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Unresolved issues of immune tolerance in chronic hepatitis B

During the natural course of chronic hepatitis B virus infection, immune-tolerant phase is characterized by high viral replication, the presence of HBV e antigen (HBeAg), and normal or minimally elevated serum alanine aminotransferase. Immune-tolerant phase is usually regarded as a benign course of...

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Autores principales: Lee, Hye Won, Chan, Henry Lik-Yuen
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Springer Singapore 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080668/
https://www.ncbi.nlm.nih.gov/pubmed/32016713
http://dx.doi.org/10.1007/s00535-020-01665-z
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author Lee, Hye Won
Chan, Henry Lik-Yuen
author_facet Lee, Hye Won
Chan, Henry Lik-Yuen
author_sort Lee, Hye Won
collection PubMed
description During the natural course of chronic hepatitis B virus infection, immune-tolerant phase is characterized by high viral replication, the presence of HBV e antigen (HBeAg), and normal or minimally elevated serum alanine aminotransferase. Immune-tolerant phase is usually regarded as a benign course of the disease. International guidelines recommend observation rather than treatment during immune-tolerant phase. In this article, we review unresolved issues related to the definition of true immune-tolerant phase and the benefit of antiviral treatment. Defining true immune-tolerant phase requires a careful approach and long-term follow-up. In previous studies, many patients were misclassified as being immune-tolerant phase. Noninvasive methods of assessing fibrosis are warranted for patients in the immune-tolerant phase. Yet, there has been controversy over the benefit and harm of antiviral treatment for immune-tolerant phase patients. Thus, further larger scale studies are needed to investigate the prognosis of patients in true immune-tolerant phase and their need for antiviral therapy.
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spelling pubmed-70806682020-03-23 Unresolved issues of immune tolerance in chronic hepatitis B Lee, Hye Won Chan, Henry Lik-Yuen J Gastroenterol Review During the natural course of chronic hepatitis B virus infection, immune-tolerant phase is characterized by high viral replication, the presence of HBV e antigen (HBeAg), and normal or minimally elevated serum alanine aminotransferase. Immune-tolerant phase is usually regarded as a benign course of the disease. International guidelines recommend observation rather than treatment during immune-tolerant phase. In this article, we review unresolved issues related to the definition of true immune-tolerant phase and the benefit of antiviral treatment. Defining true immune-tolerant phase requires a careful approach and long-term follow-up. In previous studies, many patients were misclassified as being immune-tolerant phase. Noninvasive methods of assessing fibrosis are warranted for patients in the immune-tolerant phase. Yet, there has been controversy over the benefit and harm of antiviral treatment for immune-tolerant phase patients. Thus, further larger scale studies are needed to investigate the prognosis of patients in true immune-tolerant phase and their need for antiviral therapy. Springer Singapore 2020-02-03 2020 /pmc/articles/PMC7080668/ /pubmed/32016713 http://dx.doi.org/10.1007/s00535-020-01665-z Text en © The Author(s) 2020 Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
spellingShingle Review
Lee, Hye Won
Chan, Henry Lik-Yuen
Unresolved issues of immune tolerance in chronic hepatitis B
title Unresolved issues of immune tolerance in chronic hepatitis B
title_full Unresolved issues of immune tolerance in chronic hepatitis B
title_fullStr Unresolved issues of immune tolerance in chronic hepatitis B
title_full_unstemmed Unresolved issues of immune tolerance in chronic hepatitis B
title_short Unresolved issues of immune tolerance in chronic hepatitis B
title_sort unresolved issues of immune tolerance in chronic hepatitis b
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7080668/
https://www.ncbi.nlm.nih.gov/pubmed/32016713
http://dx.doi.org/10.1007/s00535-020-01665-z
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