphocytes.
T regs may be associated with a negative immune response such as an inhibition of gamma- IFN secretion.
The impact of viral load on antiviral T cell responses may play a critical role in thaese patients, influencing disease persistence and immune response.
Antiviral drugs could be useful in these patients determing a possible down -regulation of T regs.