The clinical importance of vitamin D has been recently highlighted, due to non-skeletal effects of vitamin D and the fact that vitamin D receptors are observed in many kinds of cells. Vitamin D deficiency or insufficiency results in the development of gastrointestinal diseases, including obesity, hepatitis B, chronic hepatitis C, and inflammatory bowel disease in children. The prevalence of vitamin D insufficiency in 188 Korean adolescents, aged 12-13 years, was 98.9% for boys and 100% for girls. This article reviews recent publications, regarding vitamin D deficiency and childhood gastrointestinal diseases, and introduces new treatment and prevention guidelines for vitamin D deficiency.
Adolescent ; Aged ; Child ; Gastrointestinal Diseases ; Hepatitis B, Chronic ; Hepatitis C ; Humans ; Inflammatory Bowel Diseases ; Obesity ; Prevalence ; Receptors, Calcitriol ; Vitamin D ; Vitamin D Deficiency ; Vitamins

The cytokine patterns secreted by T cells at the site of viral replication may influence the final outcome of HBV and HCV infection. The different cytokine profiles of T cells within the liver in chronic HBV (Th0/Th2 cytokine) and HCV (Th1 cytokine) infections illustrate a different behavior of the local immune response in these two infections. The predominance of Th1-type cytokine responses has been reported to play an important role in viral clearance of patients with both acute and chronic hepatitis B. In contrast, a combined Th1-and Th2-like responses were found in chronic hepatitis C, exhibiting a pattern like that of acute hepatitis C with chronic evolution. It suggests that different patterns of cytokine expressions between HBV and HCV infection involve the difference in chronicity in each infection.
Cytokines* ; Hepacivirus ; Hepatitis B virus ; Hepatitis B, Chronic* ; Hepatitis C ; Hepatitis C, Chronic ; Hepatitis, Chronic* ; Humans ; Liver ; T-Lymphocytes

Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most common causes of chronic liver disease worldwide. The host immune pressure against hepatitis viruses during the chronic infection has led to mutations in their coding genes, which could play a pivotal role in the clinical outcomes of chronic patients. Our recent molecular epidemiologic studies regarding the HBV precore/core (preC/C) regions and HCV nonstructural 5B (NS5B) protein suggest the presence of distinct CD4 T cell immune pressure against HBV and HCV in Korean chronic patients. However, induced HBV and HCV mutations seem to exert an opposite effect on Korean chronic hepatitis B (CHB) and chronic hepatitis C (CHC) patients, respectively. On the basis of two of our recent papers, we focused in this review on the relationships between the mutation patterns of HBV preC/C and HCV NS5B, which were presumed to be caused by distinct CD4 T cell pressure in the Korean population and their effect on the clinical outcomes and liver disease progression of CHB and CHC patients.
Clinical Coding ; Epidemiologic Studies ; Hepacivirus* ; Hepatitis B virus* ; Hepatitis B* ; Hepatitis B, Chronic ; Hepatitis C* ; Hepatitis C, Chronic ; Hepatitis Viruses ; Hepatitis* ; Humans ; Liver Diseases

BACKGROUND: The Elecsys hepatitis B surface antigen (HBsAg) II quantitative assay is a newly introduced electrochemiluminescence immunoassay incorporating an initial 1:400 onboard dilution and a simple algorithm to determine HBsAg levels in serum. We evaluated the performance of the Elecsys HBsAg II assay and determined the impact of its initial onboard dilution on laboratory efficiency. METHODS: HBsAg levels were determined using both Roche Elecsys and Abbott Architect HBsAg assays. Linearity and precision of the Elecsys HBsAg II assay and its correlation with the Architect HBsAg assay were evaluated. In particular, precision was verified at Samsung Medical Center, Severance Hospital, Seoul St. Mary's Hospital in Seoul, using the same pooled serum controls. The efficiency of the dilution algorithm for both methods was verified using data from 1,848 clinical samples. RESULTS: The Elecsys HBsAg II assay showed a good linearity from 0.1 to 48,000.0 IU/mL and a good correlation (r=0.9998) between expected and measured values. Precision analyses performed at Samsung Medical Center, Severance Hospital, Seoul St. Mary's Hospital showed excellent performance with coefficients of variation between 1.28% and 6.82%. The values of the Elecsys HBsAg II and Architect HBsAg assays were well correlated (n=506, r=0.987, P<0.001) and also reliably determined in hepatitis C virus- and hepatitis B virus-co-infected patient sera (n=27). In terms of efficiency, 64.0% of samples provided a final HBsAg result on the first run without the need for further dilution, when using the 1:400 onboard pre-dilution protocol of the Elecsys HBsAg II assay. CONCLUSIONS: Given the excellent precision and correlation with the Architect assay, the Elecsys HBsAg II assay showed a potential advantage for laboratory efficiency by significantly reducing the need for retesting samples with high HBsAg levels.
Hepatitis B ; Hepatitis B Surface Antigens* ; Hepatitis B virus ; Hepatitis B, Chronic ; Hepatitis C ; Humans ; Immunoassay ; Seoul

Occult hepatitis B virus (HBV) infection is defined as the presence of HBV DNA in the liver (with or without detectable HBV DNA in serum) for individuals testing HBV surface antigen negative. Until recently, the clinical implication of occult HBV infection was unclear. Several studies suggest a high prevalence of occult HBV infection among patients with chronic liver disease. Occult HBV infection is a complex entity comprising many conditions and situations that may be widely different from the biological point of view and clinical consequences. Data regarding natural course and therapy in chronic hepatitis C patients with occult HBV are limited and based on small case numbers. These considerations imply the need for a critical re-evaluation of this field to define better strategies to diagnose and treat this infection.
Antigens, Surface ; DNA ; Hepatitis ; Hepatitis B ; Hepatitis B virus ; Hepatitis C, Chronic ; Hepatitis, Chronic ; Humans ; Liver ; Liver Diseases ; Prevalence

Antiviral Agents ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Humans

BACKGROUND/AIMS: Recently, nucleotide sequences from a novel virus, termed hepatitis G virus (HGV), were identified in serum from a patient with cryptogenic hepatitis and suggested as agent of non A-E hepatitis. HGV has been isolated from patients with various liver diseases but clinical implications of this new agent remain largely unresolved. In Korea, the etiology of substantial fraction of hepatitis has remained undefined and there has been no report concerning HGV. METHODS: To determine the infection rate of HGV, RT-PCR of 5 UTR of HGV was performed, and to understand the clinical implication of HGV, medical records of 115 patients with various liver diseases were reviewed. Of 115 patients, 63 were male and 52 were female. Their mean age was 44 years (19-74) and their mean AST and ALT were 121.3+278.7 IU/L and 172.2+253.3 IU/L, respectively. Of 115 patients, 58 (50.4%) had no specific cause of liver diseases, 37 (32.2%) were infected with hepatitis B and/or C virus and 20 (17.4%) had non-viral identifiable liver diseases. RESULTS: 1. HGV RNA was detected in 15 (13.0%) patients of 115 patients. 2, Among the 15 HGV RNA positive cases, 7 were male and 8 were female. Their mean age was 48 years (19-72) and their mean AST and ALT were 71.9+45.2 IU/L, 97.4+66.8 IU/I respectively. 3. HGV RNA was detected in 8(13.8%) of 58 patients without obvious causes of their liver diseases and in 7 (18.9%) of 37 patients infected with HBV and/or HCV. However, HGV RNA was not detected fram 20 patients with non-viral liver diseases such as alcoholic liver diseases, autoimmune hepatitis, PBC, or fatty liver. 4. HGV RNA was detected in 5 (19.2%) of 26 patients with acute hep- atitis, in 6 (9.4%) of 64 patients with chronic hepatitis, in 1 (14.3%) of 7 patients with liver cirrhasis, and iB 3 (27.3%) Of 11 pafients with hepatocellular caIcinoma. 5. These was no slatistically significant difference in sex, age, history of transfusion, serum ALT level, etiologies and status of liver diseases between HGV RNA positve and negative group. CONCLUSIONS: the prevalence of HGV infection is quite high among the patients who have no specific cause of acute or chronic liver diseases and HGV can be coinfected with HBV and/ar HCV infection in Korea.
Base Sequence ; Fatty Liver ; Female ; GB virus C* ; Hepatitis B ; Hepatitis* ; Hepatitis, Autoimmune ; Hepatitis, Chronic ; Humans ; Korea ; Liver Diseases* ; Liver Diseases, Alcoholic ; Liver* ; Male ; Medical Records ; Polymerase Chain Reaction* ; Prevalence ; RNA*

BACKGROUND/AIMS: To evaluate the therapeutic efficacy of interferon in chrcnic viral hepatitis, interferon was administered to 222 patients with biopsy proven chronic viral hepatitis. METHODS: 32 patients were excluded and the 190 patients was included, 149 men and 41 women. Average age was 34.4+-8.93 (14-67) years. 161 cases had HBsAg and HBeAg, and 29 cases had anti-HCV Ab. Three millicn units of interferon beta were given to 37 patients with chronic B hepatitis, daily for one month Six million units of interferon alpha were given to 124 patients with chronic B hepatitis and 29 patients with chr onic C hepatitis, three times a week for six months. RESULTS: 1) Out of 124 patients with clronic hepatitis B treated with a-interferon, HBeAg negativity for more tban six months was observed in 25 patients (20.2%), and defined as responder group. The 23 patients (18.5%) were defined as probable responder, because of persistent seroregativity of HBeAg for the last 6 months, despite of fluctuation of sercangativity during the follow-up. The 29 patients (23.4%) were defined as probable non-responder because of recurrence of HBeAg, which once was cleared but reappeared during last 6 months. But there was no seroconversion in 47 cases (37.9%). The overall response rate was 38.7%. 2) Out of 37 patients with chronic hepatitis B treated with B-interferon, 7 patients (18.9%) were responder, 6 patients (16.2%) probable responder, 12 patients (32.4%) probable non-responder, 12 patients (32.4%) non-responder. The overall response rate was 35.1%. 3) Out of 29 patients with chronic hepatitis C treated with a-interferon, normalization of alanine aminotransferase (ALT) level for mcrre than six months was observed in 9 patients (31.0%), and defined as responder group. The 3 patients (10.3%) were defined as probable responder, because ALT levels fluctuated but wes normalized during the last 6 months. The 5 patients (17.2%) were defined as pobable ncn-mponder, because of persistent fluctuation of ALT levels during the last 6manths, which once were normalized but reelevated. In 12 patients (41.4%), there had never been a normalization of ALT level. The overall resporate was 41.1%. 4) The period of HBeAg seropositivity was 1.33 times longer than the period of seronegativity. The faster the seroconvmion, the more the tendency to be a respander for the patients with chronic hepatitis B. CONCLUSION: Interferon therapy may be effective in some cleonic viral hepatitis.
Alanine Transaminase ; Biopsy ; Female ; Follow-Up Studies* ; Hepatitis B ; Hepatitis B e Antigens ; Hepatitis B Surface Antigens ; Hepatitis B, Chronic ; Hepatitis C, Chronic ; Hepatitis* ; Humans ; Interferon-alpha ; Interferon-beta ; Interferons* ; Male ; Recurrence

<b>OBJECTIVEb>To observe the status of occult hepatitis B virus infection in chronic viral hepatitis patients with non-A to E hepatitis virus infection and explore the diagnostic value of fluorescence quantitative polymerase chain reaction (FQ-PCR) technique for occult hepatitis B virus infection.

<b>METHODSb>The amount of HBV-DNA in serum and liver tissue from 57 patients with non-A to E hepatitis virus infection who were diagnosed as chronic viral hepatitis by Menghini method liver biopsy were detected by using FQ-PCR technique, then the relation between the viral load of HBV DNA in liver tissue and hepatic inflammatory activity were analyzed.

<b>RESULTSb>Thirteen (22.81%), 22 (38.60%) patients were positive for HBV DNA in serum and liver tissue, respectively. The positive rate and the level of HBV DNA quantity in liver tissue were significantly higher than those in serum; HBV DNA was found positive in both serum and liver tissue in 13 cases, negative in both serum and liver tissue in 35, positive in liver tissue but negative in serum in 9, and in none of the cases HBV DNA was positive in serum but negative in liver tissue (P < 0.01). The logarithmic value of HBV DNA from 13 patients in liver tissue and in serum was respectively: (6.62 +/- 1.21) copies/g vs.(4.03 +/- 1.06) copies/ml, P < 0.01. The hepatic lesions of all HBV DNA positive patients were active pathologic changes, but the level of HBV DNA in liver tissue was not significantly correlated with the grade of hepatic inflammation activity (P > 0.05).

<b>CONCLUSIONb>Occult HBV infection is the etiology of part of the chronic viral hepatitis patients with non-A-E hepatitis virus infection. Missed diagnosis will occur if diagnosis of hepatitis B is only based on detection of serum HBV markers. It is useful for improvement of the diagnostic level of HBV infection via detection of HBV DNA quantitatively in serum especially in liver tissue of chronic viral hepatitis patients with non-A-E hepatitis virus infection by using FQ-PCR technique. The chronic viral hepatitis patients with occult HBV infection should be also given effective anti-viral therapy.

Carrier State ; physiopathology ; DNA, Viral ; Hepatitis B ; physiopathology ; Hepatitis B Surface Antigens ; immunology ; Hepatitis B virus ; physiology ; Hepatitis C ; physiopathology ; Hepatitis D ; physiopathology ; Hepatitis E ; physiopathology ; Hepatitis, Viral, Human ; physiopathology ; Humans

Chronic hepatitis B virus (HBV) infection remains a global health burden. Timely and effective antiviral therapy is beneficial for patients with HBV infection. With existing antiviral drugs, including nucleos(t)ide analogs and interferon-alfa, patients can achieve viral suppression with improved prognosis. However, the rate of hepatitis B surface antigen loss is low. To achieve a functional cure and even complete cure in chronic hepatitis B patients, new antivirals need to be developed. In this review, we summarized the advantages and disadvantages of existing antiviral drugs and focused on new antivirals including direct-acting antiviral drugs and immunotherapeutic approaches.
Antiviral Agents/therapeutic use* ; Hepatitis B/drug therapy* ; Hepatitis B Surface Antigens ; Hepatitis B virus ; Hepatitis B, Chronic/drug therapy* ; Hepatitis C, Chronic/drug therapy* ; Humans