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World J Gastroenterol. Jun 28, 2014; 20(24): 7644-7652
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7644
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7644
HBeAg negative variants and their role in the natural history of chronic hepatitis B virus infection
Alexandra Alexopoulou, 2nd Department of Medicine, Medical School, University of Athens, Hippokration General Hospital, 16342 Athens, Greece
Peter Karayiannis, St George’s, University of London Medical School at University of Nicosia, Egkomi 1700, Cyprus
Author contributions: Alexopoulou A acquisition, analysis and interpretation of data, drafting the article and final approval of the version to be published; Karayiannis P conception and design, analysis and interpretation of data, drafting and revising the article for important intellectual content and final approval of the version to be published.
Correspondence to: Dr. Alexandra Alexopoulou, 2nd Department of Medicine, Medical School, University of Athens, Hippokration General Hospital, 40 Konstantinoupoleos Str., Hilioupolis, 16342 Athens, Greece. alexopou@ath.forthnet.gr
Telephone: +30-210-7774742 Fax: +30-210-7706871
Received: October 28, 2013
Revised: January 1, 2014
Accepted: March 5, 2014
Published online: June 28, 2014
Revised: January 1, 2014
Accepted: March 5, 2014
Published online: June 28, 2014
Core Tip
Core tip: Chronic hepatitis B virus infection can in turn go through the immune tolerant, the immune clearance, the inactive or low replicative and the reactivation phases. hepatitis B e antigen (HBeAg) positivity characterises the first two phases. Seroconversion from HBeAg to the corresponding antibody is the result of the appearance of the precore and basal core promoter variants, which either abrogate or lead to reduced HBeAg levels. The absence of HBeAg eliminates its tolerogenic effect on the immune system which thus becomes activated, leading to seroconversion. The reasons why some patients then enter into the reactivation phase during which the variants are the dominant virus present remain unexplained.