Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Aug;7(8):511-6.

Immune tolerant hepatitis B: a clinical dilemma

Tram T Tran

Immune tolerant hepatitis B: a clinical dilemma

Tram T Tran. Gastroenterol Hepatol (N Y). 2011 Aug.

Abstract

Chronic hepatitis B virus infection remains a global health concern, with perinatal transmission still a problem in many countries. Several new therapies for chronic hepatitis B virus infection have recently been introduced that can safely and effectively suppress viral replication with a low risk of resistance; thus, it has become increasingly tempting for many clinicians to treat patients in the immune tolerant stage of infection who have high levels of viremia yet persistently normal levels of transaminases. However, understanding the natural history of hepatitis B virus infection and how it pertains to disease progression, as well as how current therapies alter or do not alter this natural history, is important when deciding whether to treat these patients. This article will review the definition and natural history of immune tolerance, the current world guidelines and recommendations for treatment of immune tolerant patients, and data on the effectiveness of current therapies in this patient population.

Keywords: HBeAg; Hepatitis B virus; alanine aminotransferase; immune tolerant; management.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Four phases of chronic hepatitis B virus (HBV) infection. ALT

alanine aminotransferase

See this image and copyright information in PMC

References

    1. Dienstag JL. Hepatitis B virus infection. N Engl J Med. 2008;359:1486–1500. - PubMed
    1. Centers for Disease Control and Prevention. Implementation of newborn hepatitis B vaccination—worldwide, 2006. MMWR Morb Mortal Wkly Rep. 2008;57:1249–1252. - PubMed
    1. Mitchell AE, Colvin HM, Palmer Beasley R. Institute of Medicine recommendations for the prevention and control of hepatitis B and C. Hepatology. 2010;51:729–733. - PubMed
    1. Hoofnagle JH, Doo E, Liang TJ, Fleischer R, Lok ASF. Management of hepatitis B: summary of a clinical research workshop. Hepatology. 2007;45:1056–1075. - PubMed
    1. Livingston SE, Simonetti JP, Bulkow LR, et al. Clearance of hepatitis B e antigen in patients with chronic hepatitis B and genotypes A, B, C, D, and F. Gastroenterology. 2007;133:1452–1457. - PubMed

LinkOut - more resources