title: Role of antiviral therapy in the natural history of hepatitis B virus-related chronic liver disease.
abstract: Hepatitis B virus (HBV) infection is a dynamic state of interactions among HBV, hepatocytes, and the host immune system. Natural history studies of chronic hepatitis B (CHB) infection have shown an association between active viral replication and adverse clinical outcomes such as cirrhosis and hepatocellular carcinoma. The goal of therapy for CHB is to improve quality of life and survival by preventing progression of the disease to cirrhosis, decompensation, end-stage liver disease, hepatocellular carcinoma (HCC) and death. This goal can be achieved if HBV replication is suppressed in a sustained manner. The accompanying reduction in histological activity of CHB lessens the risk of cirrhosis and of HCC, particularly in non-cirrhotic patients. However, CHB infection cannot be completely eradicated, due to the persistence of covalently closed circular DNA in the nucleus of infected hepatocytes, which may explain HBV reactivation. Moreover, the integration of the HBV genome into the host genome may favour oncogenesis, development of HCC and may also contribute to HBV reactivation.
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Francesco Paolo
authors.initials: FP
authors.lastname: Russo
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Kryssia
authors.initials: K
authors.lastname: Rodríguez-Castro
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Scribano
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Giorgia
authors.initials: G
authors.lastname: Gottardo
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Veronica
authors.initials: V
authors.lastname: Vanin
authors.affiliation: Francesco Paolo Russo, Kryssia Rodríguez-Castro, Gastroenterology/Multiviseral Transplant Unit, Department of Surgery, Oncology and Gastroenterology, Padua University Hospital, 35128 PD Padua, Italy.
authors.forename: Fabio
authors.initials: F
authors.lastname: Farinati
keywords: Cirrhosis; Hepatocellular carcinoma; Liver fibrosis; Nucleos(t)ide analogues; Pegylated interferon