Viral hepatitis in practice - 2013

Hepatitis B virus in young adults
Patrick Kennedy and Upkar Gill
pp 1-4
Chronic hepatitis B remains a global healthcare challenge. Despite the availability of a vaccine for almost 40 years, an estimated 350 million people are chronically infected worldwide and the complications of persistent infection, namely cirrhosis and hepatocellular carcinoma, account for roughly one million deaths per year.
Comment: B is not for boring!
Alastair Miller
pp 3-3
In this issue of Viral hepatitis in practice, Patrick Kennedy and Upkar Gill remind us that not all is settled in the management of chronic hepatitis B virus (HBV) infection. The traditional approach to the natural history of HBV infection (with its neat division into the immune tolerant, immune active/clearance, low replicative and reactivation phases) is being challenged, with intriguing new findings from Patrick’s group at the Blizard Institute, Barts and the London School of Medicine and Dentistry (and other groups) showing that young adults infected with chronic hepatitis B demonstrate clear evidence of immune activation.
Supporting patients through therapy in a community setting
Jan Kunkel, Heather Lewis, Graham R Foster and Mandie Wilkinson
pp 5-7
Recent drug developments in chronic hepatitis B and C have made more patients eligible for treatment. At the same time, cost-cutting tendencies, in the face of the global economic crisis, have put pressure on healthcare systems and there is a need for cost-effective solutions. The discussion about delegating treatment to community settings has only just begun and, currently, there is no UK national, let alone international, consensus. This article aims to summarise the development, current state of the art and remaining challenges of viral hepatitis therapy in a community setting.
Resistance testing in hepatitis C virus infection – an overview
Patricia Cane
pp 8-10
The treatment of patients with chronic hepatitis C virus (HCV) infection is being revolutionised with the recent development of direct-acting antivirals. Experience with HIV and hepatitis B virus suggests that significant resistance to the new drugs can be expected in some situations. Two drugs, boceprevir and telaprevir, have recently been licensed for use in HCV genotype 1 - infected patients. Both these drugs target the NS3 protease, and further protease inhibitors are in development.
FAQs: When should I test for hepatitis E virus?
Theresa Hydes and Kathryn Nash
pp 10-10
The epidemiology of hepatitis E virus (HEV) has evolved recently, with an increase in sporadic cases in developed countries, including Europe and North America, where genotype 3 predominates. Infection may be zoonotic and consumption of undercooked pork or game has been identified as a risk factor. Anti-HEV immunoglobulin (Ig) is detected at symptom onset and disappears within six months; IgG appears around Day 10 and persists for years.
Stephen D Ryder, Charles Gore
pp 11-11
An update on the activities of HCV Action and The Hepatitis Trust

Viral hepatitis in practice was previously supported by Gilead Sciences from 2015 to 2016, by Gilead Sciences and Janssen in 2014, by Gilead Sciences and Roche Products in 2013 and by Gilead Sciences from 2009 to 2012.

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ISSN 2041-1162 (Print)  ISSN 2045-7863 (Online)