Chen Chien-Hung, Chiu Yi-Chun, Lu Sheng-Nan, Lee Chuan-Mo, Wang Jing-Houng, Hu Tsung-Hui, Hung Chao-Hung
Chien-Hung Chen, Yi-Chun Chiu, Sheng-Nan Lu, Chuan-Mo Lee, Jing-Houng Wang, Tsung-Hui Hu, Chao-Hung Hung, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan.
World J Gastroenterol. 2014 Jun 28;20(24):7686-95. doi: 10.3748/wjg.v20.i24.7686.
Quantification of hepatitis B surface antigen (HBsAg) has been suggested to be helpful in the management of chronic hepatitis B (CHB) patients. Nucleos(t)ide analogs (NAs) are the therapy of choice for CHB and are used in the majority of CHB patients. NAs are able to induce hepatitis B virus (HBV) viral suppression, normalization of alanine aminotransferase (ALT) levels, and improvement in liver histology. Automated quantitative assays for serum HBsAg have recently become available, facilitating standardized quantification of serum HBsAg. This has led to increased interest in the clinical application of quantitative serum HBsAg for predicting therapeutic response to NAs. Recent studies have shown that a decline in serum HBsAg levels in patients receiving peginterferon may signal successful induction of immune control over HBV, and can therefore be used to predict therapeutic response. NA treatment typically induces a less rapid decline in HBsAg than interferon treatment; it has been estimated that full HBsAg clearance can require decades of NA treatment. However, a rapid HBsAg decline during NA therapy may identify patients who will show clearance of HBsAg. Currently, there is no consensus on the clinical utility of serum HBsAg monitoring for evaluating patient responses to NA therapy. This review focuses on recent findings regarding the potential application of HBsAg quantification in the management of CHB patients receiving NA therapy.
乙型肝炎表面抗原（HBsAg）定量检测被认为有助于慢性乙型肝炎（CHB）患者的管理。核苷（酸）类似物（NAs）是CHB的首选治疗药物，大多数CHB患者都在使用。NAs能够抑制乙型肝炎病毒（HBV）复制，使丙氨酸氨基转移酶（ALT）水平恢复正常，并改善肝脏组织学。血清HBsAg的自动化定量检测方法最近已经出现，这有助于实现血清HBsAg的标准化定量。这使得人们对定量血清HBsAg在预测NAs治疗反应方面的临床应用兴趣增加。最近的研究表明，接受聚乙二醇干扰素治疗的患者血清HBsAg水平下降可能预示着对HBV的免疫控制诱导成功，因此可用于预测治疗反应。NA治疗通常比干扰素治疗引起的HBsAg下降速度慢；据估计，完全清除HBsAg可能需要数十年的NA治疗。然而，NA治疗期间HBsAg的快速下降可能提示患者将出现HBsAg清除。目前，关于血清HBsAg监测在评估患者对NA治疗反应方面的临床实用性尚无共识。本综述重点关注HBsAg定量检测在接受NA治疗的CHB患者管理中的潜在应用的最新研究结果。
