Patient information - HBV 1

Patient Information Patient Information - Viral Hepatitis B (HBV)- Viral Hepatitis B (HBV)

Liver consequences and management

Patient information - HBV 2

Epidemiology

Impact on the liver?

What is Hepatitis B (HBV)?

Liver Diagnosis: non invasive options

In this Presentation

Patient information - HBV 3

What is Hepatitis B?What is Hepatitis B?

Patient information - HBV 4

How is the virus transmitted?

Hepatitis B is the most common serious liver infection. It is caused by the Hepatitis B virus that attacks the liver

Hepatitis B virus is spread through contact with the blood or other body fluids of an infected person.

A person can become infected by: contact with a mother’s blood and body fluids at the time of birth; contact with blood and body fluids through breaks in the skin such as bites, cuts, or sores; contact with objects that could have blood or body

fluids on them such as toothbrushes or razors; having unprotected sex with an infected person; sharing needles when injecting drugs; being stuck with a used needle on the job.

Patient information - HBV 5

Symptoms

Hepatitis B: “the silent infection”Most people do not have symptomsMost common manifestation are flu like symptomsOnly 1% have severe symptoms while their body attacks the virus

Flu like symptoms Severe symptoms(Life threatening condition, requires medical

attention)

FeverVomiting and mild nauseaMuscle or joint painLoss of appetite

Nausea and vomitingYellow eyes and skin (jaundice)Bloated or swollen stomach

Patient information - HBV 6

Acute or Chronic?

Acute (short-term) illness(90% of hep B cases)

VSVS

Chronic (long-term) infection.(10% of hep B cases)

Clearance within 6 month Virus remaining in blood for more than 6 month

This can lead to:loss of appetite diarrhea and vomitingtiredness jaundice (yellow skin or eyes)pain in muscles, joints, and stomach

Can be very serious, and often leads to:liver damage (cirrhosis) liver cancer death

More common in adults. More common among infants and children.

Children usually do not have acute illness. Infected people can spread HBV to others, even if they don’t appear sick.

Patient information - HBV 7

EpidemiologyEpidemiologyWho is infected?Who is infected?

Patient information - HBV 8

Hepatitis B - EpidemiologyHepatitis B - Epidemiology

To RememberTo Remember

Over 300 millions infection cases worldwide

Hepatitis B remains to often undiagnosed : about 80%

About 1 out of 5 patients is treated after diagnosis

About 50% of treated patient don’t respond to treatment and continue to develop liver injury

Patient information - HBV 9

Hepatitis B - EpidemiologyHepatitis B - Epidemiology

To RememberTo Remember In 2005, about 51,000 people

became infected with hepatitis B.

About 1.25 million people in the United States have chronic HBV infection.

Each year about 3,000 to 5,000 people die from cirrhosis or liver cancer caused by HBV.

Asia ( China) : 10% HBV , most of them not diagnosed

Patient information - HBV 10

Hep B vaccine?

About vaccinesAbout vaccines Prevents hepatitis B disease and its

serious consequences like hepatocellular carcinoma (liver cancer). Therefore, this is the first anti-cancer vaccine.

Medical, scientific and public health communities strongly endorse using hepatitis B vaccine as a safe and effective way to prevent disease and death.

Scientific data show that hepatitis B vaccines are very safe for infants, children, and adults.

Persons allergic to yeast should not be vaccinated with vaccines containing yeast.

Patient information - HBV 11

Impact on the liver?Impact on the liver?

Patient information - HBV 12

Virus Hep BLiver

The Liver disease progression

Inflammation

-presence of inflammatory cells in the liver-change in liver structure-slowed blood circulation

Fibrosis

-scarring of the liver due to excessive liver damage -most apparent clinical

feature: hypertension

Cirrhosis

-liver becomes permanently scarred -alteration of liver

structure-liver function is impaired

Hepatic insufficiency/Liver failure

Hepatocellular carcinoma(Liver cancer) Hemorrhage

Patient information - HBV 13

Virus Hep BLiver

The Liver disease progression

Inflammation

-presence of inflammatory cells in the liver-change in liver structure-slowed blood circulation

Fibrosis

-scarring of the liver due to excessive liver damage -most apparent clinical

feature: hypertension

Cirrhosis

-liver becomes permanently scarred -alteration of liver

structure-liver function is impaired

Hepatic insufficiency/Liver failure

Hepatocellular carcinoma(Liver cancer) Hemorrhage

How to measure liver disease progression?

Patient information - HBV 14

Non-Invasive Non-Invasive liver diagnosis and staging liver diagnosis and staging

Patient information - HBV 15

Traditional method: the liver biopsy

ProProSpecificSensitiveGood diagnostic and prognostic information

ConCon

Invasive and painful (30% of cases)ExpensiveAssociated morbidity (ex: haemorrhage: 3/1.000)Associated mortality (3/10.000)Not 100% reliable

variability due to sample quality as analyses only 1/50.000 of total liver tissue

Siegel 2005; Ratziu 2005; Bateller 2005; Bravo 2001

Patient information - HBV 16

F1

Minimal fibrosis

F2

Moderate fibrosis F4

Cirrhosis

The liver biopsy analyses only 1/50.000° of total liver tissue…. The liver biopsy analyses only 1/50.000° of total liver tissue….

Patient information - HBV 17

… … clearly not enough!clearly not enough!

The very same liver!!The very same liver!!

Bedossa et al, Hepatology 2003

Patient information - HBV 18

The non invasive option: liver Biomarkers

A new Solution to unmet clinical needs: FibroTest Simple, least expensive Accurate Good diagnostic value

for every stage of fibrosis Dynamic assessment: after successful/ failed therapy

Good prognostic value (as good as biopsy) Universal fibrosis marker: validated in all common

liver diseases (83 publications, 33 validations) A Validated screening tool of at risk patients Accepted use in clinical trials

New concept in liver diseases Use of biomarkers validated for the most frequent

chronic liver diseases Public health interest :

SCREENING advanced fibrosis Treatment efficacious , at least for HCV and HBV

USA: “FibroSure”

Patient information - HBV 19

FibroTest in Hepatitis B

Virus Hep BLiver

Inflammation

-presence of inflammatory cells in the liver-change in liver structure-slowed blood circulation

Fibrosis

-scarring of the liver due to excessive liver damage -most apparent clinical

feature: hypertension

Cirrhosis

-liver becomes permanently scarred -alteration of liver

structure-liver function is impaired

ActiTest/ ActiSure (usa)(Part of FibroTest/FirboSure)

Viral inflammation quantification

FibroTest/ FibroSure (usa)Liver fibrosis measurement

Patient information - HBV 20

How to? In 4 easy steps!

Notes Step 1: Patient goes to a prescribing doctor. Step 2: With the prescription, goes to a validated lab (list on www.biopredictive.com ) Step 3: Calculation algorithms and security controls are automatically performed Step 4: Test results delivered within 24 hours

Simple. Reliable. Cost-effective.Simple. Reliable. Cost-effective.