Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B
In the natural course of chronic hepatitis B, the immune tolerance phase is characterized by HBeAg positivity, very high levels of HBV DNA, and persistent normal alanine aminotransferase. The international guideline recommendation for patients in this phase is observation without antiviral treatment...
| Main Authors: | , |
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| Format: | Article |
| Language: | English |
| Published: |
Jin Publishing & Printing Co.
2022-04-01
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| Series: | The Korean Journal of Gastroenterology |
| Subjects: | |
| Online Access: | https://www.kjg.or.kr/journal/view.html?uid=5808&vmd=Full |
| _version_ | 1827806020985946112 |
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| author | Young Mi Hong Ki Tae Yoon |
| author_facet | Young Mi Hong Ki Tae Yoon |
| author_sort | Young Mi Hong |
| collection | DOAJ |
| description | In the natural course of chronic hepatitis B, the immune tolerance phase is characterized by HBeAg positivity, very high levels of HBV DNA, and persistent normal alanine aminotransferase. The international guideline recommendation for patients in this phase is observation without antiviral treatment because of the low risk of disease progression and the lack of effective antiviral agents.
However, recent retrospective studies have shown that progression to hepatic fibrosis and hepatocellular carcinoma may occur in patients who are in the immune tolerance phase. Despite the conceptual definition and clinical diagnostic criteria for this phase, it is difficult to accurately diagnose the true immune tolerance phase. Therefore, we should pay attention to the clinical evaluation and interpretation of the immune tolerance phase and understand the clinical situations in which antiviral treatments should be considered. |
| first_indexed | 2024-03-11T21:35:29Z |
| format | Article |
| id | doaj.art-1b5798c3fa244a95a9940e92c84a81a9 |
| institution | Directory Open Access Journal |
| issn | 1598-9992 2233-6869 |
| language | English |
| last_indexed | 2024-03-11T21:35:29Z |
| publishDate | 2022-04-01 |
| publisher | Jin Publishing & Printing Co. |
| record_format | Article |
| series | The Korean Journal of Gastroenterology |
| spelling | doaj.art-1b5798c3fa244a95a9940e92c84a81a92023-09-27T02:20:06ZengJin Publishing & Printing Co.The Korean Journal of Gastroenterology1598-99922233-68692022-04-0179415616010.4166/kjg.2022.049Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis BYoung Mi Hong 0Ki Tae Yoon1https://orcid.org/0000-0002-8580-0239Department of Internal Medicine, Pusan National University College of Medicine; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital; Liver Center, Pusan National University Yangsan Hospital, Yangsan, KoreaDepartment of Internal Medicine, Pusan National University College of Medicine; Research Institute for Convergence of Biomedical Science and Technology, Pusan National University Yangsan Hospital; Liver Center, Pusan National University Yangsan Hospital, Yangsan, KoreaIn the natural course of chronic hepatitis B, the immune tolerance phase is characterized by HBeAg positivity, very high levels of HBV DNA, and persistent normal alanine aminotransferase. The international guideline recommendation for patients in this phase is observation without antiviral treatment because of the low risk of disease progression and the lack of effective antiviral agents. However, recent retrospective studies have shown that progression to hepatic fibrosis and hepatocellular carcinoma may occur in patients who are in the immune tolerance phase. Despite the conceptual definition and clinical diagnostic criteria for this phase, it is difficult to accurately diagnose the true immune tolerance phase. Therefore, we should pay attention to the clinical evaluation and interpretation of the immune tolerance phase and understand the clinical situations in which antiviral treatments should be considered.https://www.kjg.or.kr/journal/view.html?uid=5808&vmd=Fullhepatitis bchronicimmune tolerance |
| spellingShingle | Young Mi Hong Ki Tae Yoon Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B The Korean Journal of Gastroenterology hepatitis b chronic immune tolerance |
| title | Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B |
| title_full | Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B |
| title_fullStr | Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B |
| title_full_unstemmed | Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B |
| title_short | Definition and Management of the Immune Tolerance Phase in Chronic Hepatitis B |
| title_sort | definition and management of the immune tolerance phase in chronic hepatitis b |
| topic | hepatitis b chronic immune tolerance |
| url | https://www.kjg.or.kr/journal/view.html?uid=5808&vmd=Full |
| work_keys_str_mv | AT youngmihong definitionandmanagementoftheimmunetolerancephaseinchronichepatitisb AT kitaeyoon definitionandmanagementoftheimmunetolerancephaseinchronichepatitisb |