在慢性乙型肝炎的自然病史和治疗中使用HBsAg定量。 麦LY1，

StephenW

Hepatol Int. 2019 Nov 19. doi: 10.1007/s12072-019-09998-5. [Epub ahead of print]
Use of HBsAg quantification in the natural history and treatment of chronic hepatitis B.
Mak LY1, Seto WK1,2, Fung J1,2, Yuen MF3,4.
Author information

1
    Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road 102, Hong Kong, China.
2
    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China.
3
    Department of Medicine, The University of Hong Kong, Queen Mary Hospital, Pokfulam Road 102, Hong Kong, China. [email protected].
4
    State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong, China. [email protected].

Abstract

In patients with chronic hepatitis B (CHB) infection, it is important to monitor the natural history, assess treatment response, and predict the risk of liver-related complications. Quantification of serum hepatitis B surface antigen (HBsAg) has gained wide interests since the last decade. It is secreted from hepatocytes in both hepatitis B e antigen (HBeAg)-positive and HBeAg-negative phases of the disease, and can be transcribed and translated from different sources of viral genome [ccc DNA or integrated hepatitis B virus (HBV) DNA]. In untreated patients, it declines slowly through the natural course and remains stable for a long time after HBeAg seroconversion. In patients treated with nucleos(t)ide analogues (NA), it also declines very slowly, even though serum hepatitis B DNA has been rendered negative. Low serum HBsAg may predict either spontaneous or treatment-induced HBsAg seroclearance, and potentially selects out HBeAg-negative patients who can safely stop NA. High serum HBsAg is associated with high risk of hepatocellular carcinoma in untreated population, and predicts treatment failure in patients receiving pegylated interferon. These potential roles of HBsAg quantification are applicable to selected populations only. There is also a need for novel markers to study the effect of emerging antiviral therapies targeting various parts of the HBV cycle to reflect their distinct mechanistic effects. Several agents measuring HBsAg levels have shown rapid and significant decline. Ongoing studies are required to demonstrate the sustainability of HBsAg suppression by these novel agents.
KEYWORDS:

Antiviral therapy; Functional cure; Hepatitis B surface antigen; Hepatitis B virus; Hepatocellular carcinoma

PMID:
    31745711
DOI:
    10.1007/s12072-019-09998-5

StephenW

Hepatol Int。 2019年11月19日.doi：10.1007 / s12072-019-09998-5。 [Epub提前发布]
在慢性乙型肝炎的自然病史和治疗中使用HBsAg定量。
麦LY1，濑户WK1，2，冯J1，2，袁MF3，4。
作者信息

1个
香港大学，香港薄扶林道102号玛丽医院，香港大学医学系。
2
香港大学，肝脏研究国家重点实验室，中国香港。
3
香港大学，香港薄扶林道102号玛丽医院，香港大学医学系。 [email protected]。
4
香港大学，肝脏研究国家重点实验室，中国香港。 [email protected]。

抽象

在患有慢性乙型肝炎（CHB）感染的患者中，重要的是要监测自然病史，评估治疗反应并预测与肝脏相关的并发症的风险。自上个十年以来，对血清乙型肝炎表面抗原（HBsAg）的定量检测已引起广泛关注。它在该疾病的乙型肝炎e抗原（HBeAg）阳性和HBeAg阴性阶段均从肝细胞分泌，并且可以从病毒基因组的不同来源[ccc DNA或整合的乙型肝炎病毒（HBV DNA）]转录和翻译。在未经治疗的患者中，HBeAg血清转化后其下降缓慢，并在很长一段时间内保持稳定；对于具有核苷酸类似物（NA）的患者，即使B DNA呈阴性，其下降也非常缓慢。低血清HBsAg可能预示着自发性或治疗引起的HBsAg血清清除，并有可能选择可以安全停止NA的HBeAg阴性患者。高血清HBsAg与未治疗人群中肝细胞癌的高风险相关，并预测患者的治疗失败HBsAg定量的这些潜在作用仅适用于特定人群，还需要新的标记物来研究em的作用针对HBV周期各个部分的抗病毒疗法不断出现，以反映其独特的机械作用。几种测量HBsAg水平的药物已显示出迅速而显着的下降。需要正在进行的研究来证明这些新型药物抑制HBsAg的可持续性。
关键字：

抗病毒治疗；功能性治疗；乙型肝炎表面抗原；乙型肝炎病毒；肝细胞癌

PMID：
31745711
DOI：
10.1007 / s12072-019-09998-5