Hep B Immune Control Phase // cadrugdetoxcenters.com

The immune tolerant phase of chronic HBV infectionnew.

Dec 07, 2012 · So, during the immune tolerant phase the virus is happily replicating, completely unchecked by the immune system, which accounts for the high viral load and lack of liver damage during this time. People in the immune tolerant phase may remain. Most adults who are infected with hepatitis B clear the virus during the acute phase of the infection. People who have impaired immune responses have a higher risk of not clearing hep B on their own and are more likely to develop chronic HBV infection.

Chronic hepatitis B virus HBV infection progresses through distinct disease phases that are strongly associated with patient age. The so-called immune tolerant IT phase represents the classical early phase of infection; it is associated with high levels of HBV replication and. Immune clearance phase 2 Hepatitis B virus is attacking the immune system and the immune system is fighting back. Liver is getting damaged. Control. Immune control phase 3 Immune system has virus under control and there is no further liver damage. Escape. Immune escape phase 4 Virus is active again and liver is being damaged. Another major reason is that, during the Immune Clearance phase, when treatment is considered, the patients may seroconvert naturally and then enter the Immune Control inactive phase. So some doctors will advocate a period of observation when ALT is elevated and not rush to treatment.

The immune-tolerance phase is seen in HBeAg-positive disease and is characterised by high levels of HBV replication with normal ALT levels and limited liver necroinflammation. Because there is minimal immune response to the virus it is unusual for spontaneous HBeAg loss to occur. Patients can fluctuate between the active HBeAg positive, anti-HBe negative, high HBV DNA level and immune control phases of the disease over time. The absence of HBeAg, however, does not necessarily exclude active viral replication, since specific mutations in the HBV genome can prevent HBeAg synthesis – the so-called precore and core promoter mutants. For some people, hepatitis B is an acute, or short-term, illness but for others, it can become a long-term, chronic infection. Risk for chronic infection is related to age at infection: approximately 90% of infected infants become chronically infected, compared with 2%–6% of adults.

Hep B Immune Control Phase

Patients with CHB must be regularly re-evaluated to determine which phase they are in and managed accordingly. See graph over page for more information. Immune due to hepatitis B vaccination. IMMUNE CONTROL Low HBV DNA, Normal LFTs, HBeAg neg; anti-HBe pos IMMUNE ESCAPE. The immune clearance phase HBeAg-positive chronic hepatitis B is characterised by HBeAg positivity, but lower levels of viral replication. The transaminases are elevated and histologically there is more severe necroinflammation and more rapid progression of fibrosis. This phase may last several weeks to. Wallace J, McNally S, Richmond J, Hajarizadeh B, Pitts M. Managing chronic hepatitis B: a qualitative study exploring the perspectives of people living with chronic hepatitis B in Australia. BMC Res Notes 2011;4:45. Vu LH, Gu Z, Walton J, et al. Hepatitis B knowledge, testing and vaccination among Chinese and Vietnamese adults in Australia. Chronic infection with hepatitis B virus HBV progresses through multiple phases, including immune tolerant, immune active, immune control, and, in a subset of patients who achieve immune control.

Phase 1 – Immune tolerance phase Also known as HBeAg positive chronic infection, this stage is characterised by hepatitis B e antigen HBeAg positivity, high HBV DNA levels > 20,000 IU/mL, and commonly over 1 million IU/mL, normal ALT levels and minimal level liver injury. Chronic hepatitis B: Immunological profile and current therapeutic vaccines in clinical trials. Starting with an “immune tolerant” phase, characterized by high viremia, hepatitis B “e” antigen positive HBeAg, normal serum alanine aminotransferase ALT, and minimal or no liver necro-inflammation.

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