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World J Gastroenterol. Aug 14, 2014; 20(30): 10395-10404
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10395
Published online Aug 14, 2014. doi: 10.3748/wjg.v20.i30.10395
Natural history of chronic hepatitis B: Phases in a complex relationship
Catherine MN Croagh, John S Lubel, Department of Gastroenterology and Hepatology, Eastern Health, 3128 Victoria, Australia
John S Lubel, Eastern Health Clinical School, Monash University, Melbourne, 3800 Victoria, Australia
Author contributions: Croagh CMN designed and wrote the manuscript; Lubel JS revised the article critically and approved the final version to be published.
Correspondence to: Catherine MN Croagh, MBBS, FRACP, MPH, Department of Gastroenterology and Hepatology, Eastern Health, Level 2, 5, Arnold st Box Hill, 3128 Victoria, Australia. cmariadason@hotmail.com
Telephone: +61-3-90949555 Fax: +61-3-98999137
Received: November 12, 2013
Revised: February 24, 2014
Accepted: April 27, 2014
Published online: August 14, 2014
Processing time: 279 Days and 5.2 Hours
Revised: February 24, 2014
Accepted: April 27, 2014
Published online: August 14, 2014
Processing time: 279 Days and 5.2 Hours
Core Tip
Core tip: Hepatitis B is a disease of worldwide significance. It involves a complex interplay of viral, host and environmental factors. This review article on the natural history of chronic hepatitis B focuses on the phases of disease. We outline the historical development of these concepts. We describe the specific characteristics of different phases, e.g., the patterns of alanine transaminase abnormalities in the hepatitis B e antigen positive immune clearance phase. Lastly, we review some of the more recent data in relation to the outcomes of various phases, in particular the development of cirrhosis and hepatocellular carcinoma.