In line with the study "Diagnostic Efficacy of Serological Antibody Detection Tests for Hepatitis Delta Virus: A Systematic Review and Meta-Analysis" by Zhenzhen Pan et al. (2023)
Good day, Mr. Toribio!
The mechanisms involved in viral interactions in hepatitis co-infections and their impact on host responses and liver pathology involve viral interference and suppression, modulation of host's immune responses, induction of immunopathology, shared viral entry routes and tropism, genetic recombination and evolution, as well as exacerbation of liver damage. Co-infecting viruses can interfere with each other's replication, change how antigen are presented, and evade or disrupt host immune responses, such as interferon signaling and T-cell function.
Relating it to Hepatitis Viruses, according to D’souza et al. (2020), Hepatitis B Virus (HBV), Hepatitis C Virus (HCV), and Hepatitis D Virus (HDV) employs several mechanisms to co-opt infected cells, potentially contributing to the development of HCC accidentally. Shared mechanisms among these viruses include: (1) Continuous liver inflammation and oxidative stress damage caused by long-term viral infection; (2) Intracellular oxidative stress damage triggered by viral proteins; and (3) Disruption of cell signaling pathways by viral proteins (e.g. Hbx, L-HDAg, S-HDAg, HCV core, NS3, and NS5A/B)
Reference:
D'souza, S., Lau, K. C., Coffin, C. S., & Patel, T. R. (2020). Molecular mechanisms of viral hepatitis induced hepatocellular carcinoma. World journal of gastroenterology, 26(38), 5759–5783. https://doi.org/10.3748/wjg.v26.i38.5759
Hepatitis D virus (HDV) can have great effects on host immune responses and liver pathology. First, when several viruses infect the same host, they frequently fight for the few resources available to them. The rivalry between HBV and HDV for host resources can impact both viruses' replication systems and the severity of liver disease in the case of HDV, which depends on hepatitis B virus (HBV) for replication. Second, it can subdue host immune responses. These tactics could include interfering with host signaling pathways that are involved in immune activation, modulating adaptive immune responses, or inhibiting innate immune pathways. Third, cytolysis, apoptosis, or necrosis are some of the ways that viral replication can cause direct harm to host cells. Virus-induced immune responses can also lead to liver malfunctioning, resulting in activated clotting pathways, attracting immune cells to the liver, and releasing pro-inflammatory cytokines. Lastly, interactions between viruses can lead to a situation where the presence of one virus increases the pathogenicity or rate of replication of another. For example, co-infection with both HBV and HDV is linked to more severe liver disease than infection with either virus alone, indicating that these viruses work together in order to promote liver damage.
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