title: Antiviral therapy in acute viral hepatitis B: why and when.
abstract: Acute viral hepatitis B is cleared in more than 95% of patients, while the remainder ones may develop either chronic HBV infection or, rarely, fulminant hepatitis.Therefore there are elderly patients with severe acute HBV hepatitis caractherized by high serum bilirubin levels >15 mmole/dl, international normalized ratio (INR) with value more than 1.6; these patients are caractherized by a severe outcome of HBV infection.As known, outcome of infection and the pathogenesis of liver diseases are determined by viral and host factors, such as T reg lymphocytes.T regs may be associated with a negative immune response such as an inhibition of gamma- IFN secretion.The impact of viral load on antiviral T cell responses may play a critical role in these patients, influencing disease persistence and immune response.Antiviral drugs could be useful in these patients determing a possible down -regulation of T regs.
authors.affiliation: VII Department of Infectious Diseases and Immunology, "D, Cotugno" Hospital, Naples, Italy. pinomorelli25@libero.it
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Morelli
authors.forename: Alessandro
authors.initials: A
authors.lastname: Perrella
authors.forename: Costanza
authors.initials: C
authors.lastname: Sbreglia
authors.forename: Pasquale
authors.initials: P
authors.lastname: Bellopede
authors.forename: Vincenzo
authors.initials: V
authors.lastname: Riccio
authors.forename: Oreste
authors.initials: O
authors.lastname: Perrella