Natural history of chronic hepatitis B virus infection: What we knew in 1981 and

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Hepatology. 2006 Jan 30;43(S1):S173-S181 [Epub ahead of print]

Natural history of chronic hepatitis B virus infection: What we knew in 1981

and what we know in 2005.

Yim HJ, Lok AS.

Division of Gastroenterology, University of Michigan, Ann Arbor, MI.

Remarkable progress has been made in our understanding of the natural

history of chronic hepatitis B virus (HBV) infection in the past 25 years.

Availability of sensitive HBV DNA assays and application of sophisticated

immunological techniques led to the recognition that HBV replication

persists throughout the course of chronic HBV infection, and host immune

response plays a pivotal role in HBV-related liver disease. Knowledge of the

HBV genome organization and replication cycle led to the unraveling of HBV

genotypes and molecular variants, which contribute to the heterogeneity in

outcome of chronic HBV infection. The natural course of chronic HBV

infection is now perceived as consisting of 4 phases: immune tolerance,

immune clearance [hepatitis B e antigen (HBeAg)-positive chronic hepatitis],

inactive carrier state, and reactivation (HBeAg-negative chronic hepatitis

. Understanding the dynamic nature of chronic HBV infection is crucial in

the management of HBV carriers and underscores the need for long-term

monitoring. Accumulating evidence indicates that antiviral therapy can

prevent progression of HBV-related liver disease, particularly among

patients with sustained response. Newer antiviral therapies with improved

efficacy and decreased risk of resistance may lead to a complete revision of

the chapter on the natural history of chronic HBV infection on the occasion

of the golden jubilee of Hepatology . (Hepatology 2006;43:S173-S181.).

PMID: 16447285 [PubMed - as supplied by publisher]

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