Hepatitis B surface antigen monitoring and management of chronic hepatitis B

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):449-57. doi: 10.1111/j.1365-2893.2011.01465.x.

Epub 2011 May 23.Hepatitis B surface antigen monitoring and management of

chronic hepatitis B.Sonneveld MJ, Zoutendijk R, Janssen HL.SourceDepartment of

Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam,

Rotterdam, The Netherlands.AbstractSummary.  Serum hepatitis B surface antigen

(HBsAg) levels reflect intrahepatic hepatitis B virus (HBV) covalently closed

circular DNA and may be a valuable addition to HBV DNA in the management of

patients with chronic hepatitis B (CHB). Among HBeAg-negative CHB patients with

low HBV DNA levels, HBsAg quantification may help distinguish those with active

CHB from true inactive carriers with a very favourable prognosis, thus limiting

the need for long-term intensive monitoring of ALT and HBV DNA levels. In

patients treated with peginterferon (PEG-IFN), achievement of a decline in HBsAg

during therapy appears to be an important marker for treatment outcome, and

several groups have proposed stopping rules based on HBsAg thresholds. A

recently described stopping rule incorporating a combination of HBsAg and HBV

DNA levels can accurately identify HBeAg-negative patients, especially those

with HBV genotype D, not responding to PEG-IFN. Current applications of HBsAg

levels in the monitoring of patients treated with nucleo(s)tide analogues are

still being evaluated. First data from these studies show that HBsAg decline,

and thus subsequent clearance, is confined to those with an active immune

response to HBV, such as HBeAg-positive patients with elevated ALT, or those who

achieve HBeAg clearance.© 2011 Blackwell Publishing Ltd.PMID: 21692954 [PubMed

- in process]

[Guest guest]

J Viral Hepat. 2011 Jul;18(7):449-57. doi: 10.1111/j.1365-2893.2011.01465.x.

Epub 2011 May 23.Hepatitis B surface antigen monitoring and management of

chronic hepatitis B.Sonneveld MJ, Zoutendijk R, Janssen HL.SourceDepartment of

Gastroenterology and Hepatology, Erasmus MC University Medical Center Rotterdam,

Rotterdam, The Netherlands.AbstractSummary.  Serum hepatitis B surface antigen

(HBsAg) levels reflect intrahepatic hepatitis B virus (HBV) covalently closed

circular DNA and may be a valuable addition to HBV DNA in the management of

patients with chronic hepatitis B (CHB). Among HBeAg-negative CHB patients with

low HBV DNA levels, HBsAg quantification may help distinguish those with active

CHB from true inactive carriers with a very favourable prognosis, thus limiting

the need for long-term intensive monitoring of ALT and HBV DNA levels. In

patients treated with peginterferon (PEG-IFN), achievement of a decline in HBsAg

during therapy appears to be an important marker for treatment outcome, and

several groups have proposed stopping rules based on HBsAg thresholds. A

recently described stopping rule incorporating a combination of HBsAg and HBV

DNA levels can accurately identify HBeAg-negative patients, especially those

with HBV genotype D, not responding to PEG-IFN. Current applications of HBsAg

levels in the monitoring of patients treated with nucleo(s)tide analogues are

still being evaluated. First data from these studies show that HBsAg decline,

and thus subsequent clearance, is confined to those with an active immune

response to HBV, such as HBeAg-positive patients with elevated ALT, or those who

achieve HBeAg clearance.© 2011 Blackwell Publishing Ltd.PMID: 21692954 [PubMed

- in process]