Tanaka Eiji, Matsumoto Akihiro, Yoshizawa Kaname, Maki Noboru
Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan.
Intervirology. 2008;51 Suppl 1:3-6. doi: 10.1159/000122592. Epub 2008 Jun 10.
The clinical significance of the hepatitis B virus core-related antigen (HBcrAg) assay in monitoring the antiviral effects of lamivudine is reviewed.
The HBcrAg assay simultaneously measured serum levels of hepatitis B core (HBc) and e (HBe) antigens using monoclonal antibodies which recognize common epitopes of these two denatured antigens.
Although serum HBcrAg levels correlated linearly with those of hepatitis B virus (HBV) DNA in natural course, the decrease in HBcrAg was significantly slower than in HBV DNA after initiation of lamivudine administration. We analyzed the clinical significance of HBV DNA and HBcrAg levels to predict the occurrence of lamivudine resistance. HBV DNA measurement may be useful to identify patients who are at high risk of developing lamivudine resistance, and HBcrAg measurement may help to detect patients who are at low risk of drug resistance. The measurement of HBcrAg was also found to be a useful prognosticator for reactivation of hepatitis after cessation of lamivudine administration.
The HBcrAg assay is indeed useful for monitoring the antiviral effects of lamivudine, and we propose that it be adopted as a serum marker which reflects the amount of HBV covalently closed circular DNA in hepatocytes.
综述乙肝病毒核心相关抗原（HBcrAg）检测在监测拉米夫定抗病毒疗效中的临床意义。
HBcrAg检测使用识别这两种变性抗原共同表位的单克隆抗体同时测定血清中乙肝核心（HBc）抗原和e（HBe）抗原水平。
虽然在自然病程中血清HBcrAg水平与乙肝病毒（HBV）DNA水平呈线性相关，但拉米夫定治疗开始后，HBcrAg的下降明显慢于HBV DNA。我们分析了HBV DNA和HBcrAg水平预测拉米夫定耐药发生的临床意义。检测HBV DNA可能有助于识别发生拉米夫定耐药高风险的患者，而检测HBcrAg可能有助于发现耐药低风险的患者。还发现检测HBcrAg对于预测拉米夫定停药后肝炎再激活是一个有用的预后指标。
HBcrAg检测确实有助于监测拉米夫定的抗病毒疗效，我们建议将其作为反映肝细胞中HBV共价闭合环状DNA量的血清标志物采用。
