生物标志物用于治疗慢性乙型肝炎的新观点。

StephenW

Clin Mol Hepatol. 2016 Dec;22(4):423-431. doi: 10.3350/cmh.2016.0069. Epub  2016 Dec 25.
New perspectives of biomarkers for the management of chronic hepatitis B.Lin CL1,2, Kao JH3,4,5,6.
Author information

• 1Department of Gastroenterology, Renai branch, Taipei City Hospital, Taipei, Taiwan.
• 2Department of Psychology, National Chengchi University, Taipei, Taiwan.
• 3Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
• 4Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
• 5Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
• 6Department of Medical Research, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan.
  

AbstractWith recent advances in molecular and genomic investigations, the impact of hepatitis B viral and host factors on the progression of chronic HBV infection has been explored. For viral factors, hepatitis B viral load is a strong predictor for liver disease progression. Hepatitis B viral kinetics appear to be important for successful anti-viral therapy. Serum HBsAg level serves as a complementary marker to viral load for the prediction of HBV-related adverse outcomes in patients with low viral load. In those with low viral load, high serum HBsAg level is associated with higher risks of cirrhosis and HCC. Hepatitis B core-related antigen (HBcrAg) induces host immune responses, and the reduction of the HBcrAg level as well as the increment of total anti-HBc level are significantly associated with favorable outcomes. HBV genotypes (genotype C/D) and mutants (basal core promoter and deletion mutation in pre-S genes) are well known viral genetic markers to predict disease progression. For host factors, serum inflammatory biomarkers have been developed to evaluate the HBV-associated hepatic necroinflammation and fibrosis. Host single nucleotide polymorphism on sodium taurocholate cotransporting polypeptide (NTCP, an HBV entry receptor) may be associated with a decreased risk for cirrhosis and HCC. In conclusion, patients with chronic hepatitis B should be evaluated with relevant viral and host markers to identify those who are at a higher risk of liver disease progression and then receive timely antiviral therapy.


KEYWORDS: Chronic hepatitis B; HBV DNA; HBcrAg; HBsAg; Total anti-HBc

PMID:28081591DOI:10.3350/cmh.2016.0069

StephenW

Clin Mol Hepatol。 2016 Dec; 22（4）：423-431。 doi：10.3350 / cmh.2016.0069。 2016年12月25日。
生物标志物用于治疗慢性乙型肝炎的新观点。
Lin CL1,2，Kao JH3,4,5,6。
作者信息

    1台湾台北市医院仁爱分院消化科。
    2，台湾台北国立政治大学心理学系。
    3台湾台湾大学医学院临床医学研究所。
    4台湾台北大学医院内科。
    台湾台北大学医院5级肝炎研究中心。
    6台湾大学医学研究所台湾台北大学医院。

抽象

随着分子和基因组研究的最新进展，乙型肝炎病毒和宿主因素对慢性HBV感染的进展的影响已被探索。对于病毒因子，乙型肝炎病毒载量是肝脏疾病进展的强预测因子。乙型肝炎病毒动力学似乎对成功的抗病毒治疗是重要的。血清HBsAg水平作为病毒载量的互补标记，用于预测低病毒载量患者的HBV相关不良结局。在病毒载量低的患者中，高血清HBsAg水平与肝硬化和HCC的高风险相关。乙型肝炎核心相关抗原（HBcrAg）诱导宿主免疫反应，HBcrAg水平的降低以及总抗HBc水平的增加与有利的结果显着相关。 HBV基因型（基因型C / D）和突变体（前S基因中的基本核心启动子和缺失突变）是公知的预测疾病进展的病毒遗传标记。对于宿主因子，已经开发了血清炎症生物标志物来评价HBV相关的肝脏坏死性炎症和纤维化。在牛磺胆酸钠共转运多肽（NTCP，HBV进入受体）上的宿主单核苷酸多态性可能与肝硬化和HCC的降低的风险相关。总之，慢性乙型肝炎患者应该用相关的病毒和宿主标志物进行评估，以确定那些处于肝脏疾病进展的较高风险，然后及时接受抗病毒治疗的患者。
关键词：

慢性乙型肝炎; HBV DNA; HBcrAg; HBsAg;总抗HBc

PMID：
    28081591
DOI：
    10.3350 / cmh.2016.0069

TRUMPHILARY

Serum HBsAg level serves as a complementary marker to viral load for the prediction of HBV-related adverse outcomes in patients with low viral load. In those with low viral load, high serum HBsAg level is associated with higher risks of cirrhosis and HCC. Hepatitis B core-related antigen (HBcrAg) induces host immune responses, and the reduction of the HBcrAg level as well as the increment of total anti-HBc level are significantly associated with favorable outcomes.
  和病毒定量检测HBV-DNA定量一样，HBsAg定量可以作为病情发展轻重程度的一个指标。
对于HBVB-DNA定量低的病人来说，HBsAg定量越高，cirrhosis和HCC风险越大（新理论，可信吗？）
HBcRAg定量反映了病人免疫反应程度，若HBctAg定量降低伴随anti-HBC定量升高，对病情当然是好征兆。

StephenW

回复 TRUMPHILARY 的帖子

若anti-HBC定量升高，对病情是好征兆 - 这是新理论.

在HBVDNA定量低的病人人群中，HBsAg定量越高，cirrhosis和HCC风险在这人群中越大(但低于具有较高hbvdna的病人).