Clinical utility of hepatitis B surface antigen quantitation in patients with chronic hepatitis B: A review

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1002/hep.24473/abstract;jsessionid=5182898\

7FDB7DEDCC2A5E264351BBA71.d03t03

Clinical utility of hepatitis B surface antigen quantitation in patients with

chronic hepatitis B: A review†‡

Yun-Fan Liaw,§Article first published online: 25 JUL 2011

DOI: 10.1002/hep.24473

Copyright © 2011 American Association for the Study of Liver Diseases

Issue

Hepatology

Volume 54, Issue 2, pages E1–E9, August 2011

Abstract

This clinically relevant review focuses on recent findings concerning hepatitis

B surface antigen (HBsAg) quantitation in untreated patients and treated

patients with chronic hepatitis B. Recent studies and emerging data have shown

that both HBsAg and hepatitis B virus (HBV) DNA levels decline during the

natural course of a chronic HBV infection; they are lowest in the inactive

phase, which is also characterized by the highest HBsAg/HBV DNA ratio. It has

been demonstrated that the combined use of HBsAg and HBV DNA levels might help

in the identification of true inactive carriers with high accuracy.

Retrospective analyses of HBsAg levels in patients undergoing therapy have

suggested a role for HBsAg quantitation in monitoring the response to therapy.

In comparison with nucleos(t)ide analogues (NAs), interferon-based therapy

results in greater overall declines in serum HBsAg levels. A rapid on-treatment

decline in HBsAg levels appears to be predictive of a sustained response. With

the aid of HBsAg quantitation, it appears that we can anticipate an

individualized approach to tailoring the treatment duration. The proposal of

early stopping rules for patients not responding to pegylated interferon

(according to a lack of any HBsAg decline) represents a step toward a

response-guided approach. The development of stopping rules for patients treated

with NAs is desirable for reducing the need for lifelong therapy. However,

before stopping rules for antiviral therapy can be applied, we need to learn

more about the kinetics of HBsAg declines during the natural history of the

infection and as a response to therapy so that we can better define the best

timing, the relevant HBsAg cutoff levels, and the best ways to apply these rules

in clinical practice. (HEPATOLOGY 2011;)

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1002/hep.24473/abstract;jsessionid=5182898\

7FDB7DEDCC2A5E264351BBA71.d03t03

Clinical utility of hepatitis B surface antigen quantitation in patients with

chronic hepatitis B: A review†‡

Yun-Fan Liaw,§Article first published online: 25 JUL 2011

DOI: 10.1002/hep.24473

Copyright © 2011 American Association for the Study of Liver Diseases

Issue

Hepatology

Volume 54, Issue 2, pages E1–E9, August 2011

Abstract

This clinically relevant review focuses on recent findings concerning hepatitis

B surface antigen (HBsAg) quantitation in untreated patients and treated

patients with chronic hepatitis B. Recent studies and emerging data have shown

that both HBsAg and hepatitis B virus (HBV) DNA levels decline during the

natural course of a chronic HBV infection; they are lowest in the inactive

phase, which is also characterized by the highest HBsAg/HBV DNA ratio. It has

been demonstrated that the combined use of HBsAg and HBV DNA levels might help

in the identification of true inactive carriers with high accuracy.

Retrospective analyses of HBsAg levels in patients undergoing therapy have

suggested a role for HBsAg quantitation in monitoring the response to therapy.

In comparison with nucleos(t)ide analogues (NAs), interferon-based therapy

results in greater overall declines in serum HBsAg levels. A rapid on-treatment

decline in HBsAg levels appears to be predictive of a sustained response. With

the aid of HBsAg quantitation, it appears that we can anticipate an

individualized approach to tailoring the treatment duration. The proposal of

early stopping rules for patients not responding to pegylated interferon

(according to a lack of any HBsAg decline) represents a step toward a

response-guided approach. The development of stopping rules for patients treated

with NAs is desirable for reducing the need for lifelong therapy. However,

before stopping rules for antiviral therapy can be applied, we need to learn

more about the kinetics of HBsAg declines during the natural history of the

infection and as a response to therapy so that we can better define the best

timing, the relevant HBsAg cutoff levels, and the best ways to apply these rules

in clinical practice. (HEPATOLOGY 2011;)

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1002/hep.24473/abstract;jsessionid=5182898\

7FDB7DEDCC2A5E264351BBA71.d03t03

Clinical utility of hepatitis B surface antigen quantitation in patients with

chronic hepatitis B: A review†‡

Yun-Fan Liaw,§Article first published online: 25 JUL 2011

DOI: 10.1002/hep.24473

Copyright © 2011 American Association for the Study of Liver Diseases

Issue

Hepatology

Volume 54, Issue 2, pages E1–E9, August 2011

Abstract

This clinically relevant review focuses on recent findings concerning hepatitis

B surface antigen (HBsAg) quantitation in untreated patients and treated

patients with chronic hepatitis B. Recent studies and emerging data have shown

that both HBsAg and hepatitis B virus (HBV) DNA levels decline during the

natural course of a chronic HBV infection; they are lowest in the inactive

phase, which is also characterized by the highest HBsAg/HBV DNA ratio. It has

been demonstrated that the combined use of HBsAg and HBV DNA levels might help

in the identification of true inactive carriers with high accuracy.

Retrospective analyses of HBsAg levels in patients undergoing therapy have

suggested a role for HBsAg quantitation in monitoring the response to therapy.

In comparison with nucleos(t)ide analogues (NAs), interferon-based therapy

results in greater overall declines in serum HBsAg levels. A rapid on-treatment

decline in HBsAg levels appears to be predictive of a sustained response. With

the aid of HBsAg quantitation, it appears that we can anticipate an

individualized approach to tailoring the treatment duration. The proposal of

early stopping rules for patients not responding to pegylated interferon

(according to a lack of any HBsAg decline) represents a step toward a

response-guided approach. The development of stopping rules for patients treated

with NAs is desirable for reducing the need for lifelong therapy. However,

before stopping rules for antiviral therapy can be applied, we need to learn

more about the kinetics of HBsAg declines during the natural history of the

infection and as a response to therapy so that we can better define the best

timing, the relevant HBsAg cutoff levels, and the best ways to apply these rules

in clinical practice. (HEPATOLOGY 2011;)

[Guest guest]

http://onlinelibrary.wiley.com/doi/10.1002/hep.24473/abstract;jsessionid=5182898\

7FDB7DEDCC2A5E264351BBA71.d03t03

Clinical utility of hepatitis B surface antigen quantitation in patients with

chronic hepatitis B: A review†‡

Yun-Fan Liaw,§Article first published online: 25 JUL 2011

DOI: 10.1002/hep.24473

Copyright © 2011 American Association for the Study of Liver Diseases

Issue

Hepatology

Volume 54, Issue 2, pages E1–E9, August 2011

Abstract

This clinically relevant review focuses on recent findings concerning hepatitis

B surface antigen (HBsAg) quantitation in untreated patients and treated

patients with chronic hepatitis B. Recent studies and emerging data have shown

that both HBsAg and hepatitis B virus (HBV) DNA levels decline during the

natural course of a chronic HBV infection; they are lowest in the inactive

phase, which is also characterized by the highest HBsAg/HBV DNA ratio. It has

been demonstrated that the combined use of HBsAg and HBV DNA levels might help

in the identification of true inactive carriers with high accuracy.

Retrospective analyses of HBsAg levels in patients undergoing therapy have

suggested a role for HBsAg quantitation in monitoring the response to therapy.

In comparison with nucleos(t)ide analogues (NAs), interferon-based therapy

results in greater overall declines in serum HBsAg levels. A rapid on-treatment

decline in HBsAg levels appears to be predictive of a sustained response. With

the aid of HBsAg quantitation, it appears that we can anticipate an

individualized approach to tailoring the treatment duration. The proposal of

early stopping rules for patients not responding to pegylated interferon

(according to a lack of any HBsAg decline) represents a step toward a

response-guided approach. The development of stopping rules for patients treated

with NAs is desirable for reducing the need for lifelong therapy. However,

before stopping rules for antiviral therapy can be applied, we need to learn

more about the kinetics of HBsAg declines during the natural history of the

infection and as a response to therapy so that we can better define the best

timing, the relevant HBsAg cutoff levels, and the best ways to apply these rules

in clinical practice. (HEPATOLOGY 2011;)