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<http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowAbstract&ArtikelNr=323884&Ausgabe=255156&ProduktNr=224231>
Infections and the Liver
Bertus Eksteen
Centre for Liver Research, MRC Centre for Immune Regulation, Institute for
Biomedical Research, Medical School, University of Birmingham, and The
Queen Elizabeth Hospital, University Hospitals Birmingham NHS Trust,
Birmingham, UK
Address of Corresponding Author
Dig Dis 2011;29:184-190 (DOI: 10.1159/000323884)
Abstract
Background: Hepatitis B (HBV) and hepatitis C virus (HCV) have infected
nearly half a billion individuals worldwide and are major indications for
liver transplantation. Key requirements to successful outcomes with modern
antiviral drugs are favourable host factors.
Results: Single nucleotide polymorphisms near the IL28B gene location which
encode for interferon (IFN)-λ3 have a large effect in determining the
likelihood of patients obtaining a cure from pegylated IFN-α and ribavirin
combination therapy or spontaneous clearance of the HCV. 80% of patients
who carry two copies of this advantageous variant cleared the virus during
IFN therapy and remained virus-free with a sustained viral response. This
mutation is more common in Caucasian and Asian populations, whereas it is
only found in the 40-50% of sub-Saharan Africans who are known to be more
resistant to combination therapy. Similarly, host factors control tolerance
to chronic HBV infection and can fluctuate over time with increased risk of
progression to cirrhosis and particularly liver cancer. Loss of viral
tolerance with reactivation and hepatitis is increasingly seen with the
widespread use of biological treatments for diseases such as inflammatory
bowel disease or rheumatoid arthritis. Natural disasters and conflicts in
some parts of the world have also seen an increase in cases of hepatitis A
and E virus infection and highlighted the global public health burden from
viral-induced hepatitis.
Conclusions: Increased appreciation of the interaction between host factors
and the viral life cycles is likely to significantly alter the way we
target these infections in the future.
Copyright © 2011 S. Karger AG, Basel
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Author Contacts
Dr. Bertus Eksteen
Centre for Liver Research and NIHR Biomedical Research Unit
MRC Centre for Immune Regulation, Institute for Biomedical Research
University of Birmingham, Vincent Drive, Edgbaston, Birmingham B15 2TT (UK)
Tel. +44 121 415 8700, E-Mail [email protected] |
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发表于 2011-7-17 07:12