Hepatitis B virus DNA and HBsAg levels in chronic hepatitis B

liver411

Expert Rev Anti Infect Ther. 2010 Jun;8(6):717-26.

Hepatitis B virus DNA and hepatitis B surface antigen levels in chronic
hepatitis B.

Fung J, Lai CL, Yuen MF.

Department of Medicine, The University of Hong Kong, Queen Mary Hospital,
Pokfulam Road, Hong Kong SAR. [email protected]

Abstract
Despite universal vaccination, chronic hepatitis B (CHB) continues to be a
major health burden worldwide, with an estimated 350-400 million people
infected with the virus. Over the past decade, rapid progress has been made
with regards to antiviral therapy for CHB, from conventional interferon to
pegylated interferon, and with the earliest oral agent lamivudine to the
current, more potent drugs such as entecavir and tenofovir. There have also
been new developments in the diagnostic and monitoring tools for CHB.
Qualitative hepatitis B surface antigen (HBsAg) testing has been used to
diagnose patients infected with CHB. More recently, quantitative HBsAg titers
have been used to predict treatment outcome when measured at baseline or early
into treatment. The progress on the use of hepatitis B virus (HBV) DNA levels
has been more rapid. Serum HBV DNA levels have been shown to be important in
the natural history of CHB infection, with higher levels being significantly
associated with the development of cirrhosis and hepatocellular carcinoma. For
patients receiving antiviral therapy, the baseline and early on-treatment HBV
DNA levels are important in determining treatment outcomes. Monitoring of HBV
DNA levels during therapy will allow for early detection of drug resistance.
The end-of-treatment and post-treatment HBV DNA levels have been demonstrated
to be important indicators of treatment success and relapse, respectively.
With newer and more powerful antiviral agents, and with the development of
quantitative assays that are highly sensitive, further studies are needed to
optimize the use of these tools and agents in the modern management of CHB.
PMID: 20521898 [PubMed - in process]
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