Progress in study on immune-tolerant children with chronic hepatitis B / 中华实用儿科临床杂志

ABSTRACT

The natural history of chronic hepatitis B is complex including immune-tolerant phase,immune clearance phase,inactive carrier phase and reactivation phase,among these phases,it has not yet reached a consensus on the definition of the immune-tolerant phase,because its key immune features are not entirely sure.However,the current diagnostic criteria of this phase require normal alanine aminotransferase (ALT) levels,positive hepatitis B s antigen and e antigen,high serum hepatitis B virus DNA (HBV-DNA),and slight or normal inflammation of liver histology.Antiviral therapy in this phase is currently not recommended in all guidelines,but in recent years,antiviral treatment of immune-tolerant children achieved efficacy in several study.Nonetheless before new findings are published,it would be important to closely and regular monitor serum ALT and HBV-DNA in the immune-tolerant children.