Semin Liver Dis 2006; 26: 104-115 DOI: 10.1055/s-2006-939755
Copyright © 2006 by Thieme Medical Publishers, Inc., 333 Seventh Avenue, New York, NY 10001, USA.
Immunopathogenesis: Role of Innate and Adaptive Immune Responses
Kumar Visvanathan1,3, Sharon R. Lewin2,3
1 Department of Infectious Diseases, Monash Medical Centre, Clayton, Victoria, Australia 2 Infectious Diseases Unit, Alfred Hospital, Prahran, Victoria, Australia 3 Department of Medicine, Monash University, Melbourne, Victoria, Australia

ABSTRACT

Hepatitis B virus (HBV) infection in immunocompetent adults usually results in a self-limited, transient liver disease and viral clearance, with only a small percentage (5 to 10%) developing chronic hepatitis associated with viral persistence. In contrast, when neonates are infected, more than 90% become persistently infected, suffering differing degrees of chronic liver disease. Activation of immunity plays a central role in host-virus interactions, greatly influencing viral replication and the clinical outcome of infection. Although all of the specific mechanisms and consequences of this interaction have not been elucidated, the purpose of this article is to describe the basic arms of the immune system as they interact with the HBV and describe the present state of knowledge in this area. These arms may be divided broadly into innate and specific immune responses, and they have different roles and responses in acute and chronic infection.

KEYWORDS

Immunoevasion - toll receptors - noncytolytic clearance - antiviral cytokines - interferons - T-cell responses