The role of quantitative hepatitis B surface antigen revisited - PubMed (original) (raw)
Review
. 2017 Feb;66(2):398-411.
doi: 10.1016/j.jhep.2016.08.009. Epub 2016 Aug 27.
Affiliations
- PMID: 27575311
- DOI: 10.1016/j.jhep.2016.08.009
Review
The role of quantitative hepatitis B surface antigen revisited
Markus Cornberg et al. J Hepatol. 2017 Feb.
Abstract
In the past 10years, there has been a lot of enthusiasm surrounding the use of serum hepatitis B surface antigen (HBsAg) quantification to predict disease activity and monitor treatment response in chronic hepatitis B. The measurement of HBsAg levels have been standardized in IU/ml, and nowadays it is almost a mandatory measurement due to the development of new antiviral treatments aiming at HBsAg seroclearance, i.e., functional cure of hepatitis B. Recently, there has been an improved understanding of the molecular virology of HBsAg, and particularly the relative roles of covalently closed circular DNA and integrated hepatitis B virus (HBV) DNA. This has shed new light on the interpretation of HBsAg levels in different phases of chronic hepatitis B. HBsAg level can assist the differentiation of immune tolerance and immune clearance in hepatitis B e antigen (HBeAg)-positive patients, and it can predict inactive disease and spontaneous HBsAg seroclearance in HBeAg-negative patients. The determination of HBsAg level is pivotal to individualize pegylated interferon (PegIFN) treatment; it is the key investigation to decide early termination of PegIFN among non-responders. Among patients treated by nucleos(t)ide analogues, responders tend to have dramatic reduction of HBsAg to low levels, which may be followed by HBsAg seroclearance. With newer data on combination treatment of PegIFN and nucleos(t)ide analogues as well as emerging new antiviral agents, HBsAg quantification is expected to become increasingly important to monitor and guide antiviral therapy for chronic hepatitis B.
Keywords: Antiviral treatment; Entecavir; HBsAg; Hepatitis B; Pegylated interferon; Tenofovir.
Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.
Comment in
- Reply to: "Serum HBsAg kinetics in clinical prediction".
Brunetto M, Cornberg M, Chan HL. Brunetto M, et al. J Hepatol. 2017 Jul;67(1):193-194. doi: 10.1016/j.jhep.2017.03.002. Epub 2017 Mar 16. J Hepatol. 2017. PMID: 28315711 No abstract available. - Serum HBsAg kinetics in clinical prediction.
Jeng WJ, Liaw YF. Jeng WJ, et al. J Hepatol. 2017 Jul;67(1):192-193. doi: 10.1016/j.jhep.2017.01.036. Epub 2017 Mar 16. J Hepatol. 2017. PMID: 28315712 No abstract available.
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