Informed Patient Conference
June 8-9, 2007
Highlights from the Parent Session
June 8, 2007
HBV 101: What Parents Should Know About Hepatitis
Maureen Kamischke, HBV Educator
- Review of the function of the liver and description of the hepatitis B virus (HBV).
- There are as many as 1-10 trillion hepatitis B virus particles produced per day in a person, and even more surface antigen particles.
- There are numerous mutations generated every day in the process of HBV replication
- Some mutations that occur can be more aggressive than the “wild type” virus, and these mutations can become more dominant as the wild-type virus is suppressed by antiviral drugs.
- Review of the different labs test for HBV and why they are important (see slides).
- Be careful when comparing viral loads from different labs to make sure they are measuring with the same units (IU/ml, pg/ml, cp/ml) – if they are different, ask the lab for a conversion. See slides for the conversion rates between the units of measurement.
- e-antigen seroconversion is generally the desired result from current drug therapies, with surface antigen seroconversion being the “holy grail” or most desirable outcome.
- Most adopted children with HBV are in the “immune tolerant” phase where the HBV reproduces without any interference from the immune system. They can have very high viral DNA levels with normal ALT enzyme levels. Treatment is not usually recommended at this time.
- Thoughts of using treatment in kids begins during the “immune clearance stage” when the immune system has recognized the virus and begins to attack infected liver cells. This attack of liver cells results can result in a significant increase of ALT enzyme levels with variable viral DNA levels.
- Some children can spontaneously experience e-antigen seroconversion (loss of e-antigen) during this phase without therapeutic intervention.
Maureen became involved in the world of hepatitis B when she and her husband adopted their youngest daughter nine years ago. She is known for her extensive work with PKIDs (Parents of Kids with Infectious Diseases). Maureen traveled to China with PKIDs to present a pilot training program to teach doctors, health care, and orphanage workers about safe medical practices and disease prevention. Maureen has spent many years involved with the Hepatitis B Information and Support List, the PKIDs listserve, and more recently, the HBV Adoption Support List. Maureen worked previously as a systems engineer and has a degree in microbiology. She lives with her husband and two children in Highland, Maryland.
Please know that the Hepatitis B Foundation provides these summaries for information purposes only, not as personal medical advice. Be sure to consult your own health care provider with any questions or concerns you may have about your management and/or treatment.