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RISS 인기검색어
- 검색키워드
- 저자 : Stephen Locarnini (검색결과 4 건)
- 무료
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Symposium: Breaking the bricks in hepatitis B treatment : Antiviral resistance in hepatitis B
Stephen Locarnini 대한간학회 2009 Clinical and Molecular Hepatology(대한간학회지) Vol.15 No.4(S)
A high rate of viral turnover, combined with an error-prone polymerase, results in an increased frequency of mutational events during hepatitis B virus (HBV) replication, resulting in a diverse population of progeny virus (quasispecies). Not suprising then, particular selection pressures, both from within (host immune clearance) or from outside (vaccines and antivirals) the host, readily select out new "escape" mutants resulting in treatment failure. The introduction of nucleos(t)ide analogue (NA) therapy for chronic hepatitis B has resulted in the emergence of antiviral drug resistance which has itself become the major factor limiting treatment effectiveness. Furthermore, due to the overlap of the viral polymerase and envelop reading frames in the circular HBV DNA genome, NA-resistance associated mutations selected within the catalytic domains of the polymerase usually result in significant changes to the neutralising antibody binding domains of the hepatitis B surface antigen, including the emergence of antiviral drug associated potential vaccine escape mutants (ADAPVEM`s). The main reason for this is that the neutralisation domain, the "a" determinant, is a conformational epitope. The public health significance of APADVEM`s may then be very considerable in terms of the global program for control of hepatitis B via universal infant immunisation. Thus, prevention of resistance requires the adoption of strategies that not only effectively control active HBV replication but also prevent the emergence of APADVEMs.
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Hepatitis B Precore Protein: Pathogenic Potential and Therapeutic Promise
Renae Walsh,Stephen Locarnini 연세대학교의과대학 2012 Yonsei medical journal Vol.53 No.5
Hepatitis B virus (HBV), a small and economically packaged double-stranded DNA virus, represents an enormous global health care burden. In spite of an effective vaccine, HBV is endemic in many countries. Chronic hepatitis B (CHB) results in the development of significant clinical outcomes such as liver disease and hepatocellular carcinoma (HCC), which are associated with high mortality rates. HBV is a non-cytopathic virus, with the host’s immune response responsible for the associated liver damage. Indeed, HBV appears to be a master of manipulating and modulating the immune response to achieve persistent and chronic infection. The HBV precore protein or hepatitis B e antigen (HBeAg) is a key viral protein involved in these processes, for instance though the down-regulation of the innate immune response. The development of new therapies that target viral proteins, such as HBeAg, which regulates of the immune system, may offer a new wave of potential therapeutics to circumvent progression to CHB and liver disease.
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Molecular and clinical characteristics of hepatitis B virus in Korea
Ahn, Sang Hoon,Yuen, Lilly,Han, Kwang-Hyub,Littlejohn, Margaret,Chang, Hye Young,Damerow, Hans,Ayres, Anna,Heo, Jeong,Locarnini, Stephen,Revill, Peter A. Wiley Subscription Services, Inc., A Wiley Company 2010 Journal of Medical Virology Vol.82 No.7
<P>Korea is an endemic area of hepatitis B virus (HBV) infection but very little is known about the molecular characteristics of HBV isolates from Korean patients or the association with disease progression. The complete HBV genome sequences from 53 Korean patients with chronic hepatitis B, advanced cirrhosis, or hepatocellular carcinoma (HCC) were analyzed to identify (i) subgenotype distribution and genetic diversity and (ii) signature mutations associated with liver disease progression. With the exception of 1 patient infected with HBV/B, all 52 patients (98.1%) were infected with HBV/C, subgenotype C2. These strains were 98.4% identical and the frequency of amino acid substitutions occurring within key immunological epitopes increased with disease severity. A number of amino acid/nucleotide substitutions were associated with HCC, namely sR24K (HBsAg), SI126T (HBsAg), and pcA1846T (precore gene) mutations (P = 0.029, 0.001, and 0.008, respectively). HBV harboring deletions in the pre-S region were also associated with increased liver disease severity (chronic hepatitis B vs. cirrhosis, P = 0.040; chronic hepatitis B vs. HCC, P = 0.040). Despite the high degree of sequence conservation, several key HBV mutations were associated with disease progression. Prospective studies with larger cohorts of patients are required to evaluate further the clinical manifestation of HBV/C2 in Korea. J. Med. Virol. 82: 1126–1134, 2010. © 2010 Wiley-Liss, Inc.</P>
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