Abstract
hepatitis B is a global health burden and increasingly a public health concerns in US due to changing immigration pattern from mostly Western European immigrants to Asian, African and Eastern European where prevalence of chronic hepatitis B is higher. Therefore in these particular at risk populations, education of health providers and patients is vital in achieving successful disease prevention and control. Understanding the natural history of this complicated and dynamic disease will lay the ground works for comprehensive management of chronic hepatitis B. In this article, the natural history particularly the four phases of chronic hepatitis B and the outcome of the disease such as cirrhosis and HCC and the risk factors for disease progression and HCC development will be discussed. The importance of screening and vaccination is emphasized particularly the success of HCC prevention in countries with population-wide vaccination program. It is with the hope that this review will enhance and educate the primary health provider for the most at risk population of chronic hepatitis B in US and therefore alleviate the burden of this disease. with a solid knowledge of hepatitis B. The natural history of chronic hepatitis B has been studied extensively since the early 1980's even before the molecular technology of PCR (Polymerase Chain Reaction) became widely used in the study of hepatitis B. It is now clearly understood that the natural history of chronic hepatitis B represents a dynamic interaction between the host immune system and the virus. This makes the natural progression of chronic hepatitis B a very fluid situation. In this review, I will discuss the dynamic natural history of chronic HBV infection and identify factors that have been associated with disease progression and the development of hepatocellular carcinoma (HCC) and further to discuss disease prevention and control for this dreadful but preventable disease burden on Chinese community in US.
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