Natural history of hepatitis B virus infection

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  • Birth in highly endemic regions such as sub-Saharan Africa and East Asia is a risk factor for developing chronic hepatitis B (CHB) infection (1). The primary mode of transmission in such cases is vertical (i.e., mother to child).
  • The risk of developing CHB is highest in those who acquire hepatitis B virus (HBV) infection perinatally and lowest in those who acquire the infection in adulthood.
  • The natural history of HBV infection depends on complex interactions between host, virus and environment.
  • There are four phases of CHB, and the host immune response in each phase determines the outcome of infection and the severity of liver injury.
  • Liver damage is caused by the host immune response rather than the HBV itself.
  • Complications of CHB include cirrhosis with hepatocellular failure and hepatocellular carcinoma. All complications can be minimised with effective antiviral therapy.

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