Observational Study
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World J Hepatol. Aug 27, 2014; 6(8): 621-625
Published online Aug 27, 2014. doi: 10.4254/wjh.v6.i8.621
Early termination of immune tolerance state of hepatitis B virus infection explains liver damage
Mamun-Al-Mahtab, Sheikh Mohammad Fazle Akbar, Helal Uddin, Sakirul Islam Khan, Salimur Rahman
Mamun-Al-Mahtab, Salimur Rahman, Department of Hepatology, Bangabandhu Sheikh Mujib Medical University, Dhaka 1000, Bangladesh
Sheikh Mohammad Fazle Akbar, Department of Medical Sciences, Toshiba General Hospital, Tokyo140-0013, Japan
Helal Uddin, Clinical Research Organization, Dhaka 1213, Bangladesh
Sakirul Islam Khan, Department of Anatomy and Embryology, Ehime University Graduate School of Medicine, Ehime 791-0295, Japan
Author contributions: All authors contributed to this paper.
Correspondence to: Dr. Mamun-Al-Mahtab, Associate Professor of Hepatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh Rd, Dhaka 1000, Bangladesh. shwapnil@agni.com
Telephone: +880-171-1567275
Received: February 22, 2014
Revised: April 24, 2014
Accepted: June 10, 2014
Published online: August 27, 2014
Core Tip

Core tip: Immune tolerance phase usually prevails for up to 20-25 years in subjects with chronic hepatitis B virus (HBV) infection. However, the present study showed that considerable numbers of chronic HBV-infected patients of Bangladesh lost hepatitis B e antigen and developed anti-HBe. Early termination of immune tolerance phase of these young patients was also associated with elevated alanine aminotransferase, hepatic necroinflammation and considerable hepatic fibrosis in some patients. Treatment guidelines are warranted for these patients as there is a paucity of information about their entity.