Quantitative HBsAg assessment as a crucial parameter in monitoring natural course and treatment outcome of chronic hepatitis B infection
Journal Title: Postępy Nauk Medycznych - Year 2014, Vol 27, Issue 11
Abstract
Identification of HBsAg in 1965 by Blumberg was the discovery awarded by the Nobel Prize. Until today it remains the fingerprint of HBV infection. Moreover its quantitative assessment is a useful marker of natural course and treatment outcome.The essence of chronic hepatitis B infection is the presence of cccDNA, which is the transcription template, in hepatocytes. The correlation between qHBs and cccDNA has been proven and it is believed that qHBs indirectly reflects the amount of cccDNA in the liver.qHBs level changes during natural history of CHB (chronic hepatitis B). The highest titers are observed during immunotolerance phase, then qHBs declines progressively and is the lowest in the low replication phase. qHBs levels are higher in HBe-positive that HBe-negative patients. Moreover qHBs together with HBV DNA helps to identify patients with the high risk of infection reactivation.HBV genotype has a major influence on PEG-INF treatment effectiveness, however during PEG-INF therapy qHBs > 20 000 IU/ml in 24th week is connected with the lack of sustained treatment response irrespective of HBV genotype. Determining qHBs in 12th week has also a prognostic value however treatment discontinuation at this moment is not recommended.qHBs application during nucleoside analogue (NAs) therapy is the issue that requires further investigation. qHBs titers declines slowly during NAs. It is possible that in the future it may be the useful indicator of treatment cessation.Hepatitis B surface antigen quantification is a low cost assay which complements previous way of CHB monitoring with HBV DNA and provides relevant information to make better therapeutic decisions.
Authors and Affiliations
Marta Strycharz-Żak, Anna Piekarska
Keywords
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