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Semin Liver Dis 2004; 24: 17-21
DOI: 10.1055/s-2004-828674
Copyright © 2004 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.

The Natural History of Chronic Hepatitis B Virus Infection

Brian J. McMahon1
  • 1Director, Viral Hepatitis Program, Alaska Native Medical Center, Anchorage, Alaska
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Publication History

Publication Date:
11 June 2004 (online)

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Three stages of chronic hepatitis B virus (HBV) infection are recognized: the immune tolerant phase, the chronic hepatitis B phase, and the inactive hepatitis B carrier phase. Active liver disease is most often found in persons with elevated aminotransferase levels and HBV DNA levels >105 copies/mL. Possible risk factors for developing liver disease include older age, male gender, presence of hepatitis B e antigen (HBeAg), HBV genotype, mutations in the precore and core promoter regions of the viral genome, and coinfection with hepatitis D (delta) virus. All persons chronically infected with HBV should be followed every 6 to 12 months with aminotransferase levels. Those with elevated levels should be tested for HBeAg and its antibody (anti-HBe) as well as HBV DNA levels to determine if they are in need of further evaluation with a liver biopsy and are candidates for antiviral therapy. Future research will help clarify the outcome of chronic HBV infection.

KEYWORDS

Hepatitis B virus - natural history - hepatocellular carcinoma

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Brian J McMahonM.D. 

4055 Tudor Centre Drive

Anchorage, AK 99508-5902

Email: bdm9@cdc.gov

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