HBV Natural Evolution

Hi.

I have a question unanswered for a long time: what happens to immuno-tolerant patients (VL in the billions) long term ? Is it a must that they do enter immuno-clearance phase sooner or later or they can be immuno-tolerant all their life (with the corresponding high risk of HCC associated from high exposure 9 log VL) ? Immuno-tolerant patients while having astronomical VL they do exhibit totally normal liver and liver parameters. How long can they be in this state ? I know little is known about immuno-tolerant patients (what triggers the eventual immuno-clearance) but I could not find a clear answer (even hypothesis) anywhere.

Thanks a bunch,
F.

[stef2011]

yes, i dont know of reports of life long immune tollerance

[stef2011]

they do enter immuno-clearance phase sooner or late
yes

they can be immuno-tolerant all their life (with the corresponding high risk of HCC associated from high exposure 9 log VL)
hcc risk is ultralow like inactive carriers

[stef2011]

VL they do exhibit totally normal liver and liver parameters
yes same as uninfected

all you ask is not important at all hbv makes no damage at all it is immune system that does
and people with hbvdna und are full of virus anyway, cccdna is still present, replicates and makes antigens hbsag and so on in the people with hbvdna und

[focault]

Very interesting ... So basically immuno-clearance phase is not a question of "if" but of "when" (even if it is very very late). Am I correct in saying that ?

[stef2011]

yes, i dont know of reports of life long immune tollerance