Hepatitis B : a light microscopical and immunohistochemical study.
Degree: Department of Pathology, 1989, Erasmus University Medical Center
textabstractThe findings reported in this thesis provide a basis for a strategy for anti-viral
treatment of chronic hepatitis B.
Theoretically several approaches to the treatment of a viral infection exist.
Because there is strong evidence for a direct relation between viral replication
and activity of the liver disease, one therapeutic possibility may be to achieve
suppression of viral replication and thus amelioriation of disease activity.
For this purpose drugs that interfere with both viral RNA transcription and the
production of viral proteins can be administered in order to suppress replication
of the virus.
At present however such drugs are. not available. Moreover the infection will not
be cured: instead only the effects will mitigated. Such a drug may suppress both
the immune mechanism, by diminishing protein (HBsAg) production, and the
toxic effects, by reducing proliferation of the virus.
Elimination of the potential of an infected cell to produce a virus is another
To accomplish this aim, drugs can be used that eliminate ali infected hepatocytes
from the liver. As shown in chapter VI, in chronic hepatitis all hepatocytes
appear to be infected by the virus, as demonstrated by the diffuse cell membranebound
HBsAg localization, so that such a therapy would imply elimination of all
If this elimination were to occur rapidly, the result would be massive liver cell
necrosis and death of the patient A more realistic way to eliminate the potential of infected cells to produce virus
would be to cure infection of the hepatocyte.
Such a therapy may be achieved by inhibition of viral DNA synthesis. Since viral
DNA formation depends on reverse transcription, drugs such as phosphonoformic
acid that interfere with reverse transcriptasewould prevent the generation
of cccDNA. However preliminary results with this type of drug are not hopeful. A
decline in viral replication activity is followed by rapid restoration of this activity
after withdrawal of the drug.
Finally, another possibility is to cure the chronic infection by creating a situation
in which newly formed hepatocytes are protected against reinfection by the virus.
In this way, the number of infected hepatocytes will slowly decrease, as a result
of regeneration of the liver, and all infected cells will eventually disappear.
Subjects/Keywords: hepatitis B; HBsAg-positive patients; liver tissue; chronic infection; Australia antigen; pathobiology
to Zotero / EndNote / Reference
APA (6th Edition):
Kate, F. (1989). Hepatitis B : a light microscopical and immunohistochemical study. (Doctoral Dissertation). Erasmus University Medical Center. Retrieved from http://hdl.handle.net/1765/50943
Chicago Manual of Style (16th Edition):
Kate, Fiebo. “Hepatitis B : a light microscopical and immunohistochemical study.” 1989. Doctoral Dissertation, Erasmus University Medical Center. Accessed December 14, 2019.
MLA Handbook (7th Edition):
Kate, Fiebo. “Hepatitis B : a light microscopical and immunohistochemical study.” 1989. Web. 14 Dec 2019.
Kate F. Hepatitis B : a light microscopical and immunohistochemical study. [Internet] [Doctoral dissertation]. Erasmus University Medical Center; 1989. [cited 2019 Dec 14].
Available from: http://hdl.handle.net/1765/50943.
Council of Science Editors:
Kate F. Hepatitis B : a light microscopical and immunohistochemical study. [Doctoral Dissertation]. Erasmus University Medical Center; 1989. Available from: http://hdl.handle.net/1765/50943