[英语，临床]The clinical utility of HBsAg quantitation in chronic hepatitis

StephenW

<http://onlinelibrary.wiley.com/doi/10.1002/hep.24364/abstract>

Viral Hepatitis
The clinical utility of HBsAg quantitation in chronic hepatitis B patients:
A review†

Yun-Fan Liaw,‡DOI: 10.1002/hep.24364

Copyright © 2011 American Association for the Study of Liver Diseases
Issue

Hepatology
Accepted Article (Accepted, unedited articles published online for future
issues)

Abstract
This clinically relevant review focuses on recent findings relating to
hepatitis B surface antigen (HBsAg) quantitation in untreated and treated
patients with chronic hepatitis B. Recent studies and emerging data have
shown that both HBsAg and hepatitis B virus (HBV) DNA levels decline along
the natural course of chronic HBV infection, being lowest in inactive phase
which is also characterized by the highest HBsAg/HBV DNA ratio. It was
demonstrated that combined use of HBsAg and HBV DNA levels might help
identify true inactive carriers with high accuracy. Retrospective analyses
of HBsAg levels in patients undergoing therapy suggest a role for HBsAg
quantitation in monitoring response to therapy. Interferon-based therapy
results in greater overall decline in serum HBsAg level than nucleos(t)ide
analogs (NAs) . A rapid on-treatment decline in HBsAg level appears to be
predictive of sustained response. With the aid of HBsAg quantitation, it
appears that we could anticipate an individualized approach to tailoring
treatment duration. Early stopping rules being proposed for patients not
responding to pegylated interferon, based on lack of HBsAg decline,
represent a step towards a response-guided approach. The development of
stopping rules for patients treated with NAs would be a desirable step to
reduce the burden of a need for life-long therapy. However, before stopping
rules for anti-viral therapy can be applied, there is still more to learn
about the kinetics of HBsAg decline, in both natural history and response
to therapy, to better define the best timing and relevant HBsAg cut-off
levels and how best to apply these in clinical practice. (HEPATOLOGY 2011.)

StephenW

病毒性肝炎
在中HBsAg定量慢性乙型肝炎患者的临床实用程序：
综述†

廖运范，‡分类号：10.1002/hep.24364

版权所有© 2011年的美国肝病研究协会
发行

肝脏病
接受第（接受，为未来网上发表文章未经编辑
问题）

摘要
这与临床有关审查的重点是对最近的调查结果
乙型肝炎表面抗原（HBsAg）定量在未经处理和治疗
慢性乙型肝炎的最新研究和新兴的数据病人
结果表明，HBsAg和乙型肝炎病毒（HBV）DNA水平下降沿
对慢性乙肝病毒感染的自然进程，而最低的非活动期
它还有一个特点是最高的乙肝表面抗原/乙型肝炎病毒DNA的比例。这是
表明，HBsAg和HBV DNA水平结合使用可以帮助
识别精度高真正活跃的载体。回顾性分析
在接受治疗的乙肝表面抗原患者血清乙肝表面抗原的作用提出了有关
定量监测治疗反应。干扰素为基础的治疗
在更大的整体下降导致血清HBsAg水平比核苷（酸）的IDE
类似物（NAS）的。一个快速上治疗乙肝表面抗原水平的下降似乎是
预测持续的反应。随着乙肝表面抗原定量，它的援助
看来，我们可以预见一个个性化的方法来剪裁
治疗时间。提早停止拟议规则对病人不
响应聚乙二醇干扰素，缺乏对乙肝表面抗原下降的基础上，
是朝着一个响应制导方法步骤。的发展
停车规则与NAS治疗的患者将是一个理想的步骤
减少一个终身需要治疗的负担。不过，在停止
抗病毒治疗的规则可以适用，但仍有更多的学习
对乙肝表面抗原下降动力学在自然历史和响应，
对治疗，以便更好地确定最佳的时机和有关乙肝表面抗原截止
水平和如何最好地应用于临床实践这些。 （2011年肝病。）

StephenW

[Dr Sharat,有经验的肝病专家,的意见]
Hi all,
We do not have enough data to use HbsAg levels as a monitoring tool for
treatment. Hence we should follow guidelines as per HBV-DNA levels. Updated
EASL and AASLD guidelines are on these lines only
Best
Dr Sharat Misra

大家好，
我们没有足够的数据来采用乙肝表面抗原水平作为治疗监测工具。因此，我们应遵循按乙肝病毒DNA水平的指导方针。更新欧洲肝病学会和美国肝病学会准则只对这些线路.
最佳
Dr Sharat

lin12345