Analysis of a cellular model to account for the natural history of infection by the hepatitis B virus and its role in the development of primary hepatocellular carcinoma.

Infection with the hepatitis B virus (HBV) can have many different outcomes. Transient infection may result in acute hepatitis or may remain subclinical. Persistent infection may also be subclinical, or may involve chronic active hepatitis, and can finally lead to the development of primary hepatocellular carcinoma. A mathematical model is given to account for the many different outcomes of HBV pathogenesis. The model is based on the assumption that the liver contains two cell populations with differing abilities to support active HBV replication and/or viral integration into the genome. The model helps account for the relationship of the different clinical courses of HBV infection to the age when the disease is acquired, together with the state of the immune system of the patient.