Unresolved issues of immune tolerance in chronic hepatitis B
Journal of Gastroenterology, ISSN: 1435-5922, Vol: 55, Issue: 4, Page: 383-389
2020
- 19Citations
- 33Captures
- 1Mentions
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Metrics Details
- Citations19
- Citation Indexes19
- 19
- CrossRef1
- Captures33
- Readers33
- 33
- Mentions1
- News Mentions1
- 1
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Abstract Congenital avian leukosis virus subgroup J (ALV-J) infection can induce persistent immunotolerance in chicken, however, the underlying mechanism remains unclear. Here, we demonstrate that
Review Description
During the natural course of chronic hepatitis B virus infection, immune-tolerant phase is characterized by high viral replication, the presence of HBV e antigen (HBeAg), and normal or minimally elevated serum alanine aminotransferase. Immune-tolerant phase is usually regarded as a benign course of the disease. International guidelines recommend observation rather than treatment during immune-tolerant phase. In this article, we review unresolved issues related to the definition of true immune-tolerant phase and the benefit of antiviral treatment. Defining true immune-tolerant phase requires a careful approach and long-term follow-up. In previous studies, many patients were misclassified as being immune-tolerant phase. Noninvasive methods of assessing fibrosis are warranted for patients in the immune-tolerant phase. Yet, there has been controversy over the benefit and harm of antiviral treatment for immune-tolerant phase patients. Thus, further larger scale studies are needed to investigate the prognosis of patients in true immune-tolerant phase and their need for antiviral therapy.
Bibliographic Details
http://www.scopus.com/inward/record.url?partnerID=HzOxMe3b&scp=85078956053&origin=inward; http://dx.doi.org/10.1007/s00535-020-01665-z; http://www.ncbi.nlm.nih.gov/pubmed/32016713; http://link.springer.com/10.1007/s00535-020-01665-z; https://dx.doi.org/10.1007/s00535-020-01665-z; https://link.springer.com/article/10.1007/s00535-020-01665-z
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