Hudu Shuaibu Abdullahi, Shinkafi Sa'adatu Haruna, Jimoh Abdulgafar Olayiwola
Department of Basic Medical and Dental Sciences, Faculty of Dentistry, Zarqa University, Zarqa, Jordan.
Department of Microbiology and Parasitology, Usmanu Danfodiyo University Teaching Hospital, Sokoto, Sokoto State, Nigeria.
Med Rev (2021). 2024 May 8;4(3):225-234. doi: 10.1515/mr-2024-0022. eCollection 2024 Jun.
A major worldwide health concern, chronic hepatitis B necessitates precise prognostic and diagnostic indicators for clinical guidance. This article highlights the clinical importance and current issues of the major markers used in both the detection and prognosis of chronic hepatitis B. An important indicator of an ongoing and persistent infection is the hepatitis B surface antigen. Hepatitis B virus DNA quantification monitoring aids in assessing viral load and hepatic cancer risk. While limited evidence of liver damage is provided by alanine aminotransferase levels, the hepatitis B core antibody verifies acute infection. Seroconversion to the hepatitis B e antibody is linked to a lower risk of disease development, and the hepatitis B e antigen status is a critical prognostic factor. Treatment choices are guided by a biopsy of the liver or minimally invasive liver fibrosis detection. Genotypes of the hepatitis B virus and host variables influence the prognosis by adding to the disease's variability. Noninvasive techniques to evaluate the severity of the disease are provided by serum markers of fibrosis, such as the fibrosis score based on four criteria and the aspartate aminotransferase-to-platelet ratio index. The requirement for indicators that distinguish between distinct viral phases and increase specificity in evaluating liver damage is one of the challenges facing chronic hepatitis B research. Even though it is quite difficult to find reliable biomarkers for resistance especially when it comes to hepatocellular cancer risk estimation, there are advanced methods, which include imaging and omics that can help in improving the accuracy of the diagnostics and prognosis. Interventions early point that improve patient outcomes are made possible using diagnostics and prognostics as they are quite effective in managing the complicated landscape of chronic hepatitis B. Key in addressing these challenges today and improving the diagnostic and prognostic markers in the future, particularly those that would support the development of successful treatment plans for people living with chronic hepatitis B virus (HBV), are scientific research, technological advances and collaborations.
慢性乙型肝炎是一个全球主要的健康问题,需要精确的预后和诊断指标来指导临床。本文重点介绍了用于慢性乙型肝炎检测和预后的主要标志物的临床重要性和当前问题。乙肝表面抗原是持续感染的一个重要指标。乙肝病毒DNA定量监测有助于评估病毒载量和肝癌风险。虽然丙氨酸转氨酶水平提供的肝损伤证据有限,但乙肝核心抗体可证实急性感染。血清转换为乙肝e抗体与疾病发展风险较低有关,乙肝e抗原状态是一个关键的预后因素。治疗选择以肝脏活检或微创肝纤维化检测为指导。乙肝病毒的基因型和宿主变量会增加疾病的变异性,从而影响预后。纤维化血清标志物,如基于四项标准的纤维化评分和天冬氨酸转氨酶与血小板比值指数,提供了评估疾病严重程度的非侵入性技术。区分不同病毒阶段并提高评估肝损伤特异性的指标需求是慢性乙型肝炎研究面临的挑战之一。尽管很难找到可靠的耐药生物标志物,尤其是在估计肝细胞癌风险方面,但有一些先进的方法,包括影像学和组学方法,有助于提高诊断和预后的准确性。早期干预改善了患者的预后,因为诊断和预后在管理慢性乙型肝炎的复杂情况方面非常有效。应对这些挑战并在未来改进诊断和预后标志物,特别是那些支持为慢性乙肝病毒感染者制定成功治疗方案的标志物,关键在于科学研究、技术进步和合作。