• I. V. D. Weller
Part of the The Bloomsbury Series in Clinical Science book series (BLOOMSBURY)


This chapter is largely devoted to hepatitis B virus infection, because of its high prevalence amongst homosexual men and the morbidity and mortality associated with the chronic carrier state, which develops in approximately 5% of those infected. There are three other main categories of viral hepatitis (Table 5.1).


Human Immune Deficiency Virus Hepatitis Delta Virus Chronic Persistent Hepatitis Adenine Arabinoside Lymphoblastoid Interferon 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. Adler MW, Belsey EM, McCutchan JA, Mindel A (1983) Should homosexuals be vaccinated against hepatitis B virus? Cost and benefit assessment. Br Med J 286:1621–1624CrossRefGoogle Scholar
  2. Aldershville J, Dietrichson O, Skinhoj P, Kryger P, Mathiesen LR, Christoffersen P, Nielsen JO and the Copenhagen Hepatitis Acute Programme (1982) Chronic persistent hepatitis: serological classification and meaning of the hepatitis Be system. Hepatology 2:243–246.CrossRefGoogle Scholar
  3. Alexander GJM, Fagan EA, Guarner P et al. (1986a) A controlled trial of 6 months thrice weekly lym-phoblastoid interferon versus no therapy in chronic hepatitis B virus infection. J Hepatol 3 (suppl 2): S183–S188PubMedCrossRefGoogle Scholar
  4. Alexander GJM, Fagan EA, Hegarty JE et al. (1986b) A controlled trial of acyclovir in stable chronic HBsAg, HBeAg positive carriers. J Hepatol 3 (suppl 2): S123–S127PubMedCrossRefGoogle Scholar
  5. Alexander GJM, Brahm J, Fagan EA et al. (1987) Loss of HBsAg with interferon therapy in chronic hepatitis B virus infection. Lancet ii: 66–68CrossRefGoogle Scholar
  6. Amoroso P, Lettieri G, Giorgio A et al. (1986) Lack of correlation between fulminant form of viral hepatitis and retrovirus infection associated with the acquired immunodeficiency syndrome (AIDS) in drug addicts. Br Med J 292:376–377CrossRefGoogle Scholar
  7. Anderson MG, Harrison TJ, Alexander G, Zuckerman AJ, Murray-Lyon IM (1987) Randomised controlled trial of lymphoblastoid interferon for chronic active hepatitis B. Gut 28:619–622PubMedCrossRefGoogle Scholar
  8. Barbara L, Mazzella G, Baraidini M et al. (1986) Randomised controlled trial with human lymphoblastoid interferon versus no treatment in chronic hepatitis B virus infection. J Hepatol 3 (suppl 2): S235–S238PubMedCrossRefGoogle Scholar
  9. Biggar RJ, Goedert JJ, Hoofnagle J (1987) Accelerated loss of antibody to hepatitis B surface antigen among immunodeficient homosexual males infected with HIV. N Engl J Med 316:630–631PubMedCrossRefGoogle Scholar
  10. Blumberg BS, Alter HJ, Visnich S (1965) Anew antigen in leukaemia sera. JAMA 191:541–546PubMedCrossRefGoogle Scholar
  11. Brechot C, Purcel C, Louise A, Rain B, Tiollais P (1980) Presence of integrated hepatitis B virus DNA sequences in cellular DNA of human hepatocellular carcinoma. Nature 286:533–535PubMedCrossRefGoogle Scholar
  12. Brechot C, Hadchouel M, Scotto J et al. (1981) State of hepatitis B virus DNA in hepatocytes of patients with hepatitis B surface antigen positive and negative liver diseases. Proc Natl Acad Sci USA 78:3906–3910PubMedCrossRefGoogle Scholar
  13. Burke CA (1986) A statistical view of clinical trials in chronic hepatitis B. J Hepatol 3 (suppl 2): S261–S267PubMedCrossRefGoogle Scholar
  14. Carne CA, Weller IVD, Johnson AM et al. (1987a) Prevalence of antibodies to human immunodeficiency virus, gonorrhoea rates and changed sexual behaviour in homosexual men in London. Lancet i: 656–658CrossRefGoogle Scholar
  15. Carne CA, Weller IVD, Waite J et al. (1987b) Impaired responsiveness of homosexual men with HIV antibodies to plasma derived hepatitis B vaccine. Br Med J 294:866–868CrossRefGoogle Scholar
  16. Chadwick RG, Galizzi J, Heathcost J et al. (1979) Chronic persistent hepatitis: hepatitis B virus markers and histological follow-up. Gut 20: 372–377PubMedCrossRefGoogle Scholar
  17. Chakraborty PR, Ruiz-opazo N, Shouval D, Shafritz DA (1980) Identification of integrated hepatitis B virus DNA and expression of viral RNA in an HBsAg producing human hepatocellular carcinoma cell line. Nature 286:531–533PubMedCrossRefGoogle Scholar
  18. Chalmers TC, Eckhardt RD, Reynolds WE et al. (1955) The treatment of acute infectious hepatitis. Controlled studies on the effects of diet, rest and physical reconditioning on the acute course of the disease and on the incidence of relapses and residual abnormalities. J Clin Invest 34:1163–1235PubMedCrossRefGoogle Scholar
  19. Christenson B, Brostrom CH, Bottiger M et al. (1982) An epidemic outbreak of hepatitis A among homosexual men in Stockholm. Hepatitis A, a special hazard for the male homosexual subpopulation in Sweden. J Epidemiol 116:599–607Google Scholar
  20. Corey L, Holmes KK (1980) Sexual transmission of hepatitis A in homosexual men. Incidence and mechanism. N Engl J Med 302:435–438PubMedCrossRefGoogle Scholar
  21. Coutinho RA, Albrecht-van lent P, Lelie N, Nagelkerke N, Kuipers H, Rijsdijk T (1983) Prevalence and incidence of hepatitis A among male homosexuals. Br Med J 287:1743–1745CrossRefGoogle Scholar
  22. Dane DS, Cameron CH, Briggs M (1970) Virus like particles in serum of patients with Australia antigen associated hepatitis. Lancet i: 695–698CrossRefGoogle Scholar
  23. Eddieston ALWF, Mandelli M, Mieli-Vergani G, Williams R (1982) Lymphocyte cytotoxicity to autologous hepatocytes in chronic hepatitis B virus infection. Hepatology 2:122S–127SGoogle Scholar
  24. Edman JC, Gray P, Valenzuela P, Rail LB, Rutter WJ (1980) Integration of hepatitis B virus sequences and their expression in a human hepatoma cell. Nature 286:535–538PubMedCrossRefGoogle Scholar
  25. Fagan EA, Williams R (1986) Serological responses to HBV infection. Gut 27:858–867PubMedCrossRefGoogle Scholar
  26. Fischl MA, Richman DD, Grieco MH et al. (1987) The efficacy of azidothymidine (AZT) in the treatment of patients with AIDS and AIDS-related complex. A double-blind, placebo controlled trial. N Engl J Med 317:185–191PubMedCrossRefGoogle Scholar
  27. Francis DP, Hadler SC, Thompson SE et al. (1982) The prevention of hepatitis B with vaccine. Report of the Centers for Disease Control multi-center efficacy trial among homosexual men. Ann Intern Med 97: 362–366PubMedGoogle Scholar
  28. Grady GF, Lee VA, Prince AM et al. (1978) Hepatitis B immune globulin for accidental exposures among medical personnel: final report of a multicenter controlled trial. J Infect Dis 138:625–638PubMedCrossRefGoogle Scholar
  29. Harville DD, Summerskill WHJ (1963) Surgery in acute hepatitis. J Am Med Assoc 184:257–261CrossRefGoogle Scholar
  30. Heathcote J, Sherlock S (1973) Spread of acute type B hepatitis in London. Lancet i: 1468–1470CrossRefGoogle Scholar
  31. Hoofnagle JH (1980) Hepatitis B surface antigen (HBsAg) and antibody (anti-HBs). In: Bianchi L, Gerok W, Sickinger K, Stalder GA (eds) Virus and the liver. MTP Press Limited, pp 27–37Google Scholar
  32. Hoofnagle J (1986) Clinical trials of the interferons. J Hepatol 3 (suppl 2): S253–S258Google Scholar
  33. Hoofnagle JH, Seef LB, Bales B et al. (1979) Passive-active immunity from hepatitis B immune globulin re-analysis of a Veterans Administration Group study of needlestick hepatitis. Ann Intern Med 91: 813–818PubMedGoogle Scholar
  34. Hoofnagle JH, Minuk GY, Dusheiko GM et al. (1982) Adenine arabinoside 5’-monophosphate treatment of chronic type B hepatitis. Hepatology 2:784–788PubMedCrossRefGoogle Scholar
  35. Hoofnagle JH, Mullen KD, Jones B et al. (1986) Treatment of chronic non-A, non-B hepatitis with recombinant human alpha interferon-a preliminary report. N Engl J Med 315:1575–1578PubMedCrossRefGoogle Scholar
  36. Iwarson SA (1987) Non-A, non-B hepatitis: dead ends or new horizons? Br Med J 295:946–948CrossRefGoogle Scholar
  37. Krogsgaard K, Lindhardt BO, Nielsen JO et al. (1987) The influence ofHTLV-III infection on the natural history of hepatitis B virus infection in male homosexual HBsAg carriers. Hepatology 1:37–41CrossRefGoogle Scholar
  38. Lai CL, Lok ASF, Lin HJ, Wu PC, Yeoh EU, Yeung CY (1987) Placebo controlled trial of recombinant alpha-2 interferon in Chinese HBsAg-carrier children. Lancet ii: 877–683CrossRefGoogle Scholar
  39. Lam KC, Lai CL, Ng RP, Trepo C, Wu PC (1981) Deleterious effect of prednisolone in HBsAg positive chronic active hepatitis. N Engl J Med 304:380–386PubMedCrossRefGoogle Scholar
  40. Laure F, Chatenoud C, Pasquinelli C et al. (1987) Frequent lymphocyte infection by hepatitis B virus in haemophiliacs. Br J Haematol 65:181–185PubMedCrossRefGoogle Scholar
  41. Liaw YF, Chu CM, Chen TJ, Lin DY, Chang-Chien CS, Wu CS (1982) Chronic lobular hepatitis: a clinicopathological and prognostic study. Hepatology 2:258–262PubMedCrossRefGoogle Scholar
  42. Lok ASF, Weller IVD, Karayiannis P et al. (1984) Thrice weekly lymphoblastoid interferon is effective in inhibiting hepatitis B virus replication. Liver 4:45–49PubMedGoogle Scholar
  43. Lok ASF, Lai CL, Wu PC (1986) Interferon therapy of chronic hepatitis B virus infection in Chinese. J Hepatol 3 (suppl 2): S209–S215PubMedCrossRefGoogle Scholar
  44. Mackay P, Lees J, Murray K (1981) The conversion of hepatitis B core antigen synthesized in E. coli : into“e” antigen. J Med Virol 8:237–243CrossRefGoogle Scholar
  45. Magnius LO, Epsmark JA (1972) New specificities in Australia antigen positive sera distinct from the Le Bouvier determinants. J Immunol 109:1017–1021PubMedGoogle Scholar
  46. McDonald JA, Caruso L, Karayiannis P et al. (1987a) Diminished responsiveness of male homosexual chronic hepatitis B virus carriers with HTLV-III antibodies to recombinant alpha-interferon. Hepatology 7: 719–723PubMedCrossRefGoogle Scholar
  47. McDonald JA, Harris S, Waters JA, Thomas HC (1987b) Effect of human immunodeficiency virus (HIV) infection on chronic hepatitis B viral antigen display. J Hepatol 4:337–342PubMedCrossRefGoogle Scholar
  48. Mindel A, Tedder RS (1981) Hepatitis A in homosexuals. Br Med J 282:1666CrossRefGoogle Scholar
  49. MRC and PHLS (Medical Research Council and Public Health Laboratory Service) (1980) The incidence of hepatitis B infection after accidental exposure and anti-HBs immunoglobulin prophylaxis. Lancet i: 6–8Google Scholar
  50. Mulley AG, Silverstein MD, Dienstag JC (1982) Indications for hepatitis B vaccine, based on cost effectiveness analysis. N Engl J Med 307:644–652PubMedCrossRefGoogle Scholar
  51. Nielsen JO, Dietrichson O, Elling P, Christoggersen P (1971) Incidence and meaning of persistence of Australia antigen in patients with acute viral hepatitis: development of chronic hepatitis. N Engl J Med 285:1157–1160PubMedCrossRefGoogle Scholar
  52. Noonan CA, Yoffe B, Mansell PW, Melnick JL, Hollinger FB (1986) Extxachromosomal sequences of hepatitis B virus DNA in peripheral blood mononuclear cells of acquired immune deficiency syndrome patients. Proc Natl Acad Sci USA 83:5698–5702PubMedCrossRefGoogle Scholar
  53. Novick DM, Lok SF, Thomas HC (1985) Diminished responsiveness of homosexual men to antiviral therapy for HBsAg positive chronic liver disease. J Hepatol 1:15–27CrossRefGoogle Scholar
  54. Novick DM, Brown DJC, Lok ASF, Lloyd JC, Thomas HC (1986) Influence of sexual preference and chronic hepatitis B virus infection and T lymphocyte subsets, natural killer cell activity and suppressor cell activity. J Hepatol 3:363–370PubMedCrossRefGoogle Scholar
  55. Omata M, Uchiumi K (1986) Combination of prednisolone withdrawal and antiviral agents (adenine, arabinoside, interferon) in chronic hepatitis B. J Hepatol 3 (suppl 2): S65–S69PubMedCrossRefGoogle Scholar
  56. Pasquinelli C, Laure F, Chatenoud L (1986) Hepatitis B virus DNA in mononuclear blood cells. A frequent event in hepatitis B surface antigen-positive and negative patients with acute and chronic liver disease. J Hepatol 3:95–103PubMedCrossRefGoogle Scholar
  57. Perillo RP (1986) The use of corticosteroids in conjunction with antiviral therapy in chronic hepatitis B with ongoing viral replication. J Hepatol 3 (suppl 2); S57–S64CrossRefGoogle Scholar
  58. Perillo RP, Gelb L, Campbell C et al. (1979) Hepatitis BeAg, DNA polymerase activity and infection of household contacts with hepatitis B virus. Gastroenterology 76:1319–1325Google Scholar
  59. Perillo R, Regenstein F, Bodicky C et al. (1985) Comparative efficacy of adenine arabinoside 5’-monophosphate and prednisone withdrawal followed by adenine arabinoside 5’-monophosphate in the treatment of chronic active hepatitis B. Gastroenterology 88:780–786Google Scholar
  60. Perillo RP, Regenstein FG, Roodman ST (1986) Chronic hepatitis B in asymptomatic homosexual men with antibody to the human immunodeficiency virus. Ann Intern Med 105:382–383Google Scholar
  61. Pignatelli M, Waters J, Lever A, Iwarson S, Gerety R, Thomas HC (1987) Cytotoxic T-cell responses to the nucleocapsid proteins of HB V in chronic hepatitis-evidence that antibody modulation may cause protracted infection. J Hepatol 4:11–21CrossRefGoogle Scholar
  62. Prinsen H, Goilav C, Safary A, Andre FE, Piot P (1987) Immunogenicity and tolerance of a yeast derived hepatitis B vaccine in homosexual men. Postgrad Med J 63 (suppl 2): 147–150PubMedGoogle Scholar
  63. Redeker AG, Mosley JW, Gocke DJ, McKee AP, Pollack W (1975) Hepatitis B immune globulin as a prophylactic measure for spouses exposed to acute type B hepatitis. N Engl J Med 293:1055–1059PubMedCrossRefGoogle Scholar
  64. Reiner NE, Judson FN, Bond WW, Francis DP, Petersen NJ (1982) Asymptomatic rectal mucosal lesions and hepatitis B surface antigen at sites of sexual contact in homosexual men with persistent hepatitis B virus infection. Ann Intern Med 96:170–173PubMedGoogle Scholar
  65. Repsher LH, Freebern RK (1969) Effect of exercise on recovery from infective hepatitis. N Engl J Med 281:1393–1396PubMedCrossRefGoogle Scholar
  66. Rizzetto M, Verme G (1985) Delta hepatitis-present status. J Hepatol 1:187–193 Rizzetto M, Rosina F, Saracco G et al. (1986) Treatment of chronic delta hepatitis with alpha-2 recombinant interferon. J Hepatol 3 (suppl 2): S229–S233Google Scholar
  67. Schreeder MT, Thompson SE, Hadler SC et al. (1982) Hepatitis B in homosexual men: prevalence of infection and factors related to transmission. J Infect Dis 146:7–15PubMedCrossRefGoogle Scholar
  68. Scott RM (1980) Experimental transmission of hepatitis B virus by semen and saliva. J Infect Dis 142: 67–71PubMedCrossRefGoogle Scholar
  69. Scullard GA, Smith CI, Merigan TC, Robinson Ws, Gregory PB (1981a) Effects of immunosuppressive therapy on viral markers in chronic active hepatitis B. Gastroenterology 81:987–991PubMedGoogle Scholar
  70. Scullard GH, Pollard RB, Smith JI et al. (1981b) Antiviral treatment of chronic hepatitis B virus infection. Changes in viral markers with interferon combined with adenine arabinoside. J Infect Dis 143:772–783PubMedCrossRefGoogle Scholar
  71. Summers J (1981) Three recently described animal virus models for human hepatitis B virus. Hepatology 1:179–183PubMedCrossRefGoogle Scholar
  72. Summers J, Mason WS (1982) Properties of the hepatitis B like viruses related to their taxonomic classification. Hepatology 2: 61S–66SGoogle Scholar
  73. Swift WE, Gardner HT, Moore DJ, Streitfeld FH, Havens WP (1950) Clinical course of viral hepatitis and the effect of exercise during convalescence. Am J Med 8: 614–622PubMedCrossRefGoogle Scholar
  74. Szmuness W (1978) Hepatocellular carcinoma and the hepatitis B virus: evidence for a causal association. Prog Med Virol 24:40–69PubMedGoogle Scholar
  75. Szmuness W, Stevens CE, Harley EJ et al. (1980) Hepatitis B vaccine. Demonstration of efficacy in a controlled clinical trial in a high risk population in the United States. N Engl J Med 303:833–841PubMedCrossRefGoogle Scholar
  76. Tedder RS, Cameron CH, Wilson-Croome R, Howell DR, Colgrove A, Barbara JAJ (1980) Contrasting patterns and frequency of antibodies to the surface, core and e antigens of hepatitis B virus in blood donors and in homosexual patients. J Med Virol 6: 323–332CrossRefGoogle Scholar
  77. Teixeira MR Jr, Weiler IVD, Murray A et al. (1982) The pathology of hepatitis A in man. Liver 2:53–60PubMedGoogle Scholar
  78. Thomas HC, Scully LJ, McDonald JA (1986) Lymphoblastom and recombinant alpha-A interferon therapy of chronic hepatitis B virus infection-the Royal Free Hospital experience. J Hepatol 3 (suppl 2): S193–S197PubMedCrossRefGoogle Scholar
  79. Toillais P, Charnay P, Vyas GN (1981) Biology, hepatitis B virus. Science 213:406–411CrossRefGoogle Scholar
  80. Trepo C, Hartz O, Ouzan D (1984) Therapeutic efficacy of ARA-AMP in symptomatic HBeAg positive CAH: a randomised placebo controlled study. Hepatology 4:1055Google Scholar
  81. Underhill GS, Jeffries DJ, Forster GE, Harris JR (1986) Correlation between fulminant form of viral hepatitis and retrovirus infection associated with AIDS. Br Med J 292:1080–1081CrossRefGoogle Scholar
  82. Villa E, Rubbiani L, Barchi T et al. (1982) Susceptibility of chronic symptomless HBsAg carriers to ethanol-induced hepatic damage. Lancet ii: 1243–1244CrossRefGoogle Scholar
  83. Viola LA, Barrison IG, Coleman JC, Paradinas FJ, Fluker JL, Murray-Lyon IM (1981) Natural history of liver disease in chronic hepatitis B surface antigen carriers survey of 100 patients from Great Britain. Lancet ii: 1156–1159Google Scholar
  84. Viola LA, Barrison IG, Coleman JC, Murray-Lyon IM (1982) The clinical course of acute type A hepatitis in chronic HBsAg carriers-a report of 3 cases. Postgrad Med J 58: 80–81PubMedCrossRefGoogle Scholar
  85. Ware AJ, Cuthbert JA, Shorey J, Gurian LE, Eigenbrodt EH, Combes B (1981) A prospective trial of steroid therapy in severe viral hepatitis. Gastroenterology 80:219–224PubMedGoogle Scholar
  86. Weller IVD, Bassendine MF, Craxi A et al. (1982a) Successful treatment of HBs and HBeAg positive chronic liver disease: prolonged inhibition of viral replication by highly soluble adenine arabinoside 5’-monophosphate (ARA-AMP). Gut 23:717–723PubMedCrossRefGoogle Scholar
  87. Weller IVD, Bassendine MF, Murray A, Craxi A, Thomas HC, Sherlock S (1982b) Effects of pred-nisolone/azathioprine in chronic hepatitis B viral infection. Gut 23:650–655PubMedCrossRefGoogle Scholar
  88. Weller IVD, Fowler MJF, Monjardino J, Carreno V, Thomas HC, Sherlock S (1982c) Inhibition of hepatitis B viral replication by lymphoblastoid interferon. Philos Trans R Soc Lond (Biol) 299:128–130CrossRefGoogle Scholar
  89. Weller IVD, Carreno V, Fowler MJF et al. (1983a) Acyclovir in HBeAg-positive chronic liver disease. J Antimicrob Chemother 11:223–231PubMedCrossRefGoogle Scholar
  90. Weller IVD, Karayiannis P, Lok ASF et al. (1983b) The significance of delta agent infection in chronic hepatitis B virus infection: a study in British carriers. Gut 24:1016–1063CrossRefGoogle Scholar
  91. Weller IVD, Cohn D, Sierralta A et al. (1984) Clinical, biochemical, serological, histological and ultra-structural features of liver disease in drug abusers. Gut 25:417–423PubMedCrossRefGoogle Scholar
  92. Weller IVD, Lok ASF, Mindel A et al. (1985) Randomised controlled trial of adenine arabinoside 5’-monophosphate (ARA-AMP) in chronic hepatitis B virus infection. Gut 26:745–751PubMedCrossRefGoogle Scholar
  93. Weller IVD, Brown A, Morgan B et al. (1986) Spontaneous loss of HBeAg and the prevalence of HTLV-III/LAV infection in a cohort of homosexual hepatitis B virus carriers and the implications for antiviral therapy. J Hepatol 3 (suppl 2): S9–S16PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • I. V. D. Weller

There are no affiliations available

Personalised recommendations