Viral Hepatitis B and D

  • S. Gupta
  • D. A. Shafritz

Abstract

Although mankind has suffered the ravages of hepatitis from biblical times, it is only in the past three decades that we have begun to understand the nature of the viruses which infect the liver. We can now confidently talk of at least five viruses designated as hepatitis viruses (А, B, С or post-transfusion non-A non-B, D or delta, and E or water-borne epidemic non-A non-B). All cause acute hepatitis. Clinical manifestations alone are insufficient to allow distinction of one virus from another. However, an understanding of the biology and epidemiology of hepatitis viruses has greatly facilitated diagnosis. Hepatitis D virus (HDV) is unique because it is defective and requires hepatitis B virus (HBV) to survive. Both HBV and HDV (as well as HCV) can persist long-term and cause chronic hepatitis, cirrhosis, and/or death. Therefore, recognition of the onset and resolution of HBV or HDV infection are equally important. Moreover, highly effective vaccines against HBV have been developed and means are at hand to prevent HBV altogether and consequently, HDV.

Keywords

Corticosteroid Pancreatitis Disulfide Neutropenia Meningitis 

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. 1.
    Blumberg BS, Alter HJ, Visnich S (1965) A “new” antigen in leukemia sera. JAMA 191:541–546PubMedGoogle Scholar
  2. 2.
    Ganem D, Varmus HE (1978) The molecular biology of the hepatitis B viruses. Annu Rev Biochem 56:651–693CrossRefGoogle Scholar
  3. 3.
    Robinson WS, Lutwick LI (1987) The virus of hepatitis, type B. N Engl J Med 295:1168–1175, 1232–1236CrossRefGoogle Scholar
  4. 4.
    Tiollais P, Purcell C, Dejean A (1985) The hepatitis B virus. Nature 317:489–495PubMedCrossRefGoogle Scholar
  5. 5.
    Carman WF, Hadziyannis S, McGarvey MJ, Jacyna MR, Karayiannis P, Makris A, Thomas HC (1989) Mutation preventing formation of hepatitis B e antigen in patients with chronic hepatitis B infection. Lancet II:588–591CrossRefGoogle Scholar
  6. 6.
    Okamoto H, Yotsumoto S, Akahane Y et al. (1990) Hepatitis B viruses with precore region defects prevail in persistently infected hosts along with seroconversion to the antibody against e antigen. J Virol 64:1298–1303PubMedGoogle Scholar
  7. 7.
    Summers J, Mason WS (1982) Replication of the genome of a hepatitis B-like virus by reverse transcription of an RNA intermediate. Cell 29:403–415PubMedCrossRefGoogle Scholar
  8. 8.
    Yokosuka O, Omata M, Imazeki F, Ito Y, Okuda K (1986) Hepatitis B virus RNA transcripts and DNA in chronic liver disease. N Engl J Med 315:1187–1192PubMedCrossRefGoogle Scholar
  9. 9.
    Gerlich WH, Harman KH, Bruss V et al. (1989) Structure, expression, and potential oncogenicity of hepatitis B virus proteins. In: Bannasch P, Keppler D, Weber G (eds) Liver cell carcinoma, Kluwer Academic, Dordrecht, pp 139–163Google Scholar
  10. 10.
    Hadziyannis SJ, Gerber MA, Vissoulis C et al. (1973) Cytoplasmic hepatitis B antigen in “ground-glass” hepatocytes of carriers. Arch Pathol 96:327–330PubMedGoogle Scholar
  11. 11.
    Magnius LO, Epsmark JA (1972) New specificities in Australia antigen positive sera distinct from the Le Bouviert determinants. J Immunol 109:1017–1021PubMedGoogle Scholar
  12. 12.
    Moriarty AM, Alexander H, Lerner RA (1985) Antibodies to peptides detect new hepatitis B antigen: serological correlation with hepatocellular carcinoma. Science 227:429–433PubMedCrossRefGoogle Scholar
  13. 13.
    Tur-Kaspa R, Burk RD, Shaul Y, Shafritz DA (1986) Hepatitis B virus DNA contains a glucocorticoid responsive element. Proc Natl Acad Sci USA 83:1627–1631PubMedCrossRefGoogle Scholar
  14. 14.
    Twu, JR-S, Schloemer RH (1987) Transcriptional trans-activating function of hepatitis B virus. J Virol 61:3448–3453PubMedGoogle Scholar
  15. 15.
    Szmuness W (1978) Hepatocellular carcinoma and the hepatitis B virus: evidence for a causal association. Prog Med Virol 24:40–69PubMedGoogle Scholar
  16. 16.
    Beasley RP, Hwang LY (1984) Epidemiology of hepatocellular carcinoma. In: Vyas GN, Dienstag JL, Hoofnagle JH (eds) Viral hepatitis and liver disease. Grune and Stratton, New York, pp 209–225Google Scholar
  17. 17.
    McMahon BJ, Rhoades ER, Heyward WL et al. (1987) A comprehensive program to reduce the incidence of hepatitis B virus infection and its sequelae in Alaskan natives. Lancet II:1134–1136CrossRefGoogle Scholar
  18. 18.
    Gust ID (1984) The epidemiology of viral hepatitis. In: Vyas GN, Dienstag JL, Hoofnagle JH (eds) Viral hepatitis and liver disease. Grune and Stratton, New York, pp 415–421Google Scholar
  19. 19.
    Beasley RP, Trepo C, Stevens CE et al. (1977) The e antigen and vertical transmission of hepatitis B surface antigen. Am J Epidemiol 105:94–98PubMedGoogle Scholar
  20. 20.
    Lieberman HM, LaBrecque DR, Kew MC, Hadziyannis SJ, Shafritz DA (1983) Detection of hepatitis B virus DNA directly in human serum by a simplified molecular hybridization test: comparison to HBeAg/anti-HBe status in HBsAg carriers. Hepatology 3:285–291PubMedCrossRefGoogle Scholar
  21. 21.
    Chau KH, Hargie MP, Decker RH et al. (1983) Serodiagnosis of recent hepatitis B infection by IgM class anti-HBc. Hepatology 3:142–149PubMedCrossRefGoogle Scholar
  22. 22.
    Gupta S, Govindarajan S, Fong TL, Redeker AG (1990) Spontaneous reactivation in chronic type B hepatitis: patterns and natural history. J Clin Gastroenterol 12:562–568PubMedCrossRefGoogle Scholar
  23. 23.
    Alter HJ, Holland PV, Purcell RH (1975) The emerging patterns of posttransfusion hepatitis. Am J Med Sci 270:329–334PubMedCrossRefGoogle Scholar
  24. 24.
    Dunsford HA, Sell S, Chisari FV (1990) Hepatocarcinogenesis due to chronic liver cell injury in hepatitis B virus transgenic mice. Cancer Res 50:3400–3407PubMedGoogle Scholar
  25. 25.
    Milich DR, McLachlan A, Moriarty A, Thornton GB (1987) Immune response to hepatitis B virus core antigen (HBcAg): localization of T cell recognition sites within HBcAg/HBeAg. J Immunol 139:1223–1231PubMedGoogle Scholar
  26. 26.
    Shafritz DA, Hadziyannis SJ (1984) Hepatitis B virus DNA in liver and serum, viral antigens and antibodies, virus replication, and liver disease activity in patients with persistent hepatitis B virus infection. In: Chisari FV (ed) Advances in hepatitis research. Masson, New York, pp 80–90Google Scholar
  27. 27.
    Raimondo G, Burk RD, Lieberman HM et al. (1988) Interrupted replication of hepatitis D virus in liver tissue of HBsAg carriers with hepatocellular carcinoma. Virology 166:103–111PubMedCrossRefGoogle Scholar
  28. 28.
    Tanaka T, Miyamoto H, Hino O et al. (1988) Primary hepatocellular carcinoma with hepatitis B virus - DNA integration in a 4 year old boy. Hum Pathol 17:202–204CrossRefGoogle Scholar
  29. 29.
    Shafritz DA, Kew MC (1981) Identification of integrated hepatitis B virus DNA sequences in human hepatocellular carcinomas. Hepatology 1:1–8PubMedCrossRefGoogle Scholar
  30. 30.
    Fong TL, Govindarajan S, Valinluck B, Redeker AG (1988) Status of hepatitis B virus DNA in alcoholic liver disease: a study of a large urban population in the United States. Hepatology 8:1602–1604PubMedCrossRefGoogle Scholar
  31. 31.
    Dejean A, Bouguelert L, Grzeschik KH, Tiollais P (1986) Hepatitis B virus DNA integration in a sequence homologous to v-erb-A and steroid receptor genes in a hepatocellular carcinoma. Nature 322:70–72PubMedCrossRefGoogle Scholar
  32. 32.
    Wang J, Chenivesse X, Henglein B, Brechot C (1990) Hepatitis B virus integration in a cyclin A gene in a hepatocellular carcinoma. Nature 343:555–557PubMedCrossRefGoogle Scholar
  33. 33.
    Rogler CE, Hino O, Yang D, Shafritz DA (1989) Viral DNA integration, chromosome aberrations and growth factor activation in hepatocellular carcinomas of hepadnavirus carriers. In: Bannasch P, Keppler D, Weber G (eds) Liver cell carcinoma. Kluwer Academic, Dordrecht, pp 93–106Google Scholar
  34. 34.
    Seeff LB (1990) Diagnosis, therapy and prognosis of viral hepatitis. In: Zakim D, Boyer TD (eds) Hepatology. A textbook of liver disease. W.B. Saunders, Philadelphia, pp 958–1025Google Scholar
  35. 35.
    Peters RL (1975) Viral hepatitis: a pathologic spectrum. Am J Med Sci 270:17–31PubMedCrossRefGoogle Scholar
  36. 36.
    Boyer JL, Klatskin G (1970) Pattern of necrosis in acute viral hepatitis. Prognostic value of bridging (subacute hepatic necrosis). N Engl J Med 283:1063–1071PubMedCrossRefGoogle Scholar
  37. 37.
    Redeker AG (1975) Viral hepatitis: clinical aspects. Am J Med Sci 270:7–16CrossRefGoogle Scholar
  38. 38.
    Sherlock S (1976) Predicting progression of acute type-B hepatitis to chronicity. Lancet 2:354–356PubMedCrossRefGoogle Scholar
  39. 39.
    McMahon BJ, Alward WLM, Hall DB et al. (1985) Acute hepatitis B virus infection: relation of age to the clinical expression of disease and subsequent development of the carrier state. J Infect Dis 151:599–603PubMedCrossRefGoogle Scholar
  40. 40.
    Beasley RP, Hwang LY, Lee GC et al. (1983) Prevention of perinatally transmitted hepatitis B virus infection with hepatitis B immune globulin and hepatitis B vaccine. Lancet II:1099–1102CrossRefGoogle Scholar
  41. 41.
    Ip HM, Lelie PN, Wong VC, Kuhns MC, Reesink HW (1989) Prevention of hepatitis B virus carrier state in infants according to maternal serum levels of HBV DNA. Lancet I:406–410CrossRefGoogle Scholar
  42. 42.
    Rizzetto M, Canese MG, Arico S et al. (1977) Immunofluorescence detection of a new antigen/antibody system (delta/anti-delta) associated with hepatitis B virus in liver and serum of HBsAg carriers. Gut 18:997–1003PubMedCrossRefGoogle Scholar
  43. 43.
    Wang KS, Choo W-L, Weiner AJ et al. (1986) Structure, sequence and expression of the hapatitis delta (δ) viral genome. Nature 323:508–514PubMedCrossRefGoogle Scholar
  44. 44.
    Chen P-J, Kalpana G, Goldberg J et al. (1986) Structure and replication of the genome of the hepatitis delta virus. Proc Natl Acad Sci USA 83:8774–8778PubMedCrossRefGoogle Scholar
  45. 45.
    Makino S, Chang MF, Shieh CK et al. (1987) Molecular cloning, sequencing and replication of a human hepatitis delta virus RNA. Nature 329:343–346PubMedCrossRefGoogle Scholar
  46. 46.
    Xia YP, Chang MF, Wei D, Govindarajan S, Lai MM (1990) Heterogeneity of hepatitis delta antigen. Virology 178:331–336PubMedCrossRefGoogle Scholar
  47. 47.
    Hsieh SY, Chao M, Coates L, Taylor J (1990) Hepatitis delta virus genome replication: a polyadenylated mRNA for delta antigen. J Virol 64:3192–3198PubMedGoogle Scholar
  48. 48.
    Kuo MY, Chao M, Taylor J (1989) Initiation of replication of the human hepatitis delta virus genome from cloned DNA: role of delta antigen. J Virol 63:1945–1950PubMedGoogle Scholar
  49. 49.
    Negro F, Korba BE, Forzani B et al. (1989) Hepatitis delta virus (HDV) and woodchuck hepatitis virus (WHV) nucleic acids in tissues of HDV-infected chronic WHV carrier woodchucks. J Virol 63:1612–1618PubMedGoogle Scholar
  50. 50.
    Bergmann KF, Gerin JL (1986) Antigens of hepatitis delta virus in the liver and serum of humans and animals. J Infect Dis 154:702–706PubMedCrossRefGoogle Scholar
  51. 51.
    Purcell RH, Gerin JL, Rizzetto M et al. (1983) Experimental transmission of delta agent to chimpanzees. Prog Clin Biol Res 143:79–89PubMedGoogle Scholar
  52. 52.
    Hadziyannis SJ, Sherman M, Lieberman HM, Shafritz DA (1985) Liver disease activity and hepatitis B virus replication in chronic delta antigen-positive hepatitis B virus carriers. Hepatology 5:544–547PubMedCrossRefGoogle Scholar
  53. 53.
    Morante AL, De La Cruz F, DeLope CR, Echevarria S, Rodriguez GM, Pons-Romero F (1989) Hepatitis B virus replication in hepatitis B and D coninfection. Liver 9:65–70PubMedGoogle Scholar
  54. 54.
    Villari D, Raimondo G, Smedile V et al. (1989) Hepatitis B-DNA replication and histological patterns in liver biopsy specimens of chronic HBsAg positive patients with and without hepatitis delta virus superinfection. J Clin Pathol 42:689–693PubMedCrossRefGoogle Scholar
  55. 55.
    Cassidy WM, Govindarajan S, Gupta S, Valinluck B, Redeker AG (1989) Influence of HIV on chronic hepatitis B and D infection. Hepatology 10:690Google Scholar
  56. 56.
    Karayiannis P, Saldanha J, Monjardino J et al. (1990) Immunization of woodchucks with recombinant hepatitis delta antigen does not protect against hepatitis delta virus infection. Hepatology 12:1125–1128PubMedCrossRefGoogle Scholar
  57. 57.
    Govindarajan S, Gupta S, Valinluck B, Redeker AG (1989) Correlation of IgM anti-hepatitis D virus (HDV) to HBV RNA in sera of chronic HDV. Hepatology 10:34–35PubMedCrossRefGoogle Scholar
  58. 58.
    Macagno S, Smedile A, Caredda F, Ottobrelli A, Rizzetto M (1990) Monomeric (7S) immunoglobulin M antibodies to hepatitis delta virus in hepatitis type D. Gastroenterology 98:1582–1586PubMedGoogle Scholar
  59. 59.
    Negro F, Shapiro M, Satterfield WC, Gerin GL, Purcell RH (1989) Reappearance of hepatitis D virus (HDV) replication in chronic hepatitis B carrier chimpanzees rechallenged with HDV. J Infect Dis 160:507–511CrossRefGoogle Scholar
  60. 60.
    Rizzetto M, Verma G, Gerin JL, Purcell RH (1986) Hepatitis delta virus disease. Prog Liver Dis 8:417–431PubMedGoogle Scholar
  61. 61.
    Jacobson IM, Dienstag JL, Werner BG et al. (1985) Epidemiology and clinical impact of hepatitis D virus (delta) infection. Hepatology 5:188–191PubMedCrossRefGoogle Scholar
  62. 62.
    DeCock KM, Jones B, Govindarajan S, Redeker AG (1988) Prevalence of hepatitis (delta) virus infection. A seroepidemiologic study. West Med J 148:307–309Google Scholar
  63. 63.
    Hadler SC, DeMonzon M, Ponzetto A et al. (1984) Delta virus infection and severe hepatitis. An epidemic in the Yucpa Indians of Venezuela. Ann Intern Med 100:339–344PubMedGoogle Scholar
  64. 64.
    Hansson BG, Moestrup T, Widell A, Nordenfeit E (1982) Infection with delta agent in Sweden: introduction of a new hepatitis agent. J Infect Dis 146:472–478PubMedCrossRefGoogle Scholar
  65. 65.
    Govindarajan S, Chin KP, Redeker AG, Peters RL (1984) Fulminant B viral hepatitis: role of delta agent. Gastroenterology 86:1417–1420PubMedGoogle Scholar
  66. 66.
    Govindarajan S, Valinluck B, Peters RL (1986) Relapse of acute B viral hepatitis - role of delta agent. Gut 27:19–22PubMedCrossRefGoogle Scholar
  67. 67.
    Arico S, Aragona M, Rizzeto M et al. (1985) Clinical significance of antibody to the hepatitis delta virus in symptomless HBsAg carriers. Lancet II:356–357CrossRefGoogle Scholar
  68. 68.
    Mas A, Buti M, Esteban R et al. (1990) Hepatitis B virus and hepatitis D virus replication in HBsAg-positive fulminant hepatitis. Hepatology 11:1062–1065PubMedCrossRefGoogle Scholar
  69. 69.
    Karvountsis GG, Redeker AG (1974) Relation of alpha-fetoprotein in acute hepatitis to severity and prognosis. Ann Intern Med 80:156–160Google Scholar
  70. 70.
    Krugman S, Giles JP, Hammond JP (1970) Hepatitis virus: effect of heat on the infectivity and antigenicity of the MS-1 and MS-2 strain. J Infect Dis 122:432–436PubMedCrossRefGoogle Scholar
  71. 71.
    Buynak EB, Roehm RR, Tytell AA et al. (1976) Vaccine against human hepatitis B. JAMA 235:2832–2834PubMedCrossRefGoogle Scholar
  72. 72.
    Szmuness W, Stevens CE, Harley EJ et al. (1980) Hepatitis B vaccine: demonstration of efficacy in a controlled trial in a high-risk population in the United States. N Engl J Med 303:833–841PubMedCrossRefGoogle Scholar
  73. 73.
    Emini EA, Ellis RW, Miller WJ et al. (1986) Production and immunological analysis of recombinant hepatitis B vaccine. J Infect [Suppl A] 13:3Google Scholar
  74. 74.
    Carman WF, Zanetti AR, Karayiannis P et al. (1990) Vaccine-induced escape mutant of hepatitis B virus. Lancet 336:325–329PubMedCrossRefGoogle Scholar

Suggested Reading

  1. Ganem D, Varmus HE (1987) The molecular biology of the hepatitis B viruses. Annu Rev Biochem 56:651–693PubMedCrossRefGoogle Scholar
  2. Robinson WS (1990) Biology of human hepatitis viruses. In: Zakim D, Boyer TD (eds) Hepatology. A textbook of liver disease. W.B. Saunders, Philadelphia, pp 890–945Google Scholar
  3. Seeff LB (1990) Diagnosis, therapy and prognosis of viral hepatitis. In: Zakim D, Boyer TD (eds) Hepatology. A textbook of liver disease. W.B. Saunders, Philadelphia, pp 958–1025Google Scholar
  4. Tiollais P, Purcell C, Dejean A. (1985) The hepatitis B virus. Nature 317:489–495PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1992

Authors and Affiliations

  • S. Gupta
  • D. A. Shafritz

There are no affiliations available

Personalised recommendations