HBsAg定量在慢性乙型肝炎自然病史和治疗中的应用

StephenW

Use of HBsAg quantification in the natural history and treatment of chronic hepatitis B

    Authors
    Authors and affiliations

    Lung-Yi MakWai-Kay SetoJames FungMan-Fung YuenEmail author

    Lung-Yi Mak
        1
    Wai-Kay Seto
        12
    James Fung
        12
    Man-Fung Yuen
        12Email author

    1.Department of MedicineThe University of Hong Kong, Queen Mary HospitalHong KongChina
    2.State Key Laboratory for Liver ResearchThe University of Hong KongHong KongChina

Review Article
First Online: 19 November 2019

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

StephenW

HBsAg定量在慢性乙型肝炎自然病史和治疗中的应用

s
作者和单位

麦龙凯·塞托·龙伊（James FungMan-Fung Yuen）

麦龙义
1个
怀基濑户
12
冯国荣
12
袁文峰
12电子邮件作者

1.香港大学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

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首次在线：2019年11月19日

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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，血清乙型肝炎表面抗原（HBsAg）的定量分析已引起广泛关注。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转录和翻译[ccc DNA或整合的乙型肝炎病毒（HBV）DNA] 。在未经治疗的患者中，HBeAg血清转化后，它在自然过程中缓慢下降，并在很长一段时间内保持稳定。即使使用血清乙型肝炎DNA阴性，使用核苷类似物（NA）治疗的患者，其下降速度也非常缓慢。血清HBsAg较低可能预示了自发的或治疗引起的HBsAg血清清除，并可能选择了可以安全停止NA的HBeAg阴性患者。高血清HBs Ag与未治疗人群中肝细胞癌的高风险相关，并预测接受聚乙二醇干扰素治疗的患者治疗失败。 HBsAg定量的这些潜在作用仅适用于选定的人群。还需要新颖的标记物来研究针对HBV循环各个部分的新兴抗病毒疗法的作用，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。
关键词
乙型肝炎病毒乙型肝炎表面抗原功能治疗抗病毒治疗肝细胞癌