Phases in natural history of chronic hepatitis B virus infection
| HBV phases | HBeAg+infection*/Immune-tolerant phase** | HBeAg+ hepatitis*/Immune-active phase** | HBeAg−infection*/Inactive carrier/immune-control phase** | HBeAg−hepatitis*/Immune-escape phase** | HBsAg−infection*/Occult HBV infection (anti-HBc-positive)** |
|---|---|---|---|---|---|
| Indicators | |||||
| Serum HBV DNA | >10 · IU/ml | >2000 IU/ml (constantly raised or fluctuating) | <2000 IU/mL | >2000 IU/mL | undetectable |
| ALT | normal | elevated | normal | elevated | normal |
| HBeAg | positive | positive | negative | negative | negative |
| HBsAg | high | high/intermediate | low | intermediate | negative |
| cccDNA | +++++ | +++++ | ++ | +++ | + |
| Integrated HBV DNA | +++ | ++++ | +++ | ++++ | + |
| Liver disease (Necro-inflammatory changes) | none/minimal | moderate to severe | none | moderate to severe | none |
| Progression to cirrhosis | none | possible | none | more rapid than in other phases | none |
| Treatment | not generally indicated | may be indicated | not indicated | may be indicated | not indicated |