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HB sAg quantification: useful for monitoring natural history and treatment outcome
Author(s) -
MartinotPeignoux Michelle,
Lapalus Martine,
Asselah Tarik,
Marcellin Patrick
Publication year - 2014
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.12403
Subject(s) - hepatitis b virus , hepatocellular carcinoma , medicine , immune system , hepatitis b , immunology , viral load , antigen , virus , virology , gastroenterology
The template of hepatitis B virus transcription, the covalently closed circular DNA (ccc DNA ), plays a key role in the life cycle of the virus and permits the persistence of infection. It has been suggested that hepatitis B surface antigen ( HB sAg) quantification reflects the concentration of ccc DNA in the liver. In hepatitis B e antigen ( HB eAg) positive chronic hepatitis B, HB sAg levels are higherduring the immune tolerance phase than during the immune clearance phase. During the natural history of chronic hepatitis B, serum HB sAg declines progressively from the immune‐tolerant to the low replicative phase. In HB eAg negative patients, the combination of low hepatitis B virus ( HBV ) DNA (<2000 IU/ml) and low HB sAg levels (<1000 IU/ml) can predict inactive carrier status, low risk of hepatocellular carcinoma, and the probability of HB sAg loss. HB sAg in combination with HBV DNA predicts the outcome of Peg‐Interferon therapy: An absence of decline at week 12 is a good predictor of non‐response and to stop therapy. Any decline at week 24, suggests that therapy should be continued to 48 weeks. Although the decrease in HB sAg decline slow with nucleos(t)ide analogue therapy, a rapid decline can predict future HB sAg seroclearance. A level <100 IU/ml during six consecutive months could be a marker of a sustained response after treatment cessation.