New insights into immunotolerant phase of chronic hepatitis B virus infection

Abstract

Patients in "immunotolerant phase" of chronic hepatitis B virus infection are HBsAg and HBeAg-positive, with high HBV DNA level, normal ALT and no obvious histopathological hepatic necrotizing inflammation or fibrosis. However, in recent years, some studies have found that HBV DNA integration, clonal hepatocyte expansion, HBV-specific T cell immune response, liver injury and disease progression exist in patients with "immunotolerant phase" of chronic HBV infection. Therefore, the concept of "immunotolerant phase" is controversial. This paper summarizes the new insights into the "immunotolerant phase" of chronic hepatitis B virus infection, including its new concepts in nomenclature, diagnosis, treatment and management.