Understanding the natural course of chronic hepatitis B virus(HBV)infection is very important for the management and treatment of chronic hepatitis B in children.Based on treatment guidelines,the management of HBV car...Understanding the natural course of chronic hepatitis B virus(HBV)infection is very important for the management and treatment of chronic hepatitis B in children.Based on treatment guidelines,the management of HBV carriers and treatment of active hepatitis have been advancing and resulted in increased survival,as well as decreased risks of complications such as liver cirrhosis and hepatocellular carcinoma.Development of a continuing medical education(CME)program for primary physicians becomes an important responsibility of pediatric hepatologists.CME could prevent misdiagnosis and unnecessary treatment that could lead to liver complications or antiviral resistance.In addition,education of patients and their parents is necessary to achieve better therapeutic outcomes.展开更多
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...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.展开更多
基金Supported by Kyungpook National University Research Fund,2012
文摘Understanding the natural course of chronic hepatitis B virus(HBV)infection is very important for the management and treatment of chronic hepatitis B in children.Based on treatment guidelines,the management of HBV carriers and treatment of active hepatitis have been advancing and resulted in increased survival,as well as decreased risks of complications such as liver cirrhosis and hepatocellular carcinoma.Development of a continuing medical education(CME)program for primary physicians becomes an important responsibility of pediatric hepatologists.CME could prevent misdiagnosis and unnecessary treatment that could lead to liver complications or antiviral resistance.In addition,education of patients and their parents is necessary to achieve better therapeutic outcomes.
文摘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.
