Hepatitis B Epidemiology, Pathogenesis, Diagnosis, and Natural History

  • Author: Marc G. Ghany, MD (More Info)
  • Editor In Chief: Stefan Zeuzem, MD
  • Last Reviewed: 7/2/18 (What's New)


  • HBV DNA is detectable within a few days following acute infection, peaks with serum ALT level, and then declines with resolution of infection[Fong 1994]
  • In chronic infection, HBV DNA levels are highest in the immune-tolerant phase, high in the immune-active HBeAg-positive and HBeAg-negative phases, and very low or undetectable in the inactive phase (Table 7)[Kao 2008]
  • HBV DNA quantification is used to estimate phase of disease, prognosis, the need for therapy, and response to therapy

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