Hepatitis B surface antigen Quantification: Why and How to use it in 2011 - A Core Group Report

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J Hepatol. 2011 Jun 27. [Epub ahead of print]

Hepatitis B surface antigen Quantification: Why and How to use it in 2011 - A

Core Group Report.

Chan HL, A, ot-Peignoux M, Piratvisuth T, Cornberg M, Brunetto

MR, Tillmann HL, Kao JH, Jia JD, Wedemeyer H, Locarnini S, Janssen HL, Marcellin

P; for the Good Practice in using sAg in Chronic Hepatitis B Study Group

(GPs-CHB Study Group).

Source

Department of Medicine and Therapeutics and Institute of Digestive Disease, The

Chinese University of Hong Kong.

Abstract

Quantitative HBsAg had been suggested to be helpful in management of HBV, but

assays were cumbersome. The recent availability of commercial quantitative

assays has restarted the interest in quantitative serum hepatitis B surface

antigen (HBsAg) as a biomarker for prognosis and treatment response in chronic

hepatitis B. HBsAg level reflects the transcriptional activity of cccDNA rather

than the absolute amount of cccDNA copies. Serum HBsAg level tend to be higher

in hepatitis B e antigen (HBeAg)-positive than HBeAg-negative patients. Among

patients with a low HBV DNA (<2000 IU/ml), HBsAg <1000 IU/ml in genotype D HBV

infection and HBsAg <100 IU/ml in genotype B/C HBV infection is associated with

inactive carrier state in HBeAg-negative patients. The HBsAg reduction by

nucleos(t)ide analogues (NA) is not as pronounced as by interferon treatment. On

peginterferon treatment, sustained responders tend to show greater HBsAg decline

than the non-responders. The optimal on-treatment HBsAg cutoff to predict

response needs further evaluation in HBeAg-positive patients, but an absence of

HBsAg decline together with a <2 log reduction in HBV DNA at week 12 can serve

as stopping rule in HBeAg-negative patients with genotype D HBV infection. A

rapid serum HBsAg decline during NA therapy may identify patients who will clear

HBsAg in the long-term. There are early reports among Asian patients that an

HBsAg level of <100 IU/ml might predict lower risk of relapse after stopping NA

treatment. In clinical practice, serum HBsAg level should be used together with,

but not as a substitute for, HBV DNA.

Copyright © 2011. Published by Elsevier B.V.

PMID: 21718667 [PubMed - as supplied by publisher]