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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
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