Talk:Hepatitis B/Archive 2

Broken Link to CDC page on Hepatitis B
the first external link is broken... it leads to nowhere. —Preceding unsigned comment added by 174.88.50.157 (talk • contribs) 01:52, 28 February 2010


 * Great catch - thank you! Fixed.  -- Scray (talk) 15:16, 28 February 2010 (UTC)

Serotypes and genotypes
I think the information in this section would be easier to read as a table. Graham Colm (talk) 18:37, 17 April 2010 (UTC)

External Review Comments
The following comments are from an external reviewer BSW-RMH as part of the new joint Wikipedia talk:WikiProject Medicine/Google Project.

Hello Hepatitis B article writers and editors, This article currently has GA status and is a high priority article for the Wikipedia talk:WikiProject Medicine/Google Project. I hope that I can offer some useful suggestions to enhance it further. Specific suggestions are as follows:

Genome
There is information showing that Hbx is important for persistent viral infection because of it's gene expression and viral replication enhancer activity. These properties may contribute to the development of HCC, however this is controversial. Perhaps this info could be incorporated to refine the last sentence. See:
 * Benhenda S, Cougot D, Buendia MA, Neuveut C. Hepatitis B virus X protein molecular functions and its role in virus life cycle and pathogenesis. Adv Cancer Res. (2009);103:75-109. PMID: 19854353
 * Tsai WL, Chung RT. Viral hepatocarcinogenesis. Oncogene. 2010;29(16):2309-24. PMID: 20228847

Serotypes and Gentotypes
The lists of worldwide distributions of serotypes and genotypes requires referencing. The following references may be useful for this purpose:
 * Norder H, Couroucé AM, Coursaget P, Echevarria JM, Lee SD, Mushahwar IK, Robertson BH, Locarnini S, Magnius LO. Genetic diversity of hepatitis B virus strains derived worldwide: genotypes, subgenotypes, and HBsAg subtypes. Intervirology. (2004) Nov-Dec;47(6):289-309. PMID: 15564741
 * Pujol FH, Navas MC, Hainaut P, Chemin I. Worldwide genetic diversity of HBV genotypes and risk of hepatocellular carcinoma. Cancer Lett. (2009);286(1):80-8. PMID: 19683385

Prognosis
I think it would be useful to add information on the percentages of chronically infected individuals (20-30 yrs) that go on to develop cirrhosis (20-30%). Of these, 3-8% go on to develop liver cancer (HCC). This gives a perspective of how rare the development of liver cancer is for infected individuals.
 * Fattovich G. Natural history and prognosis of hepatitis B. Sem Liver Diseas. (2003);23: 47–58.
 * more info: Tsai WL, Chung RT. Viral hepatocarcinogenesis. Oncogene. 2010;29(16):2309-24. PMID: 20228847

Epidemiology
I think this section could benefit from expansion of worldwide statistics. Examples:
 * 5 million new cases of HBV each year (Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J. Viral. Hepat. (2004); 11: 97–107, also a useful general reference written by WHO official)
 * HBV-related deaths estimates range from 200,000-1.2 million each year. (Fattovich G, Bortolotti F, Donato F. Natural history of chronic hepatitis B: special emphasis on disease progression and prognostic factors. ‘’J Hepatol’’. (2008);48(2):335-52. PMID: 18096267, Chen DS. Toward elimination and eradication of hepatitis B. J Gastroenterol Hepatol. (2010) ;25(1):19-25. PMID: 20136972)


 * HBV causes about 80% of HCC worldwide, which one of the top three causes of death in Africa, Asia and the Pacific Rim. Ref: Tsai WL, Chung RT. Viral hepatocarcinogenesis. ‘’Oncogene’’. 2010;29(16):2309-24. PMID: 20228847, Parkin DM, Bray F, Ferlay J, Pisani P. Estimating the world cancer burden:Globocan Int J Cancer (2001);94(2):153-6
 * HCC is the fifth most common cancer and the third leading cause of cancer-related death worldwide: see primary reference in Tsai WL, Chung RT. Viral hepatocarcinogenesis. Oncogene. 2010;29(16):2309-24. PMID: 20228847

BSW-RMH (talk) 17:39, 13 May 2010 (UTC)

Response — Thank you for this review. I haven't got copies of all these references, so I will need some time to respond in full. My immediate impression is that the "numbers" need updating and referencing. I am pleased that no obvious omissions were found. BTW why are these comments addressed to "Hypertension" editors? Graham Colm (talk) 10:47, 14 May 2010 (UTC)


 * Sorry about the reference to Hypertension-fixed it. If you need a particular article for personal research use you can contact me on the talk page and I may be able to help with that. The need to update statistics is common and usually an ongoing issue. A stats review every 6-12 months (depending on the subject and how fast research moves in that area) is probably good practice to keep all articles up to date. BSW-RMH (talk) 17:30, 14 May 2010 (UTC)

Enterovirus &!
Why no vaccine ne?? —Preceding unsigned comment added by 137.132.243.143 (talk) 10:40, 2 December 2010 (UTC)
 * Good question but wrong article, try enterovirus. Graham Colm (talk) 11:12, 2 December 2010 (UTC)

origination of vaccine
According to The Economist of April 30 2011 Barry Blumberg developed the vaccine for Hepatitis B.    You attribute it to  Maurice Milleman. also see; http://en.wikipedia.org/wiki/Barry_Blumberg —Preceding unsigned comment added by Arydberg (talk • contribs) 13:22, 4 May 2011 (UTC)
 * I have removed the reference to Hilleman. Both of these researchers worked on a vaccine, but they are not the vaccines in use today. Blumberg first described a candidate vaccine in the late 1960s, but he could not persuade the pharmaceutical industry to develop it. Hilleman published research papers in the 1970s ( e.g. ), but unlike Blumberg, his candidate vaccine was tested in large clinical trials. It difficult, if not impossible to say who has priority. Graham Colm (talk) 18:03, 4 May 2011 (UTC)

You are probably right. Must be the Nobel Prize people got it wrong. —Preceding unsigned comment added by Arydberg (talk • contribs) 02:04, 5 May 2011 (UTC)

Use and reuse
The emphasis in the sentence with the phrase "more importantly" is on the reuse of the hypodermic needles. This seems to be an important emphasis as the cause of the epidemic. I am at a loss as to why someone wants to remove this emphasis. Yobol (talk) 17:19, 13 January 2012 (UTC)
 * So am I. The salient point is the reuse of the needles. Graham Colm (talk) 19:17, 13 January 2012 (UTC)

"DANE particle" - should be "Dane"?; + explanation needed
Can someone provide a (sub-)section on the DANE particle? And shouldn't it be "Dane" not "DANE"?

The section on Pathogenesis offers the term "DANE particle" - apparently as a synonym for "HBV virion", but without confirming this or explaining the term.

This leaves the reader guessing whether the term is specific to Hep B, hepadna viruses more generally, or virology as a whole or what. (Also guessing, as the term's presented in CAPS, whether it's an acronym - thus: "DNA, no, wait, DNA, uh, Antigen, uh, mmm"!)

According to Merriam-Webster (http://www.merriam-webster.com/medical/dane%20particle) it's named for a British pathologist, David Dane, and I gather that (as our article hints) it's wholly specific to HepB. SquisherDa (talk) 09:49, 28 April 2012 (UTC)


 * Prof. D.S. Dane is mentioned under "History". I don't think a separate section is needed but I have added a line to "Structure" with a reference. Graham Colm (talk) 11:17, 28 April 2012 (UTC)


 * Thanks - that's great . . (and a much smoother edit than I had proposed) SquisherDa (talk) 17:40, 30 April 2012 (UTC)

Prognosis section
There is a sentence in this section that is likely wrong or missing information. Where it talks about people who have cleared the disease, it says 40% will suffer from cirrhosis of the liver or cancer. I imagine it is referring to a subset who suffered from liver damage (in which case that should be specified) or it's referring to chronic sufferers. I attempted to read the reference but needed a subscription to the New England Journal. I saw similar wording on a Site where the writer was struggling with English, so I wonder whether it is just an unclear concept that is propagating the Internet. — Preceding unsigned comment added by 69.158.129.127 (talk) 01:36, 9 May 2012 (UTC)Suzanne Kettley May 8, 201269.158.129.127 (talk) 01:31, 9 May 2012 (UTC)

Review

 * Doc James (talk · contribs · email) 12:26, 12 June 2012 (UTC)

Map needs to be updated
The current map uses data from 2005 and is no longer accurate. Northern Canada and Alaska are no longer "high"- they are now "intermediate". See this:2A02:2F01:1059:F003:0:0:BC19:A1B4 (talk) 05:57, 21 November 2012 (UTC)

Regression of fibrosis and cirrhosis with prolonged treatment
Though a primary source, this study in The Lancet might be a good specific example of fibrosis regression during HBV treatment, which is supported by secondary sources:, ,. -- Scray (talk) 02:43, 13 August 2013 (UTC)

Lancet
10.1016/S0140-6736(14)60220-8 - Seminar. JFW &#124; T@lk  11:46, 7 December 2014 (UTC)

about hepatitis b infection
hello i am 30 yr old men i have taken 0 and 1 doses of hepatitis B vaccine doses before 20 months. before 20 days i have physically interacted with hepatitis B positive girl is there any possibility that i get infected. — Preceding unsigned comment added by 117.214.125.198 (talk) 06:10, 8 May 2015 (UTC)
 * Sorry, Wikipedia does not advise on personal issues. Graham Beards (talk) 13:00, 8 May 2015 (UTC)
 * You need to see a doctor. Doc James  (talk · contribs · email) 17:09, 8 May 2015 (UTC)

article size, split
the article size is 61 kiB approximately, word count not performed by this user but it hits the attention span limit rather quickly. article splitting requiredFAMASFREENODE (talk) 17:47, 31 May 2016 (UTC)

Epidemiology
10.1016/S0140-6736(15)61412-X JFW &#124; T@lk  14:14, 19 October 2015 (UTC)

Screening before cancer chemotherapy
... makes sense. 10.7326/M15-1121 JFW &#124; T@lk  08:22, 24 November 2015 (UTC)

Management in pregnancy
10.1136/gutjnl-2015-310317 JFW &#124; T@lk  08:59, 7 January 2016 (UTC)

New agents
Lancet Infectious Diseases 10.1016/S1473-3099(15)00436-3 JFW &#124; T@lk  10:47, 27 January 2016 (UTC)

External links modified
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 * Added archive https://web.archive.org/20081127101705/http://www.surgery.usc.edu/divisions/hep/livernewsletter-reactivationofhepatitisb.html to http://www.surgery.usc.edu/divisions/hep/livernewsletter-reactivationofhepatitisb.html

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article size, split
the article size is 61 kiB approximately, word count not performed by this user but it hits the attention span limit rather quickly. article splitting requiredFAMASFREENODE (talk) 17:47, 31 May 2016 (UTC)
 * There are a couple of sections with links to main articles that have already been split off. Perhaps some trimming and summary styling of those sections could reduce article size. - HyperGaruda (talk) 14:11, 13 June 2016 (UTC)
 * Per here no need to split article.  Doc James  (talk · contribs · email) 16:03, 13 June 2016 (UTC)

Hepatitis B and Hepatocellur Carcinoma
My brother is told earlier that he has Hepatitis B in Lorengau General Hospital, Manus Province, Papua New Guinea through several blood test and a week later after going through a CT Scan in Pacific International Hospital (PIH) in the capital of Papua New Guinea, Port Moresby showing his results that he has hepatocellur carcinoma. Is there any possible treatment somewhere somehow could anyone thought of could help him? The only option I have now is God's healing hand. Bata Pomie (talk) 09:21, 19 December 2016 (UTC)
 * Hello, we are very saddened to hear about your brother. Wikipedia does not give medical advice and we cannot help you. This is because Wikipedia is a general encyclopaedia and not a forum for helping with specific problems. This does not mean that we are not concerned for your brother and we hope for the best possible outcome. Kind regards, Graham Beards (talk) 10:32, 19 December 2016 (UTC) Thank you

Thank you GB, Bata Pomie (talk) 20:01, 19 December 2016 (UTC)

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Phases 1-5 of chronic infection graph
I have been preparing some slides for a talk about hepatitis B. As part of this I wanted a graphical slide that detailed phases 1-5 of chronic infection and associated serology consistent with the new EASL guidelines. I couldn't find one that I liked and so I ended up making one, which is here:

https://commons.wikimedia.org/wiki/File:Hepatitis_B_virus_phases_of_chronic_infection.png

Do others think that this would be a useful addition to the Hepatitis B page or not?

Thanks

Gwilz (talk) 16:52, 29 January 2018 (UTC)
 * User:Gwilz which EASL guideline is this based on? Can you provide a url? Doc James  (talk · contribs · email) 11:47, 31 January 2018 (UTC)

Simplification
User:Graham Beards wondering your thoughts on?

"Hepatitis B incidence rate in 2017" -> "New cases of hepatitis B in 2017"

Doc James (talk · contribs · email) 19:34, 20 April 2020 (UTC)
 * James, incidence and prevalence are proportions . Prevalence is those who are already infected at  a defined time per total population. Incidence is those who acquire an infection during a defined timescale per total population. They are not simple totals. That's why they are given as a rate. I think it is best to link the terms rather than attempt to simplify them. Graham Beards (talk) 20:47, 20 April 2020 (UTC)
 * Yes incidence in this case is "new cases per 100,000 people in 2017" and prevalence is current cases per X number of people in 2005. It is the percentage of the population affected. Doc James  (talk · contribs · email) 22:36, 20 April 2020 (UTC)

Made this minor update to the body of the article. Let me know if you have any concerns and feel free to adjust as you see fit. Doc James (talk · contribs · email) 22:53, 20 April 2020 (UTC)

Updated image


Any concerns with replacing the prior prevalence image with this one? This gives numbers for prevalence rather than just high, intermediate, low. Doc James (talk · contribs · email) 22:42, 20 April 2020 (UTC)
 * This was in the years between 1965 and 2013. A bit dated. Graham Beards (talk) 06:18, 21 April 2020 (UTC)
 * Based on a Lancet from 2015 which than uses older data.
 * Our current image is from the Yellow Book aswell but the 2007 rather than the 2020 version.
 * We also have this one from 2006 which includes what high intermediate and low means. Doc James (talk · contribs · email) 04:25, 22 April 2020 (UTC)
 * We need a map that's for sure. In the absence of anything more up-to-date, I prefer the first one. The second one is labelled "HBsAg" which will confuse some readers. Graham Beards (talk) 15:55, 22 April 2020 (UTC)

2022 WHO Stats and Global Health Sector Strategies
I'm looking to edit key HBV statistics (infection rates, deaths, geographical distribution, etc.) based on WHO's updated fact sheet and Global Health Sector Strategies 2022-2030 report, released June 2022.

This article currently cites the 2014 WHO fact sheet 32 times. Many of these citations cover basic HBV information that has stayed the same between fact sheet versions.

For these, is it a best practice to update each citation to the newer version, or can the 2014 version remain a relevant source?

Thanks for your help and input.

Thinkinink (talk) 21:23, 27 June 2022 (UTC)


 * I've moved forward with updating all the outdated epidemiological stats I could find on the page. Many were from 2014 or before. With the changes, hopefully the article better reflects the current global situation and the decline in infections seen more recently in many regions. I've also rewritten or reworked some areas to remove possible confusion, and cut down the number of duplicate or conflicting statements.
 * Anything new has been sourced (10+ new sources, archived when possible). I'm still learning and would be grateful for others' review, input, and any pointers on what I can do better.
 * Also, updated distribution maps would be helpful if others are able to locate any. A few "new" maps have been published but they display outdated numbers.
 * Thinkinink (talk) 23:10, 12 August 2022 (UTC)