Armandi Angelo, Rosso Chiara, Ribaldone Davide G, Caviglia Gian P
Department of Medical Sciences, University of Turin, Turin, Italy.
Division of Gastroenterology, Molinette Hospital, Città della Salute e della Scienza, Turin, Italy.
Panminerva Med. 2021 Dec;63(4):499-507. doi: 10.23736/S0031-0808.20.04163-4. Epub 2020 Oct 19.
Chronic Hepatitis B virus (HBV) infection encompasses a wide virologic and clinical spectrum with heterogeneous outcomes. The natural history of chronic HBV infection ranges from an inactive carrier state (hepatitis B e antigen-negative chronic infection) to progressive chronic hepatitis that may evolve in end-stage liver disease and hepatocellular carcinoma. The issue becomes even more complicated when we consider the unique biology of the virus; the HBV covalently-closed-circular DNA, that acts as virus transcription template, is the key factor responsible of the persistence of the infection even after hepatitis B surface antigen loss. In the last decade, novel serological and immunological biomarkers associated to the core protein of HBV have been approached in different clinical conditions. Remarkable results have been obtained both in the setting of overt and occult HBV infection. Here, we reviewed the meaning and the potential clinical applications of the measurement of core antigen and antibodies.
慢性乙型肝炎病毒（HBV）感染涵盖了广泛的病毒学和临床谱，其结局具有异质性。慢性HBV感染的自然史从非活动性携带者状态（乙肝e抗原阴性慢性感染）到可能进展为终末期肝病和肝细胞癌的进行性慢性肝炎。当我们考虑该病毒独特的生物学特性时，问题变得更加复杂；HBV共价闭合环状DNA作为病毒转录模板，即使在乙肝表面抗原消失后，也是感染持续存在的关键因素。在过去十年中，与HBV核心蛋白相关的新型血清学和免疫学生物标志物已在不同临床情况下进行了研究。在显性和隐匿性HBV感染的情况下均取得了显著成果。在此，我们综述了核心抗原和抗体检测的意义及潜在临床应用。
