Natural history of hepatitis B virus infection: An update for clinicians

Surakit Pungpapong, W. Ray Kim, John J. Poterucha

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

Hepatitis B virus (HBV) is a common viral pathogen that causes a substantial health burden worldwide. Significant progress has been made in the past few decades in understanding the natural history of HBV infection. A dynamic balance between viral replication and host immune response is pivotal to the pathogenesis of liver disease. In immunocompetent adults, most HBV infections spontaneously resolve, whereas in most neonates and infants they become chronic. Those with chronic HBV may present in 1 of 4 phases of infection: (1) in a state of immune tolerance, (2) with hepatitis B e antigen (HBeAg)-positive chronic hepatitis, (3) as an inactive hepatitis B surface antigen carrier, or (4) with HBeAg-negative chronic hepatitis. Of these, HBeAg-positive and HBeAg-negative chronic hepatitis may progress to cirrhosis and its long-term sequelae including hepatic decompensation and hepatocellular carcinoma. Several prognostic factors, such as serum HBV DNA concentrations, HBeAg status, serum aminotransferases, and certain HBV genotypes, have been identified to predict long-term outcome. These data emphasize the importance of monitoring all patients with chronic HBV infection to identify candidates for and select optimal timing of antiviral treatment, to recognize those at risk of complications, and to implement surveillance for early detection of hepatocellular carcinoma.

Original languageEnglish (US)
Pages (from-to)967-975
Number of pages9
JournalMayo Clinic Proceedings
Volume82
Issue number8
DOIs
StatePublished - 2007

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Virus Diseases
Natural History
Hepatitis B virus
Hepatitis B e Antigens
Chronic Hepatitis
Chronic Hepatitis B
Hepatocellular Carcinoma
Immune Tolerance
Physiologic Monitoring
Hepatitis B Surface Antigens
Transaminases
Serum
Antiviral Agents
Liver Diseases
Fibrosis
Genotype
Newborn Infant
Liver
DNA
Infection

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Natural history of hepatitis B virus infection : An update for clinicians. / Pungpapong, Surakit; Kim, W. Ray; Poterucha, John J.

In: Mayo Clinic Proceedings, Vol. 82, No. 8, 2007, p. 967-975.

Research output: Contribution to journalArticle

Pungpapong, Surakit ; Kim, W. Ray ; Poterucha, John J. / Natural history of hepatitis B virus infection : An update for clinicians. In: Mayo Clinic Proceedings. 2007 ; Vol. 82, No. 8. pp. 967-975.
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