The Hepatitis B Virus

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Introduction
Hepatitis B virus (HBV) infection is reported as a major health problem in Africa, Western Pacific and Asian countries especially in sub-Saharan Africa with population 65 million patients that has chronic HBV [3, 4]. The HBV infection is interplay between virus replication and host immune system. Large numbers of regulatory T cell (Treg) are found in the HBV patients because the HBV specific CD8 T cell is inhibited by this Treg cell [5]. By transmitting through the skin or mucous membrane, HBV will cause chronic infection and affect the liver cancer and followed with hepatocellular carcinoma (HCC) [2]. Basically, HBV infection are described by four levels of phase that is immune tolerant phase, immune reactive phase, resolution phase and reactivation phase [2].
Hepatitis B and Hepatocellular Carcinoma
Hepatocellular carcinoma is one of the diseases that closely related to the infections with hepatitis B virus (HBV). The institution of Taiwan’s program of universal Hepatitis B vaccination reported that children have stronger association towards HBV and hepatocellular carcinoma compared to adult. After 10 years of launching the vaccination program, the data reported that the incidence of hepatocellular carcinoma is declined from 0.52 to 0.13 referring to the children between 6 to 9 years [1]. In addition, early detection of hepatocellular carcinoma can be enhancing by screening the HBV with ultrasonography and alfa-fatoprotein [2]. The decrease in HBsAg-seropositivity automatically reduced the rate of horizontal HBV infection and reflects the decline in hepatocellular carcinoma [1].
Based on the case-control and cohort studies show that the presence of HBsAg in serum causes the chronic HBV infection and elevated for...

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...atient with moderate HBV and offered 4-6 months interferon, 1 year course of lamivudine and adefovir. However, the patient that has chronic HBV is not recommended to use the treatment because the efficacy of existing therapy is very low but at the same time, it must be monitored [4]. In patients, interferon-α are contraindicated with the severe depression, autoimmune disease or deteriorated HBV related cirrhosis. Other than that, interferon-α also give the better response to the HBV genotype A and B compared to the genotype C and D [6, 10].
After 1 year treatment with interferon-α, the HBeAg of HBV patients are lost about 15-25% [4]. Lamivudine on the other hands show that 10-15% with lower incidence seroconversion of HBeAg [4, 10]. Emergence of adefovir resistance is associated with liver failure and reported that resistance to adefovir is slower that lamivudine.

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