评论文章：乙型肝炎核心相关抗原（HBcrAg）：慢性乙型肝炎

StephenW

Review article: hepatitis B core-related antigen (HBcrAg): an emerging marker for chronic hepatitis B virus infection

    L.-Y. Mak1, D. K.-H. Wong1,2, K.-S. Cheung1, W.-K. Seto1,2, C.-L. Lai1,2 andM.-F. Yuen1,2,*

Version of Record online: 16 OCT 2017

DOI: 10.1111/apt.14376

© 2017 John Wiley & Sons Ltd

Issue
Alimentary Pharmacology & Therapeutics

Volume 47, Issue 1, pages 43–54, January 2018
Article has an altmetric score of 13


    1    Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong, Hong Kong
    2    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, Hong Kong

Email: M.-F. Yuen ([email protected])

* Correspondence
Prof. Man-Fung Yuen, Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Hong Kong.
Email: [email protected]

    Funding information

    None.

    The Handling Editor for this article was Professor Geoffrey Dusheiko, and this uncommissioned review was accepted for publication after full peer-review.


Summary
Background

Chronic hepatitis B (CHB) cannot be completely eradicated due to the presence of covalently closed circular DNA (cccDNA) in the nuclei of infected hepatocytes. While quantification of intrahepatic cccDNA requires liver biopsies, serological markers can be non-invasive alternatives to reflect intrahepatic viral replicative activity. Recently, hepatitis B core-related antigen (HBcrAg) has been advocated as a novel serum marker for disease monitoring and prognostication of CHB.
Aim

To examine the virological aspect and clinical application of HBcrAg with respect to the natural history and treatment of CHB.
Methods

We reviewed all papers published in the PubMed journal list and abstracts from major international meetings that included the keyword “HBcrAg” or “hepatitis B core-related antigen” until March 2017. Selected studies were compared and summarised on the basis of existing theories, as well as the authors’ experience.
Results

HBcrAg exhibited good correlation with intrahepatic (ih) cccDNA, ih total hepatitis B virus (HBV) DNA, serum HBV DNA and to a lesser extent HBV surface antigen (HBsAg). In situations where serum HBV DNA levels become undetectable or HBsAg loss is achieved, HBcrAg can still be detectable. This marker is helpful in differentiation of HBeAg-negative chronic hepatitis from HBeAg-negative chronic infection, predicting spontaneous or treatment-induced HBeAg seroconversion, sustained response to nucleos(t)ide analogue (NA), risk of HBV reactivation in occult HBV infection under immunosuppressive therapies, and risk of hepatocellular carcinoma (HCC) development as well as post-operative HCC recurrence.
Conclusions

HBcrAg is a potential surrogate marker of cccDNA. It may soon become a useful marker for disease monitoring, predicting treatment response and disease outcome of chronic hepatitis B.

StephenW

评论文章：乙型肝炎核心相关抗原（HBcrAg）：慢性乙型肝炎病毒感染的一个新兴的标志

    L.-Y. Mak1，D.K.-H. Wong1,2，K.-S. Cheung1，W.-K. Seto1,2，C.-L. Lai1,2和M.-F. Yuen1,2，*

在线记录版本：2017年10月16日

DOI：10.1111 / apt.14376

©2017 John Wiley＆Sons Ltd

问题
消化药理学和治疗学

第47卷，第1期，第43-54页，2018年1月
文章有一个13的分数评分


    1香港大学医学院玛丽医院香港香港
    2香港大学肝脏研究国家重点实验室，香港，香港

电子邮件：M.-F.元（[email protected]）

*通信
香港玛丽医院香港大学医学系Man-Fung Yuen教授。
电邮：[email protected]

    资金信息

    没有。

    这篇文章的处理编辑是Geoffrey Dusheiko教授，这个未经审查的评论在完全同行评审后被接受发表。


概要
背景

慢性乙型肝炎（CHB）由于感染肝细胞核中存在共价闭合的环状DNA（cccDNA）而不能完全根除。虽然肝内cccDNA的定量需要肝脏活检，但血清学标志物可能是反映肝内病毒复制活性的非侵入性替代方法。最近，乙肝核心相关抗原（HBcrAg）被认为是CHB疾病监测和预测的新型血清标志物。
目标

探讨HBcrAg在CHB自然病程和治疗方面的病毒学表现和临床应用。
方法

我们回顾了PubMed杂志上发表的所有论文以及主要国际会议的摘要，其中包括关键词“HBcrAg”或“乙肝核心相关抗原”，直到2017年3月。选择的研究在现有理论的基础上进行比较和总结，以及作者的经验。
结果

HBcrAg与肝内（ih）cccDNA，全部乙肝病毒（HBV）DNA，血清HBV DNA和较小程度的HBV表面抗原（HBsAg）具有良好的相关性。在血清HBV DNA水平检测不到或HBsAg消失的情况下，HBcrAg仍然可以检测到。该标志物有助于区分HBeAg阴性慢性肝炎与HBeAg阴性慢性感染，预测自发性或治疗性诱导的HBeAg血清学转换，对核苷（酸）类似物（NA）的持续反应，隐匿性HBV感染中HBV再激活的风险免疫抑制治疗，以及肝细胞癌（HCC）发展的风险以及术后HCC复发。
结论

HBcrAg是cccDNA的潜在替代指标。它可能很快成为慢性乙型肝炎疾病监测，预测治疗反应和疾病结局的有用标志物。

StephenW

http://onlinelibrary.wiley.com/doi/10.1111/apt.14376/epdf

antiHBVren

HBcrAg与肝内（ih）cccDNA，全部乙肝病毒（HBV）DNA，血清HBV DNA和较小程度的HBV表面抗原（HBsAg）具有良好的相关性。在血清HBV DNA水平检测不到或HBsAg消失的情况下，HBcrAg仍然可以检测到。该标志物有助于区分HBeAg阴性慢性肝炎与HBeAg阴性慢性感染，预测自发性或治疗性诱导的HBeAg血清学转换，对核苷（酸）类似物（NA）的持续反应，隐匿性HBV感染中HBV再激活的风险免疫抑制治疗，以及肝细胞癌（HCC）发展的风险以及术后HCC复发。
——这个不错，之前HBcrAg的精度不行，在HBeAg阴性后，就查不到
假如精度提高啦，对以后药物研究的效果有了更精准的衡量终点