Antiviral therapy in acute viral hepatitis B: why and when

doi:10.1186/1750-9378-4-2

Infectious Agents and Cancer

Volume 4

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Perrella A
Sbreglia C
Bellopede P
Riccio V
Perrella O

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Letter to the Editor

Antiviral therapy in acute viral hepatitis B: why and when

Giuseppe Morelli¹ , Alessandro Perrella¹^,2 , Costanza Sbreglia¹ , Pasquale Bellopede¹ , Vincenzo Riccio¹ and Oreste Perrella¹

¹VII Department of Infectious Diseases and Immunology, "D. Cotugno" Hospital, Naples, Italy

²"Liver Unit," A. Cardarelli Hospital, Naples, Italy

author email corresponding author email

Infectious Agents and Cancer 2009, 4:2doi:10.1186/1750-9378-4-2


Published:	16 January 2009

Abstract

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.