Victorian Infectious Diseases Reference Laboratory, North Melbourne, VIC, Australia,
Hepatol Int. 2008 May;2(Supplement 1):3-11. doi: 10.1007/s12072-008-9051-8. Epub 2008 Feb 13.
New standardized assays for the quantification of hepatitis B virus (HBV) DNA have yielded insights into the association of HBV DNA levels with the relative risk of developing liver disease. Quantification of HBV DNA has also played a role in the management of chronic hepatitis B by allowing criteria to be established for determining patient eligibility for antiviral therapy, monitoring response, and identifying the development of resistance. In addition to serum HBV DNA levels, the HBV genotype may influence disease progression and response to therapy. However, many of the studies that have included genotype assessment do not compare across the range of genotypes, and current management guidelines do not incorporate genotype determination. More recently, quantitative assays for intrahepatic HBV replicative intermediates, as well as hepatitis B e antigen and hepatitis B surface antigen, indicate that these factors may have promise in identifying patients likely to respond to treatment. Additional work is needed to standardize and validate these assays before they can be considered to be of true diagnostic value. A wide variety of research techniques are being used to investigate chronic hepatitis B. Further evaluation is needed to decide which will have the greatest clinical applicability.
新的标准化检测方法可定量检测乙型肝炎病毒 (HBV) DNA，从而深入了解 HBV DNA 水平与发生肝脏疾病风险的相关性。HBV DNA 的定量检测在慢性乙型肝炎的管理中也发挥了重要作用，它为确定抗病毒治疗的患者资格、监测治疗应答和识别耐药性的发展确立了标准。除了血清 HBV DNA 水平，HBV 基因型也可能影响疾病进展和治疗反应。然而，许多包括基因型评估的研究并未在整个基因型范围内进行比较，而且目前的管理指南并未纳入基因型确定。最近，针对肝内 HBV 复制中间体、乙型肝炎 e 抗原和乙型肝炎表面抗原的定量检测表明，这些因素可能有望用于识别可能对治疗有反应的患者。在这些检测方法能够真正具有诊断价值之前，还需要进行标准化和验证。目前正在使用多种研究技术来研究慢性乙型肝炎。需要进一步评估，以确定哪种技术具有最大的临床适用性。
