Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB R3E 0J9, Canada.
National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, Canada.
Viruses. 2021 May 21;13(6):951. doi: 10.3390/v13060951.
Even though an approved vaccine for hepatitis B virus (HBV) is available and widely used, over 257 million individuals worldwide are living with chronic hepatitis B (CHB) who require monitoring of treatment response, viral activity, and disease progression to reduce their risk of HBV-related liver disease. There is currently a lack of predictive markers to guide clinical management and to allow treatment cessation with reduced risk of viral reactivation. Novel HBV biomarkers are in development in an effort to improve the management of people living with CHB, to predict disease outcomes of CHB, and further understand the natural history of HBV. This review focuses on novel HBV biomarkers and their use in the clinical setting, including the description of and methodology for quantification of serum HBV RNA, hepatitis B core-related antigen (HBcrAg), quantitative hepatitis B surface antigen (qHBsAg), including ultrasensitive HBsAg detection, quantitative anti-hepatitis B core antigen (qAHBc), and detection of HBV nucleic acid-related antigen (HBV-NRAg). The utility of these biomarkers in treatment-naïve and treated CHB patients in several clinical situations is further discussed. Novel HBV biomarkers have been observed to provide critical clinical information and show promise for improving patient management and our understanding of the natural history of HBV.
尽管已有乙型肝炎病毒 (HBV) 疫苗获得批准并广泛应用，但目前仍有超过 2.57 亿人患有慢性乙型肝炎 (CHB)，他们需要监测治疗反应、病毒活性和疾病进展，以降低发生 HBV 相关肝病的风险。目前缺乏预测标志物来指导临床管理，并允许在降低病毒再激活风险的情况下停止治疗。目前正在开发新型 HBV 生物标志物，以努力改善 CHB 患者的管理，预测 CHB 的疾病结局，并进一步了解 HBV 的自然史。这篇综述重点介绍了新型 HBV 生物标志物及其在临床环境中的应用，包括血清 HBV RNA、乙型肝炎核心相关抗原 (HBcrAg)、定量乙型肝炎表面抗原 (qHBsAg)（包括超敏 HBsAg 检测）、定量抗乙型肝炎核心抗原 (qAHBc) 和 HBV 核酸相关抗原 (HBV-NRAg) 的描述和定量方法。进一步讨论了这些生物标志物在几种临床情况下治疗初治和治疗的 CHB 患者中的应用。新型 HBV 生物标志物已被观察到可提供重要的临床信息，并有望改善患者管理和我们对 HBV 自然史的理解。
