定量乙肝表面抗原的作用重新审查。

StephenW

J Hepatol. 2016 Aug 26. pii: S0168-8278(16)30441-X. doi: 10.1016/j.jhep.2016.08.009. [Epub ahead of print]
The role of quantitative hepatitis b surface antigen revisited.Cornberg M1, Wong VW2, Locarnini S3, Brunetto M4, Janssen HL5, Chan HL6.
Author information

• 1Department of Gastroenterology, Hepatology and Endocrinology. Hannover Medical School; German Center for Infection Research (DZIF), partner site Hannover-Braunschweig, Germany. Electronic address: [email protected].
• 2Department of Medicine and Therapeutics, Institute of Digestive Disease and State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. Electronic address: [email protected].
• 3Victorian Infectious Diseases Reference Laboratory (VIDRL), Doherty Institute for Infection and Immunity, Melbourne, Australia. Electronic address: [email protected].
• 4Hepatology Unit and Laboratory of Molecular Genetics and Pathology of Hepatitis Viruses, Reference Center of the Tuscany Region for Chronic Liver Disease and Cancer, University Hospital of Pisa, Italy. Electronic address: [email protected].
• 5Toronto Center for Liver Disease, Toronto General Hospital, University Health Network, Toronto, Canada. Electronic address: [email protected].
• 6Department of Medicine and Therapeutics, Institute of Digestive Disease and State Key Laboratory of Digestive Disease, The Chinese University of Hong Kong, Hong Kong. Electronic address: [email protected].
  

AbstractIn the past 10 years, there are a lot of enthusiasms on 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 level has been standardized in IU/mL and nowadays it is almost mandatory with the development of new antiviral treatments as HBsAg seroclearance, i.e. functional cure of hepatitis B, is now considered the goal of therapy. Recently, improved understanding on molecular virology of HBsAg, particularly on the relative roles of covalently closed circular DNA and integrated HBV DNA, has shed new lights on the interpretation of HBsAg level 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 peginterferon treatment; it is the key investigation to decide early termination of peginterferon 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 peginterferon 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.
Copyright © 2016 European Association for the Study of the Liver. Published by Elsevier B.V. All rights reserved.


KEYWORDS: Antiviral treatment; Entecavir; HBsAg; Hepatitis B; Peginterferon; Tenofovir

PMID:27575311DOI:10.1016/j.jhep.2016.08.009

StephenW

肝脏病学杂志。 2016年26月PII：S0168-8278（16）30441-X。 DOI：10.1016 / j.jhep.2016.08.009。 [打印EPUB提前]
定量乙肝表面抗原的作用重新审查。
科恩贝格M1，黄VW2，Locarnini S3，Brunetto M4，扬森HL5，陈HL6。
作者信息

    消化内科，肝病及内分泌教研室。汉诺威医学院;德国中心感染研究（DZIF），合作伙伴网站的汉诺威，德国Braunschweig。电子地址：[email protected]。
    内科及药物治疗消化疾病和香港的中国香港大学消化疾病国家重点实验室，研究所教研室。电子地址：[email protected]。
    3Victorian传染病参考实验室（VIDRL），多尔蒂研究所感染与免疫，澳大利亚墨尔本。电子地址：[email protected]。
    4Hepatology单位和分子遗传学实验室病毒和肝炎病毒的病理，对慢性肝病和癌症托斯卡纳地区的咨询中心，意大利比萨大学医院。电子地址：[email protected]。
    5Toronto中心肝病，多伦多综合医院，大学健康网络，加拿大多伦多。电子地址：[email protected]。
    内科及药物治疗消化疾病和香港的中国香港大学消化疾病国家重点实验室，研究所6Department。电子地址：[email protected]。

抽象

在过去的10年里，有关于使用血清乙肝表面抗原（HBsAg）量化了很多热情的预测疾病活动和监测慢性乙型肝炎的HBsAg水平的测量已经IU / mL的被标准化的治疗反应和现在它与新的抗病毒治疗如HBsAg的血清清除发展几乎是强制性的，即乙型肝炎功能治愈，目前被认为是治疗的目标。最近，改进的对HBsAg的分子病毒学，特别是关于共价闭合环状DNA和整合的HBV DNA的相对作用的认识，已阐明在慢性乙型肝炎的HBsAg水平的不同阶段的HBsAg水平的解释新灯可以协助的分化免疫耐受和乙肝e抗原（HBeAg）阳性患者的免疫清除，并能预测非活动性疾病和自发转阴乙肝表面抗原HBeAg阴性的患者。乙肝表面抗原水平的确定是关键，以个性化长效干扰素治疗;它是决定之间无反应聚乙二醇的提前终止的关键调查。在由核苷（酸）类似物治疗的患者，反应往往有较低的水平，其可以随后的HBsAg血清清除显着减少的HBsAg。随着联合治疗聚乙二醇干扰素和核苷（酸）类似物的新数据，以及不断涌现的新抗病毒药物，乙肝表面抗原定量有望成为日益重要的监控和指导治疗慢性乙型肝炎的抗病毒治疗

版权所有©2016年欧洲协会肝病的研究。发布时间由Elsevier B.V.保留所有权利。
关键词：

抗病毒治疗;恩替卡韦;乙肝表面抗原;乙型肝炎;聚乙二醇干扰素;替诺福韦

结论：
    27575311
DOI：
    10.1016 / j.jhep.2016.08.009