Published online Apr 27, 2014. doi: 10.4254/wjh.v6.i4.226
Revised: December 8, 2013
Accepted: February 20, 2014
Published online: April 27, 2014
Hepatitis B virus (HBV) infection is a global public health problem, with an estimated 350 million people worldwide chronically infected and approximately 500000 who die annually from HBV-related liver diseases. Management of chronic HBV is challenging and waves of guidelines emerge every year. One of the hottest topics and a matter of debate is the management of patients in their early immunotolerant phase of infection. With the lack of evidence, dealing with this particular subset of patients creates a great conflict with opposing views. In this review, the author highlights the pros and cons of these views and proposes a reasonable solution to resolve this dilemma.
Core tip: In this mini review, the author discusses the management dilemma of this peculiar subset of patients suffering from chronic hepatitis B in the immunotolerant phase. As already known, the immunotolerant phase of hepatitis B virus may last for a long period and hence there may be a potential for subtle liver damage. A thorough review of the updated published reports was carried out and a merge of the various management options, with a special point of view of the author, is stated.