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. 2020 Sep 24;8(10):1470. doi: 10.3390/microorganisms8101470

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© 2020 by the authors.

Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (http://creativecommons.org/licenses/by/4.0/).

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Phases of chronic hepatitis B infection (CHB) natural history. CHB is differentiated into HBeAg positive (phases 1–2) and negative phases (3–5) as well as phases of chronic hepatitis (phases 2 and 4). Chronic hepatitis phases are characterized with ALT flares, fluctuating Hepatitis B Virus (HBV) DNA levels, as well as liver damage and inflammation. Generally, anti-viral therapy is recommended during chronic hepatitis phases to reduce liver damage and suppress viral replication. However, treatment may also be beneficial for pregnant, cirrhotic, and/or immunosuppressed individuals. ALT = alanine aminotransferase; HBc = HBV core; HBsAg = HBV surface antigen; HBeAg = HBV e antigen; IS = immunosuppression.