Serum hepatitis B surface antigen levels predict treatment response to nucleos(t)ide analogues
Serum hepatitis B surface antigen levels predict treatment response to nucleos(t)ide analogues
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DOI：
10.3748/wjg.v20.i24.7686
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发表时间：
2014-06-28
影响因子：
4.3
通讯作者：
Hung, Chao-Hung
中科院分区：
文献类型：
--
作者：
Chen, Chien-Hung;Chiu, Yi-Chun;Hung, Chao-Hung
乙肝表面抗原(HBs)的定量检测有助于慢性乙型肝炎(CHB)的治疗。核苷(T)类似物(Nas)是治疗慢性乙肝的首选药物，大多数慢性乙肝患者都使用这种药物。NAS能够诱导乙肝病毒(乙肝)病毒抑制，丙氨酸转氨酶(ALT)水平正常化，肝脏组织学改善。近来，血清中乙肝表面抗原的自动定量检测已成为可能，这有助于标准化定量检测血清中的乙肝表面抗原。这引起了人们对定量血清乙肝表面抗原用于预测NAS治疗反应的临床应用的更大兴趣。最近的研究表明，接受聚乙二醇干扰素的患者血清中乙肝表面抗原水平的下降可能标志着成功地诱导了对乙肝病毒的免疫控制，因此可以用于预测治疗反应。与干扰素治疗相比，NA治疗通常导致乙肝表面抗原的下降不那么快；据估计，完全清除乙肝表面抗原可能需要数十年的NA治疗。然而，在NA治疗期间，乙肝表面抗原的快速下降可能会确定哪些患者的乙肝表面抗原将被清除。目前，对于血清HBs Ag监测用于评估患者对NA治疗的反应的临床应用尚无共识。这篇综述集中在关于乙肝表面抗原定量在接受NA治疗的慢性乙肝患者管理中的潜在应用的最新发现。(C)2014百仕登出版集团有限公司，版权所有。
Quantification of hepatitis B surface antigen (HBsAg) has been suggested to be helpful in the management of chronic hepatitis B (CHB) patients. Nucleos(t)ide analogs (NAs) are the therapy of choice for CHB and are used in the majority of CHB patients. NAs are able to induce hepatitis B virus (HBV) viral suppression, normalization of alanine aminotransferase (ALT) levels, and improvement in liver histology. Automated quantitative assays for serum HBsAg have recently become available, facilitating standardized quantification of serum HBsAg. This has led to increased interest in the clinical application of quantitative serum HBsAg for predicting therapeutic response to NAs. Recent studies have shown that a decline in serum HBsAg levels in patients receiving peginterferon may signal successful induction of immune control over HBV, and can therefore be used to predict therapeutic response. NA treatment typically induces a less rapid decline in HBsAg than interferon treatment; it has been estimated that full HBsAg clearance can require decades of NA treatment. However, a rapid HBsAg decline during NA therapy may identify patients who will show clearance of HBsAg. Currently, there is no consensus on the clinical utility of serum HBsAg monitoring for evaluating patient responses to NA therapy. This review focuses on recent findings regarding the potential application of HBsAg quantification in the management of CHB patients receiving NA therapy. (C) 2014 Baishideng Publishing Group Inc. All rights reserved.