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Confused about "healthy" chronic HBV carrier
Sep 29, 2004

I am confused on the concept of chronic HBV. I heard that this is what happens to a healthy carrier:

The HBV virus resides in DNA of liver cells. But for some unknown reason, the body's immune system reacts to these infected liver cells and attack them. This results in constant liver damage. Given enough time, liver scarring becomes serious enough and cirosis may happen.

Umm...If the body kills infected liver cells, why don't most chronically infected people clear the virus spontaenously? You would think that since the virus is not very active in replicating itself, and the immune system is killing infected cells ( at the price of liver damage ), all copies of HBV DNA will be destoryed after a long period of time.

What is wrong with this idea?

Response from Dr. McGovern

Your thinking is logical. Hepatitis B lives in a form called closed circular covalent DNA which lives on in the cell. Not every cell is killed effectively in patients with chronic hepatitis B. In matter of fact most patients clear hepatitis B through their immune response. Only patients with some deficiency of immune response, like someone on steroids or someone with HIV, who might have trouble clearing the virus. Dr. McGovern



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