Viral factors affecting disease progression
Journal
Hepatitis B Virus and Liver Disease
Pages
119-133
Date Issued
2018
Author(s)
Abstract
The clinical outcomes of chronic hepatitis B virus (HBV) infection are heterogeneous, ranging from spontaneous seroconversion of hepatitis B surface antigen (HBsAg) to severe detrimental consequences, including hepatic failure, cirrhosis, and hepatocellular carcinoma (HCC). Four distinctive clinical phases are recognized in the natural course of chronic hepatitis B (CHB), namely, immune tolerance, immune clearance, inactive carrier, and HBV reactivation phases. Patients with prolonged immune active phases are prone to develop cirrhosis and HCC. Conventionally, serum HBV DNA level and HBeAg serostatus combined with serum ALT level are utilized to distinguish the disease states in the natural history of CHB. A number of other viral factors, including HBV genotype, several naturally occurring viral mutations as well as serum levels of HBsAg, HBV core-related antigen (HBcrAg), and total anti-HBc antibody, have been also associated with the long-term prognosis of CHB patients. All these qualitative and quantitative viral factors contribute to the disease progression. With the advance of technology, more new viral biomarkers may emerge in the future. Combination of all current and new viral factors may allow for more sophisticated delineation of disease states, the deeper mechanistic insight into the pathogenesis, and the more optimal management for patients. ? Springer Nature Singapore Pte Ltd. 2018. All rights reserved.
Subjects
Chronic hepatitis B; Hepatitis B virus; Natural history; Viral factors
SDGs
Publisher
Springer Singapore
Type
book part