New perspective on the natural course of chronic HBV infection
New perspective on the natural course of chronic HBV infection作者机构：HB Vtech LLC 13901 Lullaby RD Germantown MD 20874 USA Division of Gastroenterology and Hepatology University of California Irvine School of Medicine Orange CA 92868 USA You An Hospital Capital Medical University Beijing 100069 China
出 版 物：《Frontiers of Medicine》 (医学前沿（英文版）)
年 卷 期：2014年第8卷第2期
页 面：129-134页
核心收录：
学科分类：090603[农学-临床兽医学] 1002[医学-临床医学] 09[农学] 0906[农学-兽医学]
主 题：hepatitis B virus chronic HBV infection natural course hepatitis B seroconversion
摘 要：Chronic hepatitis B virus （HBV） infection is a significant threat to public health and an enormous burden on society. Mechanisms responsible for chronic HBV infection remain poorly understood. A better understanding of the natural course of chronic HBV infection may shed new light on the mechanisms underlying this disease and help in designing new antiviral strategies. Natural course of chronic HBV infection is conventionally viewed as an uninterrupted process that is usually marked by HBV e antigen （HBeAg） seroconversion or characterized by different phases associated with assumed host responses to HBV infection. However, none of these descriptions captures or highlights the core events that determine the natural course of chronic HBV infection. In this review, we briefly present the current knowledge on this subject and explain the significance and implication of events that occur during infection. A pre-core mutant becomes predominant in the viral population following elimination of the wild-type virus in duck hepatitis B virus-chronically infected animals. The coupled events in which first there is viral clearance that clears wild-type virus and then there is the reinfection of wild-type virus cleared livers with mutant virus are highly relevant to understanding of the natural course of chronic HBV infection under both treated and untreated conditions. In our new perspective, a general natural course of chronic HBV infection comprises cycles of viral clearance and reinfection, and such cycles prolong the chronic HBV infection course. Reviewing published data on the natural course of chronic HBV infection can reduce the possibility of missing important points in the initial data interpretation.
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