The natural history of hepatitis B virus (HBV) infection is variable, complex, and dynamic. The best method for diagnosis is to have a clinical suspicion in at-risk individuals, and to evaluate the results of specific liver-related and HBV serological tests. Approximately 70% of patients with acute HBV are asymptomatic, and diagnosis is often difficult.[68] Patients with chronic HBV may also be asymptomatic, or may have signs and symptoms of chronic liver disease, including cirrhosis and its complications, hepatocellular carcinoma (HCC), and liver failure.

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