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The role of HBsAg quantification for monitoring natural history and treatment outcome
Author(s) -
MartinotPeignoux Michelle,
Lapalus Martine,
Asselah Tarik,
Marcellin Patrick
Publication year - 2013
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12075
Subject(s) - hbsag , medicine , hepatitis b virus , immunology , hepatitis b , antigen , natural history , virology , gastroenterology , virus
Since its discovery by Blumberg in 1965, the hepatitis B virus antigen (HBsAg) is used as the fingerprint of hepatitis B infection. The HB sAg level is a reflection of the transcriptional activity of ccc DNA . It is an important marker that not only indicates active hepatitis B infection but can also predict clinical and treatment outcomes. Assays for HB sAg quantification are fully automated and have high output. HB sAg titres are higher in HB e antigen ( HB eAg)(+) than in HB eAg(−) patients and are negatively correlated with liver fibrosis in HB eAg(+) patients. In HB eAg(−) chronic hepatitis B, an HB sAg level <1000 IU/ml and an HBV DNA titre <2000 IU/ml accurately identify inactive carriers. During PEG ‐ IFN treatment, HB sAg quantification is used to identify patients who will not benefit from therapy as early as week 12 on therapy, so that treatment may be stopped or switched‐ ‘ week 12 stopping rule ’. With nucleos(t)ide analogues ( NA ), the role of HB sAg quantification must be clarified. Several studies show that baseline and on‐treatment HB sAg levels might identify patients that can be treated with no subsequent risk of reactivation. In clinical practice, HB sAg quantification is a simple and reproducible tool that can be used in association with HBV DNA to classify patients during the natural history of HBV and to monitor therapy.