Hepatitis B Virus Pathogenesis

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The virus is divided into four major serotypes (adr, adw, ayr, ayw) based on antigenic epitopes presented on its envelope proteins, and into eight major genotypes (A–H). The genotypes have a distinct geographical distribution and are used in tracing the evolution and transmission of the virus. Differences between genotypes affect the disease severity, course and likelihood of complications, and response to treatment and possibly vaccination. [44] [45] There are two other genotypes I and J but they are not universally accepted as of 2015 [46]

This topic review will discuss the characteristics of the hepatitis B virus and the pathogenesis of HBV-related liver disease. The immune response to HBV contributes to the hepatic injury, helps control the infection, and provides the means for establishing the serologic diagnosis of HBV infection. (See "Diagnosis of hepatitis B virus infection" .)

The pathogenesis and clinical manifestations of hepatitis B are due to the interaction of the virus and the host immune system, which lead to liver injury and, potentially, cirrhosis and hepatocellular carcinoma. Patients can have either an acute symptomatic disease or an asymptomatic disease.