Les difficultés d'interprétation du diagnostic virologique de l'hépatite B

Hepatitis B virus (HBV) infection is a major world health problem. An epidemiological study estimated that more than one billion people around a world were infected by HBV. Major target tissue of HBV is the liver cells. This hepatocyte virus infection is initially associated with an acute hepatitis usually asymptomatic but occasionally related to a fulminant hepatitis. Acute HBV infection evolved either to a chronic viral disease or to a resolutive infection. However, this natural course of infection was independent to the acute pathogenesis stage. Immune host response during the course of disease was largely involved in the liver pathogenesis Epidemiological and molecular studies have clearly demonstrated the prime importance of HBV infection to the development of primary liver cancer. Actually, more than 350 millions people were HBV chronic carriers in the world. Viral diagnosis was based on immunological analysis. Almost three different parameters were studied to explore the course of viral infection. This diagnosis was completed by molecular analysis of the viral characteristic (genotype and viral load) in blood and liver tissue. Regardless of hepatitis B virus described more than 30 years ago, the recently advance of diagnosis tools revealed a natural course of liver disease more complex than believed. However, this diagnosis progress and therapeutic improvement was not enough today to project the complete disappearance of HBV viral infection.