This is the result of attack by T-cells on liver cells containing viral surface antigens. However with time antibodies will be produced and the symptoms of the disease will disappear. Very high level of chronic infections, in which virus antigen persists, but no viral antibodies are made. The virus survives in the liver and the patient becomes chronicallly infected. This appears to be due to a weak immune system, and explains why infants become chronically infected.
Chronic infection can manifest itself in different ways.
Some chronic carriers are healthy, they experience limited liver damage and have no functional deficiencies. In the worst case cirrhosis of the liver develops and finally a primary hepatic tumor. Usually the latent period for cancer is 30-50 years, for chronic carriers the incidence of hepatic cancer is about 100 times greater than in rest of population. Antibodies to HBcAg and HBsAg increase rapidly during early stages of infection. Their presence indicates acute phase of the disease.