HBV e抗原阴性慢性HBV感染HBV表面抗原定量的临床应用。

StephenW

Nat Rev Gastroenterol Hepatol. 2019 Sep 2. doi: 10.1038/s41575-019-0197-8. [Epub ahead of print]
Clinical utility of HBV surface antigen quantification in HBV e antigen-negative chronic HBV infection.
Liaw YF1.
Author information

1
    Liver Research Unit, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taipei, Taiwan. [email protected].

Abstract

Chronic hepatitis B virus (HBV) infection is a serious problem owing to its worldwide distribution and potential adverse sequelae that include cirrhosis and/or hepatocellular carcinoma. Current antiviral therapies have much improved outcomes, but few patients achieve the ultimate goal of hepatitis B surface antigen (HBsAg) loss (functional cure). As hepatitis B e antigen (HBeAg)-negative chronic HBV infection is the final phase prior to HBsAg loss, the management of patients in this phase together with quantification of HBsAg has attracted increasing clinical and research interest. This Review integrates the findings from research in HBsAg kinetics and discusses how they might inform our understanding and management of HBeAg-negative chronic HBV infection. Studies have shown that HBsAg levels are highly predictive of the presence of inactive HBV infection and that serial changes in HBsAg levels might predict HBsAg loss within 1-3 years. Data also suggest that quantitative HBsAg monitoring is important during hepatitis flare and antiviral therapy, especially in the timing of the decision to stop therapy and to start off-therapy retreatment. These findings have shed new light on the natural course of HBV infection and might lead to optimization of the management of HBeAg-negative chronic HBV infection and contribute to the paradigm shift from indefinite to finite therapy for patients with HBV infection.

PMID:
    31477873
DOI:
    10.1038/s41575-019-0197-8

StephenW

Nat Rev Gastroenterol Hepatol。 2019年9月2日。土井：10.1038 / s41575-019-0197-8。 [印刷前的电子版]
HBV e抗原阴性慢性HBV感染HBV表面抗原定量的临床应用。
Liaw YF1。
作者信息

1
    台湾台北长庚大学医学院长庚纪念医院肝脏研究室[email protected]。

抽象

慢性乙型肝炎病毒（HBV）感染是一个严重的问题，因为其在世界范围内分布和潜在的不良后遗症，包括肝硬化和/或肝细胞癌。目前的抗病毒疗法有很大改善的结果，但很少有患者达到乙型肝炎表面抗原（HBsAg）丧失（功能性治愈）的最终目标。由于乙型肝炎e抗原（HBeAg）阴性慢性HBV感染是HBsAg丧失之前的最后阶段，因此该阶段的患者管理以及HBsAg的定量化已引起越来越多的临床和研究兴趣。本综述综合了HBsAg动力学研究的结果，并讨论了它们如何为我们对HBeAg阴性慢性HBV感染的理解和管理提供信息。研究表明，HBsAg水平高度预测HBV感染非活动的存在，HBsAg水平的连续变化可能预示1  -  3年内HBsAg的丢失。数据还表明，定量HBsAg监测在肝炎发作和抗病毒治疗期间非常重要，特别是在决定停止治疗和开始治疗后再治疗时。这些发现为HBV感染的自然病程提供了新的视角，可能有助于优化HBeAg阴性慢性HBV感染的治疗，并有助于HBV感染患者从无限期治疗到有限治疗的范式转变。

结论：
    31477873
DOI：
    10.1038 / s41575-019-0197-8