Pathogenesis
Hepadnaviruses multiply themselves using an RNA intermediate. Hepatitis B Virus (HBV) can recognise bind to specific receptors on the host liver cells. After binding, it will release its genetic materials into the cell which migrates to the nucleus. In the host cell’s nucleus, the partially double stranded is completed into a circle of HBV DNA. The host cell’s RNA polymerase is duped into transcribing the foreign genome. The HBV mRNA is then translated into new HBV. The new HBV particles are formed and has its viral genome packaged within. It then buds off (exocytosis) from the host cell to infect other host cells. In the process of translating the HBV genome, the host cell will translate HBV protein coat continuously. When there is too much of the protein coat which acts as the HBV surface antigen is produced, it will be delivered out of the host cell and trigger an immune response from the host body.
Hepatitis B Infections:
Acute (FAST!)
For Acute Hepatitis B infections, about quarter to half of all cases of the acute infections shows symptoms. The rest of the cases usually do not have the symptoms or have non-related symptoms. The virus has an incubation time range of around 1 to 6 months. After this, the patient will undergo a pre-jaundice phase. They will have symptoms varying from tiredness, weakness, no appetite, nausea and pain in the top right of their abdomen. However, once the patients reach the jaundice phase, which lasts for about 21 days, these symptoms will slowly disappear. And during the recovery phase, which can be about 6 months, the symptoms will disappear completely.
When a person gets infected with the Hepatitis B virus (HBV), their body will have a clear reaction to the infection by immune response. Their blood serum will have the Hepatitis B surface antigen (HBsAg) that is present on the virus protein coat. HBsAg’s presence is used to detect acute HBV as it is in the blood serum throughout the duration of the infection before the recovery phase. In the recovery phase, the body’s immunity will respond to the viral intrusion and HBsAg belonging to the virus will be replaced by the body’s anti-HBsAg (HBsAb). At the same time, the main antibody for HBV (anti-HBc) will also be present to help attack the virus’ nucleocapsid. HBc IgM is the first to develop and then later on will be substituted with HBc IgG.
However, in some conditions, HBsAb is already present in the pre-jaundice phase. In this case, HBsAg is not used to detect acute HBV infection as HBsAg disappears when HBsAb develops. Instead, HBc IgM must be detected for the diagnosis.
Presence of antigens and antibodies in blood serum:
(pre-Recovery) HBsAg-> (Recovery) anti-HBsAg /HBsAb + anti-HBc (HBc IgM -> HBc IgG)
In cases where the person has been previously infected or vaccinated for HBV and developed anti-HBsAg /HBsAb:
* (pre-Recovery)HBsAg + anti-HBsAg /HBsAb -> (Recovery) anti-HBsAg /HBsAb + anti- HBc (HBc IgM -> HBc IgG)
Hepadnaviruses multiply themselves using an RNA intermediate. Hepatitis B Virus (HBV) can recognise bind to specific receptors on the host liver cells. After binding, it will release its genetic materials into the cell which migrates to the nucleus. In the host cell’s nucleus, the partially double stranded is completed into a circle of HBV DNA. The host cell’s RNA polymerase is duped into transcribing the foreign genome. The HBV mRNA is then translated into new HBV. The new HBV particles are formed and has its viral genome packaged within. It then buds off (exocytosis) from the host cell to infect other host cells. In the process of translating the HBV genome, the host cell will translate HBV protein coat continuously. When there is too much of the protein coat which acts as the HBV surface antigen is produced, it will be delivered out of the host cell and trigger an immune response from the host body.
Hepatitis B Infections:
Acute (FAST!)
For Acute Hepatitis B infections, about quarter to half of all cases of the acute infections shows symptoms. The rest of the cases usually do not have the symptoms or have non-related symptoms. The virus has an incubation time range of around 1 to 6 months. After this, the patient will undergo a pre-jaundice phase. They will have symptoms varying from tiredness, weakness, no appetite, nausea and pain in the top right of their abdomen. However, once the patients reach the jaundice phase, which lasts for about 21 days, these symptoms will slowly disappear. And during the recovery phase, which can be about 6 months, the symptoms will disappear completely.
When a person gets infected with the Hepatitis B virus (HBV), their body will have a clear reaction to the infection by immune response. Their blood serum will have the Hepatitis B surface antigen (HBsAg) that is present on the virus protein coat. HBsAg’s presence is used to detect acute HBV as it is in the blood serum throughout the duration of the infection before the recovery phase. In the recovery phase, the body’s immunity will respond to the viral intrusion and HBsAg belonging to the virus will be replaced by the body’s anti-HBsAg (HBsAb). At the same time, the main antibody for HBV (anti-HBc) will also be present to help attack the virus’ nucleocapsid. HBc IgM is the first to develop and then later on will be substituted with HBc IgG.
However, in some conditions, HBsAb is already present in the pre-jaundice phase. In this case, HBsAg is not used to detect acute HBV infection as HBsAg disappears when HBsAb develops. Instead, HBc IgM must be detected for the diagnosis.
Summary of Phases:
Infection -> Incubation -> Pre-jaundice -> Jaundice -> Recovery
Infection -> Incubation -> Pre-jaundice -> Jaundice -> Recovery
Presence of antigens and antibodies in blood serum:
(pre-Recovery) HBsAg-> (Recovery) anti-HBsAg /HBsAb + anti-HBc (HBc IgM -> HBc IgG)
In cases where the person has been previously infected or vaccinated for HBV and developed anti-HBsAg /HBsAb:
* (pre-Recovery)HBsAg + anti-HBsAg /HBsAb -> (Recovery) anti-HBsAg /HBsAb + anti- HBc (HBc IgM -> HBc IgG)
*HBsAg cannot be detected as HBV is destroyed by anti-HBsAg /HBsAb and will this will not give an accurate result. So the test for HBV diagnosis will be positive for anti-HBc and anti-HBsAg /HBsAb and negative for HBsAg.
Chronic (SLOW!)
If HBsAg is detected in the blood serum for over 6 months, the infection can be classified as chronic. People who have recurrent HBV infections are usually known as chronic carriers. Chronic HBV sufferers also do not develop the HBsAb to fight the infection and this leads to a more serious case compared to acute HBV. This is because the HBV can multiply without hindrance from the body’s immunity and also stay longer to create more harm as it is not eliminated by the immune system.
If the patient has been infected by HIV before, then they will have a higher chance of getting this type of HBV infection as they already have a weakened immune system. This also goes for those who are under immuno-suppressants or have some other immunity problems. Inflammation, liver cell death, and cirrhosis (liver tissue scarring) affects approximately 50% of those infected. Incidences of liver failure and also maybe liver cancer in chronic HBV sufferers are also high. Chronic HBV infection has varying disease activity (increase or decrease) and the symptoms from the infection will also vary (severe or manageable) accordingly.
please COMMENT... We need your input, insight, perspectives to increase our knowledge... *& marrkxx ;>
So chronic HBV infection is highly associated with Liver Cancer compare to acute HBV infection. What is a risk factors that will increase the chance of a person develop a chronic HBV than the other form? For example, are there any particular strain of HBV that is more commonly causing chronic infection.
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ReplyDeleteAm jeremiah, I am testifying about a great hebal man that cured my wife of hepatitis B and liver cirhosis. his name is Dr oniha. My wife was diagnose of hepatities two years ago, i almost spent all i had then, until i saw dr oniha recommendation online, and i call him, then he told me how to get the herb. You can call him on +2347089275769 or email him at dronihaspell@yahoo.com
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