慢性乙肝患者表面抗原定量在临床的应用

litao2009

如题，最新一期HEPATOLOGY综述

StephenW

Clinical Utility of Hepatitis B Surface Antigen Quantitation in Patients With Chronic
Hepatitis B: A Review
Yun-Fan Liaw
This clinically relevant review focuses on recent findings concerning hepatitis B surface
antigen (HBsAg) quantitation in untreated patients 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 during the natural course of a chronic HBV infection; they are lowest in the inactive phase, which is also characterized by the highest HBsAg/HBV DNA
ratio. It has been demonstrated that the combined use of HBsAg and HBV DNA levels
might help in the identification of true inactive carriers with high accuracy. Retrospective
analyses of HBsAg levels in patients undergoing therapy have suggested a role for HBsAg
quantitation in monitoring the response to therapy. In comparison with nucleos(t)ide analogues (NAs), interferon-based therapy results in greater overall declines in serum HBsAg levels. A rapid on-treatment decline in HBsAg levels appears to be predictive of a sustained response.With the aid of HBsAg quantitation, it appears that we can anticipate an individualized approach to tailoring the treatment duration. The proposal of early stopping rules for patients not responding to pegylated interferon (according to a lack of any HBsAg decline) represents a step toward a response-guided approach. The development of stopping rules for patients treated with NAs is desirable for reducing the need for lifelong therapy. However, before stopping rules for antiviral therapy can be applied, we need to learn more about the kinetics of HBsAg declines during the natural history of the infection and as a response to therapy so that we can better define the best timing, the relevant HBsAg cutoff levels, andthe best ways to apply these rules in clinical practice. (HEPATOLOGY 2011;54:E1-E9)

慢性患者的乙型肝炎表面抗原定量的临床应用
B型肝炎：回顾与展望
廖运范
本次临床相关的审查侧重于有关乙肝表面最近的调查结果
抗原（HBsAg）定量在未经治疗的患者和治疗的患者与慢性乙型肝炎的近期研究和新兴的数据表明，HBsAg和乙肝病毒（HBV）DNA水平下降;在一个慢性乙肝病毒感染的自然过程中，他们最低不活跃的阶段，这也是最高的乙肝表面抗原/乙型肝炎病毒DNA的特点
比率。它已经证明，HBsAg和HBV DNA水平的结合使用
可能帮助识别真正的不活动的载体，具有精度高。回顾
在接受治疗的患者HBsAg水平的分析，有建议为乙肝表面抗原的作用
定量监测对治疗的反应。在核苷（酸）IDE类似物（NAS），在血清HBsAg水平整体下降，干扰素治疗效果的比较。一个快速的治疗HBsAg水平下降，似乎是一个持续response.With援助的HBsAg定量的预测，看来，我们可以预见，一个个性化的方法来剪裁治疗的时间长短。早期患者没有响应聚乙二醇干扰素（缺乏任何HBsAg的下降）停止规则的建议，表示转向响应制导方式的一个步骤。停止治疗的患者与NAS规则的发展是可取的减少需要终身治疗。不过，在停止抗病毒治疗的规则可以应用，我们需要学习更多的HBsAg下降动力学在感染的自然史和作为治疗的反应，使我们可以更好地界定最佳时机，有关乙肝表面抗原截止水平，以及最好的方法适用于临床实践这些规则。 （肝脏病杂志2011;54：E1 - E9）

霜叶

学习了。

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