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Hepatitis B virus kinetics under antiviral therapy sheds light on differences in hepatitis B e antigen positive and negative infections.

TitleHepatitis B virus kinetics under antiviral therapy sheds light on differences in hepatitis B e antigen positive and negative infections.
Publication TypeJournal Article
Year of Publication2010
AuthorsRibeiro, R. M., Germanidis G., Powers K. A., Pellegrin B., Nikolaidis P., Perelson A. S., & Pawlotsky J-M.
JournalJ Infect Dis
Volume202
Issue9
Pagination1309-18
Date Published2010 Nov 1
ISSN1537-6613
KeywordsAdult, Animals, Antiviral Agents, DNA, Viral, Hepatitis B e Antigens, Hepatitis B virus, Hepatitis B, Chronic, Humans, Male, Middle Aged, Viral Load
Abstract

BACKGROUND: Hepatitis B e antigen (HBeAg)–negative chronic hepatitis B infection has a presentation and clinical course that is divergent from that of HBeAg‐positive infection. The former usually presents with lower viral levels but faster progression to liver disease. We sought to better understand the balance between replication and the immune response against hepatitis B virus (HBV).METHODS: Viral kinetics in 50 HBeAg‐negative patients under various treatment protocols with interferon α and/or nucleoside or nucleotide analogs was analyzed. HBV DNA level was measured frequently and the data fitted to a viral dynamic model. A meta‐analysis of all published studies of viral kinetics in HBeAg‐positive and HBeAg‐negative infection was also conducted.RESULTS: We found that the clearance of both HBV virions and infected cells was significantly faster in HBeAg‐negative infection than in HBeAg‐positive infection. In HBeAg‐negative infection, there was also a negative correlation between baseline HBV DNA levels and infected cell half‐life, suggesting that the higher the viral load the faster the turnover of infected cells.CONCLUSIONS: These results reveal the dual role played by the immune response in maintaining lower viral levels and inducing faster turnover of infected cells, the latter of which may be responsible for the more aggressive nature of HBeAg‐negative infection.

DOI10.1086/656528
Alternate JournalJ. Infect. Dis.
PubMed ID20874517
PubMed Central IDPMC3058754
Grant ListAI28433‐19 / AI / NIAID NIH HHS / United States
P20 RR018754 / RR / NCRR NIH HHS / United States
P20‐RR18754 / RR / NCRR NIH HHS / United States
R01 AI028433 / AI / NIAID NIH HHS / United States
R01 OD011095 / OD / NIH HHS / United States
R01 RR006555 / RR / NCRR NIH HHS / United States
R37 AI028433 / AI / NIAID NIH HHS / United States
RR06555‐18 / RR / NCRR NIH HHS / United States

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