Clinical Update on Inflammatory Disorders of the by Julia Mayerle, Herbert Tilg

By Julia Mayerle, Herbert Tilg

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Gastroenterology 1999; 117:49–57. 79 Louis E, Collard A, Oger AF, Degroote E, Aboul Nasr El Yafi FA, Belaiche J: Behaviour of Crohn’s disease according to the Vienna classification: changing pattern over the course of the disease. Gut 2001;49:777–782. 80 Cosnes J, Nion-Larmurier I, Beaugerie L, et al: Impact of the increasing use of immunosuppressants in Crohn’s disease on the need for intestinal surgery. Gut 2005;54:237–241. 81 Rieder F, Fiocchi C: Intestinal fibrosis in IBD: a dynamic, multifactorial process.

HBV is not directly cytopathogenic. Hepatocellular injury is mainly mediated by the host’s immune response to viral antigens on the surface of the infected hepatocytes. In acute, self-limiting hepatitis B, strong T cell responses to HBV antigens are detectable. In chronic carriers, virus-specific T cell responses in the peripheral blood are diminished. Antibody responses are strong in both settings. Loss of immunological control in immunosuppressed patients can lead to reactivation of HBV DNA replication and hepatitis.

Hepatology 2008;48:750–758. 25 Chang TT, Gish RG, de Man R, et al: A comparison of entecavir and lamivudine for HBeAg-positive chronic hepatitis B. N Engl J Med 2006;354:1001– 1010. 26 Tenney DJ, Rose RE, Baldick CJ, et al: Two-year assessment of entecavir resistance in lamivudinerefractory hepatitis B virus patients reveals different clinical outcomes depending on the resistance substitutions present. Antimicrob Agents Chemother 2007;51:902–911. 27 Thio CL, Locarnini S: Treatment of HIV/HBV coinfection: clinical and virologic issues.

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