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Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731.

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Presentation on theme: "Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731."— Presentation transcript:

1 Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731. doi:10.7326/0003-4819-132-9-200005020-00007 Genome of hepatitis B virus (HBV).SCPX3The viral genome is partially double stranded. Four overlapping reading frames (surface [ ], core [ ], polymerase [ ], and the x gene [ ]) encode for the viral proteins. Three upstream regions (preC, preS1, and preS2) are also shown. The size of each segment is shown in parentheses. aa = amino acids. Adapted with permission from reference. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

2 Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731. doi:10.7326/0003-4819-132-9-200005020-00007 Mechanism of hepatitis B virus (HBV) replication and the site of action of different treatment methods.cccDNAAfter HBV endocytosis into hepatocytes, the genome is translocated to the nucleus and converted to covalently closed circular DNA ( ), which is transcribed and translated to form an RNA intermediate. Translocation of pregenomic RNA can be inhibited by interferon-α, and reverse transcription of the pregenomic RNA by polymerase to HBV DNA can be inhibited by nucleoside analogues. Association of the partially double-stranded DNA with envelope proteins leads to the formation of mature HBV particles that are then released from the hepatocyte. mRNA = messenger RNA. Adapted with permission from Glaxo-Wellcome Pharmaceuticals. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

3 Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731. doi:10.7326/0003-4819-132-9-200005020-00007 Interferon for chronic hepatitis B virus (HBV) infection. Top.ALTHBeAgBottom.solid linesdashed lines10Sustained response. A “flare” of alanine aminotransferase ( ) activity is associated with the loss of hepatitis B e antigen ( ). Transient response. Serum levels of ALT ( ) and HBV DNA ( ) return to pretreatment levels after interferon therapy is discontinued. Hepatitis B e antigen remains positive (+). Anti-HBe = hepatitis B e antibody. Adapted with permission from reference. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

4 Date of download: 5/30/2016 From: Chronic Hepatitis B Virus Infection: Treatment Strategies for the Next Millennium Ann Intern Med. 2000;132(9):723-731. doi:10.7326/0003-4819-132-9-200005020-00007 Proposed algorithm for treatment of chronic hepatitis B virus (HBV) infection.ALT = alanine aminotransferase; HBeAg = hepatitis B e antigen; HBsAg = hepatitis B surface antigen. Figure Legend: Copyright © American College of Physicians. All rights reserved.American College of Physicians

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