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Guide to Hepatitis B for People Living With HIV

June 2009

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Acute infection -- with hepatitis B, this refers to the first six months after infection.

AFP (alpha-fetoprotein) -- a protein found in the blood, commonly used to detect early signs of liver cancer.

Albumin -- a protein made by the liver that carries drugs, hormones, and waste through the bloodstream, and helps maintain fluid levels within the body. Abnormally low levels of albumin can signal serious liver damage.

ALP (alkaline phosphatase) -- a liver enzyme also found in tissues throughout the body. ALP should be monitored regularly during HIV treatment and in persons with hepatitis B.

ALT (alanine transaminase) -- also called serum glutamate pyruvate transaminase, or SGPT; a key liver enzyme produced in liver cells. ALT should be monitored regularly during HIV treatment and in persons with hepatitis B.

Antigen -- a substance foreign to the body, such as protein particles from a virus.

Antibodies -- a substance produced by the immune system to fight off infections.

Antioxidant -- a substance that reduces oxidative damage (damage due to oxygen), such as that caused by free radicals (see definition below).

Ascites -- an abnormal accumulation of fluid in the abdomen; a sign of serious liver damage in people with hepatitis B.

AST (aspartate aminotransferase) -- also called serum glutamic oxaloacetic transaminase, or SGOT; an enzyme made in many places throughout the body (heart, intestines, muscle). AST should be monitored regularly during HIV treatment and in persons with hepatitis B.

Bilirubin -- a yellowish byproduct from the breakdown of old red blood cells; jaundice occurs if certain drugs, or bile-duct or liver damage, cause bilirubin to build up in the bloodstream.

Biopsy -- taking a small sample of body tissue for examination and testing in the laboratory.

cccDNA (covalently closed circle DNA) -- genetic coding of the hepatitis B virus.

CD4 Cells -- a type of white blood cell that is an important part of the immune system. Low CD4 cell count indicates a weakened immune system.

Chronic infection -- a persistent condition; with hepatitis B, this means any time following the acute phase.

Cirrhosis -- severe scarring of the liver that makes it difficult for the liver to carry out its functions (see Fibrosis).

Coinfection -- infection with more than one virus.

Compensated cirrhosis -- a scarred liver that is still able to function.

ross resistance -- HBV mutations that are resistant to more than one drug.

Cryoglobulinemia -- increased blood levels of a protein that can cause inflamed blood vessels and thicken blood.

Decompensated cirrhosis -- when liver scarring prevents the liver from functioning.

Diabetes -- an illness related to the inability to regulate sugar in the blood.

Drug Resistance -- when a drug is no longer effective against a virus with genetic mutations.

Encephalopathy -- degenerative brain function or disease.

End-stage liver disease (ESLD) -- liver failure.

Enzyme -- a protein in the body that speeds up other chemical reactions.

Fibrosis -- mild-to-moderate scarring of the liver (see Cirrhosis).

FibroTest -- a test that uses results from blood tests to predict liver damage; this test may become an alternative option to liver biopsy for some patients.

FibroScan -- a non-invasive ultrasound scan that measures the elasticity or stiffness of the liver.

Free radical -- a chemical produced after a molecular reaction, often containing oxygen, that has one free (unpaired) electron on its outer surface -- this makes it able to react to and damage other cells. Free radicals may perhaps increase progression of cardiovascular disease, cancers, and aging.

Fulminant hepatitis -- sudden, rapid disease progression related to liver failure.

Genotype -- a category for different strains of the hepatitis B virus; there are at least six HBV genotypes.

GGT (gamma glutamyl transferase) -- a liver enzyme made in the bile ducts. GGT levels may be abnormally high as a result of liver disease, heavy drinking, or some medications.

Grade/Grading -- The grade of hepatitis infection refers to the amount of liver inflammation found by a biopsy. It is usually measured on the Ishak scale from 1 to 18, where 0 is none and 18 is the maximum.

HBeAg (Hepatitis B "e" Antigen) -- a protein produced by hepatitis B in its replication. People who are HBeAg-positive and HBeAg-negative have different disease progressions.

HBsAg (Hepatitis B surface Antigen) -- A protein on the surface of HBV; positive HBsAg means someone is infected with HBV.

HBV DNA (viral load) -- a blood test that measures the amount of hepatitis B in the blood.

HBV flare -- an increase replication of the hepatitis B virus that triggers an immune response, causing an elevation of liver enzymes, a sign of liver inflammation.

Hepatocellular carcinoma (HCC) -- liver cancer.

IRIS (Immune Reconstitution Inflammatory Syndrome) -- when the immune system recovers as the result of effective HIV treatment and starts responding to an infection, causing an inflammation.

Interferon -- a chemical messenger produced by the human body; it can also be man-made. Interferon stimulates the immune system to fight viruses.

Jaundice -- a common symptom of hepatitis where increased levels of bilirubin (see definition above) lead to a yellowing of the skin or eyes.

Lactic acidosis -- abnormal buildup of lactate in the blood, caused by cellular damage associated with the use of nucleoside reverse transcriptase inhibitors (NRTIs; see definition below); if untreated, it can be fatal.

Liver toxicity -- When a drug or chemical cannot be adequately processed by the liver, causing a build-up of toxins in the blood.

Lipoatrophy -- fat loss, especially in the arms, legs, cheeks, and buttocks.

Lipodystrophy -- abnormal fat accumulation or fat loss.

Mitochondria -- part of a cell that produces energy in the body.

Monoinfection -- infection with one virus.

Myopathy -- muscle weakness.

Nephrotoxicity -- kidney toxicity.

NRTI (Nucleoside reverse transcriptase inhibitor) -- a type of HIV and HBV drug, also called nucleosides, or Nukes.

NNRTI (Non-nucleoside reverse transcriptase inhibitor) -- a type of HIV drug.

Occult HBV -- a form of HBV infection when the hepatitis B surface antigen can no longer be detected in a blood test, despite the presence of HBV in the blood.

Pancreatitis -- inflammation of the pancreas; it can be painful and life-threatening if not treated.

PI (Protease inhibitor) -- a type of HIV drug.

Peripheral neuropathy -- nerve damage in the hands and feet.

Portal hypertension -- increased blood pressure (hypertension) in the vein carrying blood to the liver.

Pre-core or basal-core mutations -- naturally occurring HBV mutations that can still replicate without producing HBeAg.

Reactivation -- When HBV starts replicating again after a period of inactivity.

Remission -- When HBV infection is under control and not triggering an immune response.

Seroconversion -- When an antigen is no longer detected in the blood, and the body produces antibodies to the antigen. A sign that the immune system has gained control of an infection.

SGOT -- see AST.

SGPT -- see ALT.

Spontaneous clearance -- when the immune system is able to rid the body of the hepatitis B virus; if this occurs, it will be shortly after infection (usually within six months).

Spontaneous clearance -- when the immune system is able to rid the body of the hepatitis B virus; if this occurs, it will be shortly after infection (usually within six months).

Stage/Staging -- the stage of hepatitis infection refers to the amount of liver scarring (fibrosis) detected by biopsy. It is usually measured by either the METAVIR scale of 0 to 4, where 0 represents no scarring and 4 cirrhosis, or by the Knodell scale of 0 to 6, where 0 represents no scarring and 6 cirrhosis.

Steatosis -- abnormal fat deposits in the liver.

Therapeutic drug monitoring (TDM) -- a blood test that measures the level of certain drugs in the blood.

Titer -- a measure of the concentration of antibodies to a specific antigen in a person's blood.

TIPSS (Transjugular Intrahepatic Portasystemic Stent Shunt) -- a medical procedure inserting a metal mesh tube (stent) to connect two large veins in the liver used to treat portal hypertenstion.

Upper limit of normal (ULN) -- the normal level of the liver enzyme ALT, above which can be an indication of liver inflammation.

Variceal hemorrhaging -- bleeding caused by bursting veins (see Varices).

Varices -- extended or swollen veins that can burst; a complication of cirrhosis.

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This article was provided by Treatment Action Group.
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