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Current Hepatology Reports
Published in: Current Hepatology Reports 3/2023

09-06-2023 | Hepatitis B

Management of Immune-Tolerant Patients with Chronic HBV Infection

Authors: Tai-Chung Tseng, Hung-Yao Lin, Jia-Horng Kao

Published in: Current Hepatology Reports | Issue 3/2023

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Abstract

Purpose of Review

Hepatitis B virus (HBV) is a leading cause of hepatocellular carcinoma (HCC). Patients in the early phase of chronic HBV infection are designated “immune-tolerant” due to highly active viral replication without significant liver damage. Although these individuals are believed to have a low HCC risk, recent data showed conflicting results, which are summarized in this review.

Recent Findings

Clonally expanded hepatocytes with HBV integration have been detected in immune-tolerant patients, implying a theoretical HCC risk. Different cohort studies have shown conflicting HCC risk due to the heterogeneity of the patient population defined by fluctuating variables such as HBV DNA and alanine aminotransferase levels. As antiviral treatment response is poor, initiating prolonged therapy in immune-tolerant patients poses a challenge.

Summary

The absence of a clear definition for “genuine” immune-tolerant patients underscores the necessity for novel and stable biomarkers to guide when to start antiviral treatment.
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Metadata
Title
Management of Immune-Tolerant Patients with Chronic HBV Infection
Authors
Tai-Chung Tseng
Hung-Yao Lin
Jia-Horng Kao
Publication date
09-06-2023
Publisher
Springer US
Published in
Current Hepatology Reports / Issue 3/2023
Electronic ISSN: 2195-9595
DOI
https://doi.org/10.1007/s11901-023-00604-9

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