Although most infections of humans with hepatitis B virus are self-limited, up to 10% of individuals experiencing primary infection remain persistently infected. These individuals are usually asymptomatic but may suffer episodic or progressive liver injury that can result in cirrhosis and liver failure. In addition, chronic infection with hepatitis B virus is, in certain settings, associated with the late development of primary hepatocellular carcinoma. This review summarizes the biological characteristics of persistent viral infection, with particular emphasis on host and viral factors that affect the outcome of primary infection.
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