Acute hepatitis B or exacerbation of chronic hepatitis B-that is the question

[Guest guest]

http://www.wjgnet.com/1007-9327/abstract_en.asp?f=7133 & v=14

Acute hepatitis B or exacerbation of chronic hepatitis B-that is the question

Orenbuch-Harroch E, Levy L, Ben-Chetrit E.

Department of Medicine A, Hadassah-Hebrew University, Medical Center, PO Box

12000, Jerusalem 91120, Israel. eldad@...

Hepatitis B virus (HBV) infection constitutes a serious global health problem.

In countries with intermediate or high endemicity for HBV, exacerbations of

chronic hepatitis B may be the first presentation of HBV infection. Some of

these patients may be diagnosed mistakenly as having acute hepatitis B. Accurate

diagnosis in these cases is very important for deciding whether to start

treatment or not, because acute hepatitis B does not require therapy, while

exacerbation of chronic hepatitis may benefit from it. Clinical and routine

laboratory findings cannot help distinguishing between these two conditions.

Therefore, several assays have been proposed for this purpose during the last

few years. The presence of high levels of anti-HBe antibodies, HBsAg and HBV DNA

are typical of chronic disease, whereas high titers of IgM anti-HBc, together

with their high avidity index, characterize acute HBV infection. Starting from

the description of a patient with acute hepatitis B-who recently came to our

observation-we critically review the currently available assays that may help

distinguishing between the different conditions and lead to the optimal

management of each patient.

[Guest guest]

http://www.wjgnet.com/1007-9327/abstract_en.asp?f=7133 & v=14

Acute hepatitis B or exacerbation of chronic hepatitis B-that is the question

Orenbuch-Harroch E, Levy L, Ben-Chetrit E.

Department of Medicine A, Hadassah-Hebrew University, Medical Center, PO Box

12000, Jerusalem 91120, Israel. eldad@...

Hepatitis B virus (HBV) infection constitutes a serious global health problem.

In countries with intermediate or high endemicity for HBV, exacerbations of

chronic hepatitis B may be the first presentation of HBV infection. Some of

these patients may be diagnosed mistakenly as having acute hepatitis B. Accurate

diagnosis in these cases is very important for deciding whether to start

treatment or not, because acute hepatitis B does not require therapy, while

exacerbation of chronic hepatitis may benefit from it. Clinical and routine

laboratory findings cannot help distinguishing between these two conditions.

Therefore, several assays have been proposed for this purpose during the last

few years. The presence of high levels of anti-HBe antibodies, HBsAg and HBV DNA

are typical of chronic disease, whereas high titers of IgM anti-HBc, together

with their high avidity index, characterize acute HBV infection. Starting from

the description of a patient with acute hepatitis B-who recently came to our

observation-we critically review the currently available assays that may help

distinguishing between the different conditions and lead to the optimal

management of each patient.