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==Historical Perspective==
==Historical Perspective==
Although the first descriptions of hepatitis (epidemic jaundice) are generally attributed to Hippocrates in the 5<sup>th</sup> century BCE,<ref name="CDC1">Center for Disease Control and Prevention.Epidemiology and Prevention of Vaccine Preventable Diseases 2012. http://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html</ref>  the  earliest identifiable occurrence of hepatitis B virus was documented in 1885 by Lurman. He described a form of hepatitis that was transmitted by direct inoculation of blood or blood products during a smallpox outbreak in Bremen, Germany. Thousands of shipyard employees were vaccinated against smallpox with a preparation made from human lymph. Several weeks to 8 months later, 15% of the workers became ill with [[jaundice]] while the unvaccinated workers remained healthy. Lurman's paper, now regarded as a classic example of an [[epidemiological]] study, proved that contaminated [[lymph]] was the source of the outbreak.<ref name="Hussey1981">{{cite journal|last1=Hussey|first1=Hugh H.|title=The Hepatitis B Saga|journal=JAMA: The Journal of the American Medical Association|volume=245|issue=13|year=1981|pages=1317|issn=0098-7484|doi=10.1001/jama.1981.03310380021018}}</ref>  
Although the first descriptions of hepatitis (epidemic jaundice) are generally attributed to Hippocrates in the 5<sup>th</sup> century BCE,<ref name="CDC1">Center for Disease Control and Prevention.Epidemiology and Prevention of Vaccine Preventable Diseases 2012. http://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html</ref>  the  earliest identifiable occurrence of hepatitis B virus was documented in 1885 by Lurman.<ref name="Hussey1981">{{cite journal|last1=Hussey|first1=Hugh H.|title=The Hepatitis B Saga|journal=JAMA: The Journal of the American Medical Association|volume=245|issue=13|year=1981|pages=1317|issn=0098-7484|doi=10.1001/jama.1981.03310380021018}}</ref>
He described a form of hepatitis that was transmitted by direct inoculation of blood or blood products during a smallpox outbreak in Bremen, Germany. Thousands of shipyard employees were vaccinated against smallpox with a preparation made from human lymph. Several weeks to 8 months later, 15% of the workers became ill with [[jaundice]] while the unvaccinated workers remained healthy. Lurman's paper, now regarded as a classic example of an [[epidemiological]] study, proved that contaminated [[lymph]] was the source of the outbreak.<ref name="Hussey1981">{{cite journal|last1=Hussey|first1=Hugh H.|title=The Hepatitis B Saga|journal=JAMA: The Journal of the American Medical Association|volume=245|issue=13|year=1981|pages=1317|issn=0098-7484|doi=10.1001/jama.1981.03310380021018}}</ref>  


Similar outbreaks of hepatitis were reported in the 1920’s in German and U.S. clinics treating syphilis with intravenous therapy.  At the time,  "salvarsan icterus" was thought to be a direct effect of the treatment for syphilis and not from the use of contaminated needles and syringes. In 1926, Flaum, Malmros, and Persson published a paper implicating the role of syringes and needles in the transmission of the disease and documenting the distinctive incubation period of the infection compared to the so-called spontaneous catarrhal jaundice (now known as Hepatitis A). In their paper, they questioned the possibility of two different viruses causing hepatitis.
Similar outbreaks of hepatitis were reported in the 1920’s in German and U.S. clinics treating syphilis with intravenous therapy.  At the time,  "salvarsan icterus" was thought to be a direct effect of the treatment for syphilis and not from the use of contaminated needles and syringes. In 1926, Flaum, Malmros, and Persson published a paper implicating the role of syringes and needles in the transmission of the disease and documenting the distinctive incubation period of the infection compared to the so-called spontaneous catarrhal jaundice (now known as Hepatitis A). In their paper, they questioned the possibility of two different viruses causing hepatitis.

Revision as of 04:55, 3 August 2014

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

Historical Perspective

Although the first descriptions of hepatitis (epidemic jaundice) are generally attributed to Hippocrates in the 5th century BCE,[1] the earliest identifiable occurrence of hepatitis B virus was documented in 1885 by Lurman.[2] He described a form of hepatitis that was transmitted by direct inoculation of blood or blood products during a smallpox outbreak in Bremen, Germany. Thousands of shipyard employees were vaccinated against smallpox with a preparation made from human lymph. Several weeks to 8 months later, 15% of the workers became ill with jaundice while the unvaccinated workers remained healthy. Lurman's paper, now regarded as a classic example of an epidemiological study, proved that contaminated lymph was the source of the outbreak.[2]

Similar outbreaks of hepatitis were reported in the 1920’s in German and U.S. clinics treating syphilis with intravenous therapy. At the time, "salvarsan icterus" was thought to be a direct effect of the treatment for syphilis and not from the use of contaminated needles and syringes. In 1926, Flaum, Malmros, and Persson published a paper implicating the role of syringes and needles in the transmission of the disease and documenting the distinctive incubation period of the infection compared to the so-called spontaneous catarrhal jaundice (now known as Hepatitis A). In their paper, they questioned the possibility of two different viruses causing hepatitis.


The virus was not discovered until 1965 when Baruch Blumberg, then working at the National Institutes of Health (NIH), discovered the Australia antigen (later known to be hepatitis B surface antigen, or HBsAg) in the blood of Australian aboriginal people.[3] Although a virus had been suspected since the research published by MacCallum in 1947,[4] D.S. Dane and others discovered the virus particle in 1970 by electron microscopy.[5] By the early 1980s the genome of the virus had been sequenced,[6] and the first vaccines were being tested.[7]

On March 29, 2005, the US Food and Drug Administration (FDA) approved Entecavir for the treatment of hepatitis B.[8]

On February 25, 2005, the EU Commission approved PEGASYS for the treatment of hepatitis B making it the first pegylated interferon to be approved for hepatitis B.[9]

On October 27, 2006, telbivudine gained FDA approval for treatment of chronic hepatitis B. It is marketed under the brand name Tyzeka in the US and Sebivo outside the US. It is already approved in Switzerland.[10]

World Hepatitis Day, observed July 28, aims to raise global awareness of hepatitis B and hepatitis C and encourage prevention, diagnosis and treatment. It has been led by the World Hepatitis Alliance since 2007 and on May 2010, it got global endorsement from the World Health Organization.[11]

References

  1. Center for Disease Control and Prevention.Epidemiology and Prevention of Vaccine Preventable Diseases 2012. http://www.cdc.gov/vaccines/pubs/pinkbook/hepa.html
  2. 2.0 2.1 Hussey, Hugh H. (1981). "The Hepatitis B Saga". JAMA: The Journal of the American Medical Association. 245 (13): 1317. doi:10.1001/jama.1981.03310380021018. ISSN 0098-7484.
  3. Alter HJ, Blumberg BS (1966). "Further studies on a "new" human isoprecipitin system (Australia antigen)". Blood. 27 (3): 297–309. PMID 5930797. Retrieved 2012-02-08. Unknown parameter |month= ignored (help)
  4. MacCallum, F.O. (1947). "Homologous serum hepatitis". Lancet. 2: 691.
  5. Dane DS, Cameron CH, Briggs M (1970). "Virus-like particles in serum of patients with Australia-antigen-associated hepatitis". Lancet. 1 (7649): 695–8. PMID 4190997. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  6. Galibert F, Mandart E, Fitoussi F, Tiollais P, Charnay P (1979). "Nucleotide sequence of the hepatitis B virus genome (subtype ayw) cloned in E. coli". Nature. 281 (5733): 646–50. PMID 399327. Unknown parameter |month= ignored (help); |access-date= requires |url= (help)
  7. "Hepatitis B vaccine". Lancet. 2 (8206): 1229–30. 1980. PMID 6108398. Retrieved 2012-02-08. Unknown parameter |month= ignored (help)
  8. U.S. Food and Drug Administration. March 30, 2005. FDA Talk Paper: FDA Approves New Treatment for Chronic Hepatitis B. fda.gov. Retrieved on September 11, 2007.
  9. February 25, 2005. Pegasys approved in the European Union for the treatment of chronic hepatitis B: Only pegylated interferon approved for the treatment of chronic hepatitis B. roche.com. Retrieved on September 11, 2007.
  10. October 27, 2006. FDA Approves Telbivudine for Treatment of Chronic Hepatitis B. hivandhepatitis.com. Retrieved on September 11, 2007.
  11. http://apps.who.int/gb/ebwha/pdf_files/EB126/B126_R16-en.pdf

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