PRO: Patients With Chronic Hepatitis B in Immune-Tolerant Phase Should Be Treated.

Abstract

Young adults with IT‐CHB (high viral load and normal liver enzymes) may have underlying hepatic inflammation, fibrosis, or both. Young adults with CHB are also at risk for development of HCC as early as age 30 years, suggesting that the process of development of HCC begins in the IT‐CHB phase. Patients with IT‐CHB seem to have a similar T cell cytokine profile, HBV DNA integration, and clonal expansion of altered hepatocytes as compared with IA‐CHB, suggesting that the IT‐CHB phase may not be a benign phase and may lead to the evolution of cirrhosis and HCC. Newer antiviral agents effectively suppress HBV DNA in patients with IT‐CHB with minimal drug resistance, and thus may decrease the development of cirrhosis and HCC. In conclusion, patients with IT‐CHB should be considered for treatment with antiviral therapy. This is likely to improve the overall treatment rates for CHB worldwide and decrease the risk for development of cirrhosis and HCC. Treat IT‐HBV; fight against HBV‐HCC.