|Hepatitis B Version 4.1|
| The following documents related to hepatitis B have been
elaborated for informative purpose only. They have been written by
Stuart Millinship. This report has not been
written by the Health On the Net Foundation's team and the Foundation is
not responsible for the content of the Hepatitis B report.
THE HEPATITIS D VIRUS
The Hepatitis D Virus (HDV) is a unique, defective RNA virus that can only infect an individual in the presence of hepatitis B. It occurs either as a co-infection with acute Hepatitis B or as a superinfection in people with chronic Hepatitis B. HDV is mostly found among IV drug users, but transmission by other routes is possible. Infection with HDV can make the acute phase of hepatitis B unusually severe. It can cause an acute "exacerbation" in chronic hepatitis B carriers (superinfection), or cause a relatively aggressive course of chronic Hepatitis B.
Some recent research as shown that hepatitis D can exist without Hepatitis B being present. But the presence of hepatitis B is required for the initial infection to take place.(?)
Studies indicate that coinfection with hepatitis C can suppress hepatitis B and hepatitis C is the dominant illness. However sometimes the combination can lead to very aggressive hepatitis and also the risk of liver cancer (HCC) is increased.
There is still much research to be done in this field.
In general coinfection with HIV leads to a milder form of hepatitis although this may get much worse in patients with AIDS. Current research indicates that coinfection with HIV is should not be a factor in deciding weather to take interferon treatment as response rates are only slightly lower, however the risk of viral reactivation after a successful response is increased.
There are strains of hepatitis that do not produce the "e" antigen. This strain normally shows up in cases of mild chronic infection or occasionally in very aggressive disease. Research has shown that the response rate to interferon in this strain of hepatitis B is lower than normal. However where a long term response is achieved success rates are comparable.
After a chronic hepatitis B infection people do not, to my knowledge, produce the surface antibody that would provide protection. Even after a pesponse to interferon (I.e. loss of the surface antigen) there have been rare cases of viral reactivation if the immune system becomes suppressed or it may just happen.. It is therefore advised that your Hep B antigen status if examined periodically to be on the safe side.
Chronic infection with hepatitis B can lead to an increased incidence of HCC (5%). It is believed that after several years of chronic Hep B infection the Hep B viral DNA becomes integrated with human DNA. In most cases this poses no problems and the result generally causes the liver cell(s) where integration has occurred to produce surface proteins (HBsAg) but not complete viral particles. However when the DNA integration occurs sometime mistakes may be made during integration or it may be inserted into the human gnome at a place that "turns on" the instruction to replicate uncontrollably. The error may also occur as when liver cells naturally reproduce. Anyone expressing the HBsAg generally has increased risk of HCC. Treatment of HCC is a large subject in itself and when I have the time & information and I hope to expand on this information.
Note: I cannot locate the the source of this article. If you recognise it please let me know so I can credit the authors
However before doing this your GP understandably needs evidence that these may be of benefit to you. Provided your GP with photocopies from medical journals, printouts of information from the Internet etc. If you can, and I advise it, arrange (probably via your specialist at your local hospital) to monitor your blood work for any adverse reaction and inform him of this he may write you a prescription. It may also help to inform him of the low cost of many of these compounds.
Once you have obtained your prescription you should take this to your chemist (note, this is much easier at a small local chemist than a large chain such as Boots or Superdrug) and hand the prescription to the pharmacist. For hard to find items you will need to give them the all the necessary information on where to obtain things, eg address, telephone number etc. You may wish to specify a brand name for some items. The pharmacist will then order the items on the prescription and they should be available for collection normally within a week.
Due to the delay in obtaining non standard items it is advised that you obtain and hand to your pharmacist repeat prescriptions for any items you may require 2 weeks before you need them to avoid running out.
|http://www.hon.ch/Library/Theme/HepB/other.html||Last modified: Fri Nov 1 2002|