最接近慢性乙型肝炎患者完全治愈的理想标志：高灵敏度定

StephenW

最接近慢性乙型肝炎患者完全治愈的理想标志：高灵敏度定量 HBsAg 消失
王子龙 1 、郑家瑞 1 、杨瑞峰 1 、黄林祥 1 、陈红松 1 、冯博 1
隶属关系
联系

    1个
    北京大学人民医院，北京大学肝病研究所，丙型肝炎与肝病免疫治疗北京市重点实验室，北京，中国。

    PMID：36406318 PMCID：PMC9647097 DOI：10.14218/JCTH.2022.00289

抽象的

在抗病毒治疗时代，治疗的主要目标已经从持续抑制乙型肝炎病毒（HBV）复制转变为追求HBs表面抗原（HBsAg）的血清学清除。基于HBV的生命周期，HBsAg起源于共价闭合环状DNA（cccDNA）和整合的HBV DNA，从而反映了它们的转录活性。 HBsAg 完全消失可能意味着 HBV 基因组（包括 cccDNA 和整合的 HBV DNA）的消除或持续失活。 HBsAg 消失促进异常免疫功能的恢复，进而可能进一步促进残留病毒的清除。结合功能性治愈和临床结局的巨大改善，高灵敏度定量 HBsAg 的持续血清学清除可能代表慢性乙型肝炎（CHB）的完全治愈。对于除 HBV 本身之外的许多其他危险因素，HBsAg 消失的患者仍需要定期监测。在这篇综述中，我们总结了 CHB 治疗的演变、血清 HBsAg 的起源、HBsAg 血清学清除的模式，以及 HBsAg 消失对免疫功能和疾病结果的影响。此外，我们讨论了高灵敏度 HBsAg 检测的重要性及其作为完全治愈替代指标的可能性。

关键词：生物标志物；慢性乙型肝炎；完全治愈；功能性治愈；乙肝表面抗原；乙型肝炎病毒;免疫测定。

© 2023 作者。
利益冲突声明

作者没有与本出版物相关的利益冲突。

StephenW

An Ideal Hallmark Closest to Complete Cure of Chronic Hepatitis B Patients: High-sensitivity Quantitative HBsAg Loss
Zi-Long Wang  1 , Jia-Rui Zheng  1 , Rui-Feng Yang  1 , Lin-Xiang Huang  1 , Hong-Song Chen  1 , Bo Feng  1
Affiliations
Affiliation

    1
    Peking University People's Hospital, Peking University Hepatology Institute, Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Beijing, China.

    PMID: 36406318 PMCID: PMC9647097 DOI: 10.14218/JCTH.2022.00289

Abstract

In the era of antiviral therapy, the main goal of treatment has shifted from the persistent inhibition of hepatitis B virus (HBV) replication to the pursuit of serological clearance of HBs surface antigen (HBsAg). Based on the life cycle of HBV, HBsAg originates from covalently closed circular DNA (cccDNA) and integrated HBV DNA, thus reflecting their transcriptional activity. Complete HBsAg loss may mean elimination or persistent inactivity of the HBV genome including cccDNA and integrated HBV DNA. HBsAg loss improves the recovery of abnormal immune function, which in turn, may further promote the clearance of residual viruses. Combined with functional cure and the great improvement of clinical outcomes, the continuous seroclearance of high-sensitivity quantitative HBsAg may represent the complete cure of chronic hepatitis B (CHB). For many other risk factors besides HBV itself, patients with HBsAg loss still need regular monitoring. In this review, we summarized the evolution of CHB treatment, the origin of serum HBsAg, the pattern of HBsAg seroclearance, and the effect of HBsAg loss on immune function and disease outcomes. In addition, we discuss the significance of high-sensitivity HBsAg detection and its possibility as a surrogate of complete cure.

Keywords: Biomarker; Chronic hepatitis B; Complete cure; Functional cure; HBsAg; Hepatitis B virus; Immunoassay.

© 2023 Authors.
Conflict of interest statement

The authors have no conflict of interests related to this publication.

StephenW

https://publinestorage.blob.core ... 22.0(0).0.00289.pdf