HOST AND VIRAL FACTORS ASSOCIATED WITH HEPATITIS B CLINICAL OUTCOMES IN CHRONIC INFECTION -REVIEW ARTICLE

Abstract

Viral and host factors have been implicated in persistence of HBV infection to chronicity and perhaps to liver cancer. Fortunately 90- 95% of those who get infected in adult hood clear the virus and remain with antibodies suggesting previous exposure to HBV. The underlying reasons as to why majority of the patients with acute infection clear the virus while a small proportion progress to chronic infection lies in the difference in host immunological and genetic factors. The immune determinants of complete clearance are not fully understood but both innate and adaptive are paramount in this response. Similarly, the role of the host genes in the pathogenesis of the virus are not fully elucidated but polymorphisms in genes encoding for the HLA, cytokine and vitamin D receptor (VDR) have been highlighted in in influencing both disease clearance and progression to chronicity. In this review, the host and viral factors responsible for differential clinical presentation of hepatitis B are discussed.