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hepatitis b core-related antigen:Are we near a treatment endpoint?

World Journal of Gastroenterology 2022年第27期28卷 3532-3534页

作者： Tarana Gupta Medicine Pandit Bhagwat Dayal Sharma Post Graduate Institute of Medical SciencesRohtak 124001HaryanaIndia

Different serological and virological markers in chronic hepatitis b patients guide staging of viral infection,and initiation and response to therapy.Due to the persistence of intrahepatic covalently closed circular DNA(cccDNA)in the hepatocyte nucleus,hepatitis b is not curable.Even after undetectable hepatitis b virus DNA levels,the persistence of hepatitis b surface antigen and novel markers such as hepatitis b core-related antigen(HbcrAg)indicate the persistence of intrahepatic cccDNA.In this study,HbcrAg levels at baseline and after 24 and 48 wk of antiviral therapy predicted hepatitis b e antigen seroconversion.Due to the poor sensitivity of assays and detectable levels in HbsAg-negative patients,the long-term utility of HbcrAg needs future research.

关键词： hepatitis b core-related antigen Chronic hepatitis b Covalently closed circular DNA hepatitis b e antigen seroconversion hepatitis b virus DNA Pregenomic RNA

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hepatitis b core-related antigen reflects viral replication and protein production in chronic hepatitis b patients

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Chinese Medical Journal 2021年第10期134卷 1160-1167页

作者： Jun Li Zhao Wu Gui-Qiang Wang Hong Zhao China Hepb-related Fibrosis Assessment Research Group Department of Infectious Disease Center for Liver DiseasePeking University First HospitalBeijing 100034China The Collaborative Innovation Center for Diagnosis and Treatment of Infectious Diseases Zhejiang UniversityHangzhouZhejiang 310000China Department of Infectious Disease Peking University International HospitalBeijing 100034China 不详

background:hepatitis b core-related antigen(HbcrAg)is a promising disease-monitoring marker for chronic hepatitis b(CHb).We investigated correlations between HbcrAg with antiviral efficacy and virological and histological variables.Methods:One hundred and forty-five CHb patients from the mainland of China between August 2013 and September 2016 who underwent liver biopsy received entecavir therapy and had paired liver biopsy at 78 weeks.We analyzed correlations between HbcrAg and virological and histological variables in hepatitis b e antigen(HbeAg)-positive and HbeAg-negative patients.We also explored the predictors of HbeAg loss after 78 weeks of antiviral therapy.Pearson correlation analysis and logistic forward stepwise regression were the main statistic methods.Results:HbeAg-positive patients(n=93)had higher baseline HbcrAg(median 7.4 vs.5.3 log10 U/mL PbcrAg declines(median 1.6 vs.0.9 log10 U/mL P=0.007)than HbeAg-negative patients after 78 weeks of therapy.At baseline,HbcrAg correlated with hepatitis b virus(HbV)DNA in both HbeAg-positive(r=0.641,Phepatitis b surface antigen(HbsAg)in HbeAg-positive patients(r=0.495,Pbut not with anti-hepatitis b virus core antibody(anti-Hbc).Weak correlations existed between HbcrAg,histology activity index(HAI;r=0.232,P=0.025),and Ishak fibrosis score(r=-0.292,P=0.005)in HbeAg-positive patients.At 78 weeks,significant correlations existed only between HbcrAg and anti-Hbc in HbeAg-positive(r=-0.263,P=0.014)and HbeAg-negative patients(r=-0.291,P=0.045).Decreased HbcrAg significantly correlated with reduced HbV DNA(r=0.366,P=0.001;r=0.626,PbsAg(r=0.526,P=0.001;r=0.289,P=0.044)in HbeAg-positive and-negative patients,respectively,and with reduced HAI in HbeAg-positive patients(r=0.329,P=0.001).Patients with HbeAg loss(n=29)showed a larger reduction in HbcrAg than those without(median 2.3 vs.1.3 log10 U/mL,P=0.001).In multivariate analysis,decreased HbcrAg was an independent predictor of Hb

关键词： Chronic hepatitis b hepatitis b core-related antigen hepatitis b e antigen Antiviral therapy

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hepatitis b surface antigen and hepatitis b core-related antigen kinetics after adding pegylated-interferon to nucleos(t)ids analogues in hepatitis b e antigen-negative patients

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World Journal of Hepatology 2020年第11期12卷 1076-1088页

作者： Teresa broquetas Montserrat Garcia-Retortillo Miquel Mico Lidia Canillas Marc Puigvehi Nuria Canete Susana Coll Ana Viu Juan Jose Hernandez Xavier bessa JoseA Carrion Department of Gastroenterology Liver SectionHospital del Mar Medical Research InstituteBarcelona 08003Spain Departament of de Medicina Universitat Autònoma de BarcelonaBarcelona 08003Spain Laboratori de Referencia de Catalunya El Prat de LlobregatBarcelona 08820Spain

bACKGROUND hepatitis b e antigen-negative chronic hepatitis b patients under nucleos(t)ids analogues(NAs)rarely achieve hepatitis b surface antigen(HbsAg)loss.AIM To evaluate if the addition of pegylated interferon(Peg-IFN)could decrease HbsAg and hepatitis b core-related antigen(HbcrAg)levels and increase HbsAg loss rate in patients under NAs therapy.METHODS Prospective,non-randomized,open-label trial evaluating the combination of Peg-IFN 180μg/week plus NAs during forty-eight weeks vs NAs in monotherapy.hepatitis b e antigen-negative non-cirrhotic chronic hepatitis b patients of a tertiary hospital,under NAs therapy for at least 2 years and with undetectable viral load,were eligible.Patients with hepatitis C virus,hepatitis D virus or human immunodeficiency virus co-infection and liver transplanted patients were excluded.HbsAg and HbcrAg levels(log10 U/mL)were measured at baseline and during ninety-six weeks.HbsAg loss rate was evaluated in both groups.Adverse events were recorded in both groups.The kinetic of HbsAg for each treatment group was evaluated from baseline to weeks 24 and 48 by the slope of the HbsAg decline(log10 IU/mL/week)using a linear regression model.RESULTS Sixty-five patients were enrolled,61%receiving tenofovir and 33%entecavir.Thirty-six(55%)were included in Peg-IFN-NA group and 29(44%)in NA group.After matching by age and treatment duration,baseline HbsAg levels were comparable between groups(3.1 vs 3.2)(P=0.25).HbsAg levels at weeks 24,48 and 96 declined in Peg-IFN-NA group(-0.26,-0.40 and-0.44)and remained stable in NA group(-0.10,-0.10 and-0.10)(PbsAg decline in Peg-IFN-NA group(-0.02)was higher than in NA group(-0.00)(P=0.015).HbcrAg levels did not change.Eight(22%)patients discontinued Peg-IFN due to adverse events.The HbsAg loss was achieved in 3(8.3%)patients of the Peg-IFN-NA group and 0(0%)of the NA group.CONCLUSION The addition of Peg-IFN to NAs caused a greater and faster decrease of HbsAg levels compared to NA therapy.Side effects of Peg-IFN can limit its

关键词： Chronic hepatitis b hepatitis b e antigen-negative hepatitis b surface antigen hepatitis b core-related antigen Pegylated-interferon Nucleos(t)ids analogues©The Author(s)2020.Published by baishideng Publishing Group Inc.All rights reserved

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