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目前用于乙型肝炎病毒感染诊断的实验室检测。

Current laboratory tests for diagnosis of hepatitis B virus infection.

机构信息

Department of Laboratory Medicine, Yonsei University Wonju College of Medicine, Wonju, Republic of Korea.

Department of Laboratory Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.

出版信息

Int J Clin Pract. 2021 Dec;75(12):e14812. doi: 10.1111/ijcp.14812. Epub 2021 Sep 23.

Abstract

BACKGROUND

Hepatitis B virus (HBV) has a long history in human infectious diseases. HBV infection can progress chronically, leading to cancer. After introduction of a vaccine, the overall incidence rate of HBV infection has decreased, although it remains a health problem in many countries.

PURPOSE

The aim of this review was to summarise current diagnostic efforts for HBV infection and future HBV diagnosis perspectives.

METHODS

We reviewed and summarised current laboratory diagnosis related with HBV infection in clinical practice.

RESULTS

There have been various serologic- and molecular-based methods to diagnose acute or chronic HBV infection. Since intrahepatic covalently closed circular DNAs (cccDNAs) function as robust HBV replication templates, cure of chronic HBV infection is limited. Recently, new biomarkers such as hepatitis B virus core-related antigen (HBcrAg) and HBV RNA have emerged that appear to reflect intrahepatic cccDNA status. These new biomarkers should be validated before clinical usage.

CONCLUSION

An effective diagnostic approach and current updated knowledge of treatment response monitoring are important for HBV infection management. Brand new ultrasensitive and accurate immunologic methods may pave the way to manage HBV infection in parallel with immunotherapy era.

摘要

背景

乙型肝炎病毒(HBV)在人类传染病中有着悠久的历史。HBV 感染可慢性进展,导致癌症。疫苗问世后,HBV 感染的总体发病率虽有所下降,但在许多国家仍是一个健康问题。

目的

本综述旨在总结目前用于 HBV 感染的诊断方法以及未来的 HBV 诊断前景。

方法

我们对目前临床实践中与 HBV 感染相关的实验室诊断方法进行了回顾和总结。

结果

已经有各种基于血清学和分子的方法来诊断急性或慢性 HBV 感染。由于肝内共价闭合环状 DNA(cccDNA)可作为 HBV 复制的强大模板,慢性 HBV 感染的治愈受到限制。最近,新的生物标志物如乙型肝炎病毒核心相关抗原(HBcrAg)和 HBV RNA 出现,似乎可以反映肝内 cccDNA 状态。这些新的生物标志物在临床应用前需要进行验证。

结论

有效的诊断方法和对治疗反应监测的最新知识对于 HBV 感染的管理非常重要。全新的超灵敏和准确的免疫学方法可能会为免疫治疗时代并行管理 HBV 感染铺平道路。

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