The goal of this proposal is to provide Michael Torbenson, MD with a period of mentorship in the proper scientific environment so that he can acquire the necessary skills to become an independent clinician-scientist. Dr. Torbenson has a strong background in diagnostic liver pathology and has a specific interest in viral hepatitis. This proposal focuses on occult hepatitis B, an emerging infectious entity of potentially large medical significance. Occult hepatitis B has been associated with advanced liver fibrosis, coinfection with hepatitis C, IFN alpha resistance in treatment of hepatitis C, and hepatocellular carcinoma. The overall aim of Dr. Torbenson's proposal is to assess the prevalence and clinical significance of occult hepatitis B in high risk patient population of injection drug users. This study utilizes the unique resources of a pre-existing longitudinal collection of sera and liver tissue from the mentor's ongoing research, allowing assessment of the prevalence of occult hepatitis B over time and estimation of the rate of fibrosis progression in these individuals.
The first aim examines the overall prevalence of occult hepatitis B and investigates the impact of Human Immunodeficiency Virus status on the presence of occult hepatitis B.
The second aim assess the clinical significance of occult hepatitis B by correlating the presence of occult hepatitis B with the amount of inflammation and fibrosis on liver biopsy. The rate of fibrosis progression will be investigated by comparing the amount of fibrosis on initial liver biopsy to that on follow-up biopsies. In addition, aim 2 will examine the role of occult hepatitis B in HIV progression.
The third aim focuses on potential mechanisms of occult hepatitis B and seeks to identify relevant hepatitis B gene mutations. As a final element of this aim, carefully selected (based on known involvement in typical hepatitis B viral infection) signaling pathways will be investigated by analysis of mRNA and protein expression to investigate host-viral interactions.

Agency
National Institute of Health (NIH)
Institute
National Institute on Drug Abuse (NIDA)
Type
Clinical Investigator Award (CIA) (K08)
Project #
5K08DA016370-04
Application #
7097993
Study Section
Human Development Research Subcommittee (NIDA)
Program Officer
Comolli, Jean C
Project Start
2003-09-30
Project End
2008-06-30
Budget Start
2006-07-01
Budget End
2007-06-30
Support Year
4
Fiscal Year
2006
Total Cost
$181,624
Indirect Cost
Name
Johns Hopkins University
Department
Pediatrics
Type
Schools of Medicine
DUNS #
001910777
City
Baltimore
State
MD
Country
United States
Zip Code
21218
Vivekanandan, Perumal; Micchelli, Shien T L; Torbenson, Michael (2009) Anterior gradient-2 is overexpressed by fibrolamellar carcinomas. Hum Pathol 40:293-9
Vivekanandan, Perumal; Thomas, David; Torbenson, Michael (2009) Methylation regulates hepatitis B viral protein expression. J Infect Dis 199:1286-91
Savransky, Vladimir; Reinke, Christian; Jun, Jonathan et al. (2009) Chronic intermittent hypoxia and acetaminophen induce synergistic liver injury in mice. Exp Physiol 94:228-39
Vivekanandan, Perumal; Torbenson, Michael (2008) Low frequency of Helicobacter DNA in benign and malignant liver tissues from Baltimore, United States. Hum Pathol 39:213-6
Vivekanandan, Perumal; Kannangai, Rajesh; Ray, Stuart C et al. (2008) Comprehensive genetic and epigenetic analysis of occult hepatitis B from liver tissue samples. Clin Infect Dis 46:1227-36
Vivekanandan, P; Thomas, D; Torbenson, M (2008) Hepatitis B viral DNA is methylated in liver tissues. J Viral Hepat 15:103-7
Kannangai, Rajesh; Vivekanandan, Perumal; Netski, Dale et al. (2007) Liver enzyme flares and occult hepatitis B in persons with chronic hepatitis C infection. J Clin Virol 39:101-5
Savransky, Vladimir; Bevans, Shannon; Nanayakkara, Ashika et al. (2007) Chronic intermittent hypoxia causes hepatitis in a mouse model of diet-induced fatty liver. Am J Physiol Gastrointest Liver Physiol 293:G871-7
Kannangai, Rajesh; Wang, Jianzhou; Liu, Qiong Z et al. (2005) Survivin overexpression in hepatocellular carcinoma is associated with p53 dysregulation. Int J Gastrointest Cancer 35:53-60
Kannangai, Rajesh; Diehl, Anna Mae; Sicklick, Jason et al. (2005) Hepatic angiomyolipoma and hepatic stellate cells share a similar gene expression profile. Hum Pathol 36:341-7

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