Overview of the Natural History of Chronic Hepatitis B

n the advance online edition of the Journal of Hepatology, Fattovich Giovanna and colleagues presented an overview of the natural history of chronic hepatitis B, with an emphasis on the rate of disease progression and factors influencing the course of the liver disease.

Among the major points of the review were the following:

1. Hepatitis B virus (HBV) infection is complex and its course is highly variable.
2. Chronic hepatitis B is characterized by an early replicative phase, or HBeAg positive chronic hepatitis.
3. This is followed by a late low or non-replication phase with HBeAg seroconversion and liver disease remission, known as the inactive carrier state.
4. Most infected adults become inactive carriers after spontaneous HBeAg seroconversion, with good long-term prognosis.
5. However, progression to HBeAg negative chronic hepatitis -- due to infection with mutant HBV variants that do not express the “e” antigen --occurs at a rate of 1-3 per 100 person-years following HBeAg seroconversion.
6. The incidence of liver cirrhosis appears to be about twice as high in HBeAg negative compared with HBeAg positive chronic hepatitis B patients.
7. In patients with cirrhosis, the 5-year cumulative risk of developing hepatocellular carcinoma is 17% in East Asia (where HBV is endemic) and 10% in Western Europe and the U.S.
8. The 5-year rate of liver-related death is 14% in East Asia and 15% in Europe.

In conclusion, the authors wrote, “There is a growing understanding of viral, host, and environmental factors influencing disease progression, which ultimately could improve the management of chronic hepatitis B.”

Hepatitis B doesn’t raise pancreatic cancer risk

Contrary to popular opinion, hepatitis B doesn’t appear to increase the risk of developing pancreatic cancer, say researchers.

However, the overall analysis has revealed that only age is significant predictor for pancreatic cancer.

Hepatitis B is an inflammation of the liver caused by a viral infection.

“We looked at the incidence of pancreatic cancer among hepatitis B-infected patients over a 13-year period and found that we could not confirm a higher risk for those with a previous exposure to hepatitis B, as a prior study suggested,” said Dr Jeffrey Tang, gastroenterologist at Henry Ford Hospital and lead author of the study.

“When other factors are considered - such as age, race, sex, HIV status, and the presence of diabetes - only older age and presence of diabetes proved significant, whereas prior exposure to hepatitis B was no longer an important variable,” Tang added.

The study was presented at the American Association for the Study of Liver Diseases’ Annual Meeting in Boston. (ANI)

Prevent Swine Flue by this precautions

The following message given by him, I feel makes a lot of sense and is important for all to know

The only portals of entry are the nostrils and mouth/throat. In a global epidemic of this nature, it's almost impossible to avoid coming into contact with H1N1 in spite of all precautions. Contact with H1N1 is not so much of a problem as proliferation is.

While you are still healthy and not showing any symptoms of H1N1 infection, in order to prevent proliferation, aggravation of symptoms and development of secondary infections, some very simple steps, not fully highlighted in most official communications, can be practiced (instead of focusing on how to stock N95 or Tamiflu):

1. Frequent hand-washing (well highlighted in all official communications).

2. "Hands-off-the-face" approach. Resist all temptations to touch any part of face (unless you want to eat, bathe or slap).

3. *Gargle twice a day with warm salt water (use Listerine if you don't trust salt). *H1N1 takes 2-3 days after initial infection in the throat/ nasal cavity to proliferate and show characteristic symptoms. Simple gargling prevents proliferation. In a way, gargling with salt water has the same effect on a healthy individual that Tamiflu has on an infected one. Don't underestimate this simple, inexpensive and powerful preventative method.

4. Similar to 3 above, *clean your nostrils at least once every day with warm salt water. *Not everybody may be good at Jala Neti or Sutra Neti (very good Yoga asanas to cleannasal cavities), but *blowing the nose hard once a day and swabbing both nostrils with cotton buds dipped in warm salt water is very effective in bringing down viral population.*


5. *Boost your natural immunity with foods that are rich in Vitamin C (Amla and other citrus fruits). *If you have to supplement with Vitamin C tablets, make sure that it also has Zinc to boost absorption.

6. *Drink as much of warm liquids (tea, coffee, etc) as you can. *Drinking warm liquids has the same effect as gargling, but in the reverse direction. They wash off proliferating viruses from the throat into the stomach where they cannot survive, proliferate or do any harm.

I suggest you pass this on to your entire e-list. You never know20who might pay attention to it - and STAY ALIVE because of it.

vaccination