血清HBsAg定量检测在慢性乙型肝炎临床诊疗中的应用及其意义

于德敏; 张欣欣

doi:10.3969/j.issn.1001-5256.2019.10.004

血清HBsAg定量检测在慢性乙型肝炎临床诊疗中的应用及其意义

DOI: 10.3969/j.issn.1001-5256.2019.10.004

上海交通大学医学院附属瑞金医院临床病毒研究室

基金项目:

国家自然科学基金(81672069,81572047)；

详细信息

中图分类号: R512.62
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出版历程
- 收稿日期: 2019-07-29
- 出版日期: 2019-10-20

Serum HBsAg quantification in clinical diagnosis and treatment of chronic hepatitis B

Research Laboratory of Clinical Virology,Ruijin Hospital,Shanghai Jiao Tong University School of Medicine

Research funding:

摘要

摘要: HBsAg最早应用于HBV感染的诊断,其在血清中的水平与肝细胞中HBV cccDNA水平、病毒复制能力和机体免疫功能状态有关。近年来随着血清HBsAg定量检测技术的发展和"功能性治愈"概念的提出,HBsAg定量在HBV感染临床诊疗中的作用也越来越受到重视。从慢性乙型肝炎自然病程、抗病毒治疗应答预测及停药预测等方面进行分析讨论血清HBsAg定量的作用。
- 乙型肝炎,慢性 /
- 乙型肝炎表面抗原 /
- 诊断 /
- 治疗学
Abstract: HBsAg is one of the oldest diagnostic markers for HBV infection,and serum HBsAg level is associated with HBV cccDNA level in hepatocytes,HBV replication capability,and host immune response. In recent years,with the development of serum HBsAg quantification and the concept of functional cure,HBsAg quantification has been taken more and more seriously in the clinical diagnosis and treatment of HBV infection. This article analyzes the role of serum HBsAg quantification from the aspects of natural disease course of chronic hepatitis B,prediction of response to antiviral therapy,and prediction of drug withdrawal.
- hepatitis B,chronic /
- hepatitis B surface antigens /
- diagnosis /
- therapeutics

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参考文献(40)

[1] CORNBERG M,WONG VW,LOCARNINI S,et al. The role of quantitative hepatitis B surface antigen revisited[J]. J Hepatol,2017,66(2):398-411.

[2] COFFIN CS,ZHOU K,TERRAULT NA. New and old biomarkers for diagnosis and management of chronic hepatitis B virus infection[J]. Gastroenterology,2019,156(2):355-368. e3.

[3] LIU J,YANG HI,LEE MH,et al. Serum levels of hepatitis B surface antigen and DNA can predict inactive carriers with low risk of disease progression[J]. Hepatology,2016,64(2):381-389.

[4] YU DM,LI XH,MOM V,et al. N-glycosylation mutations within hepatitis B virus surface major hydrophilic region contribute mostly to immune escape[J]. J Hepatol,2014,60(3):515-522.

[5] WARNER N,LOCARNINI S. The antiviral drug selected hepatitis B virus rt A181T/s W172*mutant has a dominant negative secretion defect and alters the typical profile of viral rebound[J]. Hepatology,2008,48(1):88-98.

[6] CHAN HL,WONG VW,TSE AM,et al. Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response[J]. Clin Gastroenterol Hepatol,2007,5(12):1462-1468.

[7] CHAN HL,WONG VW,WONG GL,et al. A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B[J]. Hepatology,2010,52(4):1232-1241.

[8] NGUYEN T,THOMPSON AJ,BOWDEN S,et al. Hepatitis B surface antigen levels during the natural history of chronic hepatitis B:A perspective on Asia[J]. J Hepatol,2010,52(4):508-513.

[9] THOMPSON AJ,NGUYEN T,ISER D,et al. Serum hepatitis B surface antigen and hepatitis B e antigen titers:Disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers[J]. Hepatology,2010,51(6):1933-1944.

[10] FATTOVICH G,OLIVARI N,PASINO M,et al. Long-term outcome of chronic hepatitis B in Caucasian patients:Mortality after 25 years[J]. Gut,2008,57(1):84-90.

[11] BROUWER WP,CHAN HL,BRUNETTO MR,et al. Repeated measurements of hepatitis B surface antigen identify carriers of inactive HBV during long-term follow-up[J]. Clin Gastroenterol Hepatol,2016,14(10):1481-1489. e5.

[12] BRUNETTO MR,OLIVERI F,COLOMBATTO P,et al. Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D carriers[J]. Gastroenterology,2010,139(2):483-490.

[13] SALI S,SHARAFI H,ALAVIAN SH,et al. Can serum level of HBsAg differentiate HBe Ag-negative chronic hepatitis B from inactive carrier state?[J]. Diagn Microbiol Infect Dis,2015,82(2):114-119.

[14] World Health Organization. Guidelines for the prevention,care and treatment of persons with chronic hepatitis B infection[R].Geneva:WHO,2015.

[15] SETO WK,WONG DK,FUNG J,et al. High hepatitis B surface antigen levels predict insignificant fibrosis in hepatitis B e antigen positive chronic hepatitis B[J]. PLo S One,2012,7(8):e43087.

[16] MARTINOT-PEIGNOUX M,CARVALHO-FILHO R,LAPALUS M,et al. Hepatitis B surface antigen serum level is associated with fibrosis severity in treatment-nave,e antigenpositive patients[J]. J Hepatol,2013,58(6):1089-1095

[17] MARCELLIN P,MARTINOT-PEIGNOUX M,ASSELAH T,et al. Serum levels of hepatitis B surface antigen predict severity of fibrosis in patients with e antigen-positive chronic hepatitis B[J]. Clin Gastroenterol Hepatol,2015,13(8):1532-1539. e1.

[18] LIANG LB,ZHU X,YAN LB,et al. Serum hepatitis B surface antigen titer and transient elastography in screening for insignificant fibrosis in HBe Ag-positive chronic hepatitis B patients[J]. Ther Clin Risk Manag,2015,11:229-235.

[19] XUN YH,ZANG GQ,GUO JC,et al. Serum hepatitis B surface antigen quantification as a useful assessment for significant fibrosis in hepatitis B e antigen-positive hepatitis B virus carriers[J]. J Gastroenterol Hepatol,2013,28(11):1746-1755.

[20] JANSSEN HL,KERHOF-LOS CJ,HEIJTINK RA,et al. Measurement of HBs Ag to monitor hepatitis B viral replication in patients on alpha-interferon therapy[J]. Antiviral Res,1994,23(3-4):251-257.

[21] MARTINOT-PEIGNOUX M,ASSELAH T,MARCELLIN P. HBs Ag quantification to optimize treatment monitoring in chronic hepatitis B patients[J]. Liver Int,2015,35(Suppl 1):82-90.

[22] SONNEVELD MJ,HANSEN BE,PIRATVISUTH T,et al. Response-guided peginterferon therapy in hepatitis B e antigen-positive chronic hepatitis B using serum hepatitis B surface antigen levels[J]. Hepatology,2013,58(3):872-880.

[23] MOUCARI R,MACKIEWICZ V,LADA O,et al. Early serum HBs Ag drop:A strong predictor of sustained virological response to pegylated interferon alfa-2a in HBe Ag-negative patients[J].Hepatology,2009,49(4):1151-1157.

[24] MARCELLIN P,BONINO F,YURDAYDIN C,et al. Hepatitis B surface antigen levels:Association with 5-year response to peginterferon alfa-2a in hepatitis B e-antigen-negative patients[J]. Hepatol Int,2013,7(1):88-97.

[25] PAVLOVIC V,YANG L,CHAN HL,et al. Peginterferon alfa-2a(40 kD)stopping rules in chronic hepatitis B:A systematic review and meta-analysis of individual participant data[J].Antivir Ther,2019,24(2):133-140.

[26] CHEVALIEZ S,HZODE C,BAHRAMI S,et al. Long-term hepatitis B surface antigen(HBs Ag)kinetics during nucleoside/nucleotide analogue therapy:Finite treatment duration unlikely[J]. J Hepatol,2013,58(4):676-683.

[27] KIM WR,BERG T,ASSELAH T,et al. Evaluation of APRI and FIB-4 scoring systems for non-invasive assessment of hepatic fibrosis in chronic hepatitis B patients[J]. J Hepatol,2016,64(4):773-780.

[28] WURSTHORN K,JUNG M,RIVA A,et al. Kinetics of hepatitis B surface antigen decline during 3 years of telbivudine treatment in hepatitis B e antigen-positive patients[J]. Hepatology,2010,52(5):1611-1620.

[29] HEATHCOTE EJ,MARCELLIN P,BUTI M,et al. Three-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B[J]. Gastroenterology,2011,140(1):132-143.

[30] ZOUTENDIJK R,ZAAIJER HL,de VRIES-SLUIJS TE,et al.Hepatitis B surface antigen declines and clearance during long-term tenofovir therapy in patients coinfected with HBV and HIV[J]. J Infect Dis,2012,206(6):974-980.

[31] HOSAKA T,SUZUKI F,KOBAYASHI M,et al. Clearance of hepatitis B surface antigen during long-term nucleot(s)ide analog treatment in chronic hepatitis B:Results from a nineyear longitudinal study[J]. J Gastroenterol,2013,48(8):930-941.

[32] SETO WK,WONG DK,FUNG J,et al. Reduction of hepatitis B surface antigen levels and hepatitis B surface antigen seroclearance in chronic hepatitis B patients receiving 10 years of nucleoside analogue therapy[J]. Hepatology,2013,58(3):923-931.

[33] HADZIYANNIS E,LARAS A. Viral biomarkers in chronic HBe Ag negative HBV infection[J]. Genes(Basel),2018,9(10). pii:E469.

[34] BROQUETAS T,GARCIA-RETORTILLO M,HERNANDEZ JJ,et al. Quantification of HBs Ag to predict low levels and seroclearance in HBe Ag-negative patients receiving nucleos(t)ide analogues[J]. PLo S One,2017,12(11):e0188303.

[35] GRAMENZI A,LOGGI E,MICCO L,et al. Serum hepatitis B surface antigen monitoring in long-term lamivudine-treated hepatitis B virus patients[J]. J Viral Hepat,2011,18(10):e468-e474.

[36] SU CW,WU CY,HUNG HH,et al. Differential roles of serum hepatitis B virus DNA and hepatitis B surface antigen level in predicting virological breakthrough in patients receiving lamivudine therapy[J]. J Gastroenterol Hepatol,2013,28(12):1849-1858.

[37] TERRAULT NA,LOK ASF,McMAHON BJ,et al. Update on prevention,diagnosis,and treatment of chronic hepatitis B:AASLD 2018 hepatitis B guidance[J]. Hepatology,2018,67(4):1560-1599.

[38] SARIN SK,KUMAR M,LAU GK. Asian-Pacific clinical practice guidelines on the management of hepatitis B:A 2015 update[J]. Hepatol Int,2016,10(1):1-98.

[39] QIU YW,HUANG LH,YANG WL,et al. Hepatitis B surface antigen quantification at hepatitis B e antigen seroconversion predicts virological relapse after the cessation of entecavir treatment in hepatitis B e antigen-positive patients[J]. Int J Infect Dis,2016,43:43-48.

[40] WANG CC,TSENG KC,HSIEH TY,et al. Assessing the durability of entecavir-treated hepatitis B using quantitative HBsAg[J]. Am J Gastroenterol,2016,111(9):1286-1294.

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