Progress in study on immune-tolerant children with chronic hepatitis B

The natural history of chronic hepatitis B is complex including immune-tolerant phase, immune clearance phase, inactive carrier phase and reactivation phase, among these phases, it has not yet reached a consensus on the definition of the immune-tolerant phase, because its key immune features are not entirely sure.However, the current diagnostic criteria of this phase require normal alanine aminotransferase (ALT) levels, positive hepatitis B s antigen and e antigen, high serum hepatitis B virus DNA(HBV-DNA), and slight or normal inflammation of liver histology.Antiviral therapy in this phase is currently not recommended in all guidelines, but in recent years, antiviral treatment of immune-tolerant children achieved efficacy in several study.Nonetheless before new findings are published, it would be important to closely and regular monitor serum ALT and HBV-DNA in the immune-tolerant children. Key words: Chronic hepatitis B; Immune tolerance phase; Child; Antiviral treatment; Monitor