Qiu Yue, Tang Qiao, Liu Xiao-Qing, Xue Yun-Ling, Zeng Yi, Hu Peng
Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China.
World J Hepatol. 2025 Jan 27;17(1):98658. doi: 10.4254/wjh.v17.i1.98658.
Hepatitis B virus (HBV) infection is a global health concern. The current sequential endpoints for the treatment of HBV infection include viral suppression, hepatitis B e antigen (HBeAg) seroconversion, functional cure, and covalently closed circular DNA (cccDNA) clearance. Serum hepatitis B core-related antigen (HBcrAg) is an emerging HBV marker comprising three components: HBeAg, hepatitis B core antigen, and p22cr. It responds well to the transcriptional activity of cccDNA in the patient's liver and is a promising alternative marker for serological testing. There is a strong correlation, and a decrease in its level corresponds to sustained viral suppression. In patients with chronic hepatitis B (CHB), serum HBcrAg levels are good predictors of HBeAg seroconversion (both spontaneous and after antiviral therapy), particularly in HBeAg-positive patients. Both low baseline HBcrAg levels and decreasing levels early in antiviral therapy favored HBsAg seroconversion, which may serve as a good surrogate option for treatment endpoints. In this review, we summarize the role of serum HBcrAg in the treatment of CHB. Therefore, long-term continuous monitoring of serum HBcrAg levels contributes to the clinical management of patients with CHB and optimizes the choice of treatment regimen, making it a promising marker for monitoring HBV cure.
乙型肝炎病毒（HBV）感染是一个全球性的健康问题。目前用于治疗HBV感染的序贯终点包括病毒抑制、乙肝e抗原（HBeAg）血清学转换、功能性治愈和共价闭合环状DNA（cccDNA）清除。血清乙肝核心相关抗原（HBcrAg）是一种新兴的HBV标志物，由三个成分组成：HBeAg、乙肝核心抗原和p22cr。它对患者肝脏中cccDNA的转录活性反应良好，是血清学检测中一个有前景的替代标志物。它与病毒抑制之间存在很强的相关性，其水平的降低对应于持续的病毒抑制。在慢性乙型肝炎（CHB）患者中，血清HBcrAg水平是HBeAg血清学转换（自发转换和抗病毒治疗后转换）的良好预测指标，尤其是在HBeAg阳性患者中。较低的基线HBcrAg水平和抗病毒治疗早期水平的下降都有利于HBsAg血清学转换，这可能是治疗终点的一个良好替代指标。在这篇综述中，我们总结了血清HBcrAg在CHB治疗中的作用。因此，长期持续监测血清HBcrAg水平有助于CHB患者的临床管理，并优化治疗方案的选择，使其成为监测HBV治愈的一个有前景的标志物。
