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On-treatment monitoring of liver fibrosis with serum hepatitis B core-related antigen in chronic hepatitis B

World Journal of Gastroenterology 2019年第32期25卷 4764-4778页

作者： Xiu-Juan Chang Chao Sun Yan Chen Xiao-Dong Li Zu-Jiang Yu Zheng Dong Wen-Lin Bai Xiao-Dong Wang Zhi-Qin Li Da Chen Wen-Juan Du Hao Liao Qi-Yu Jiang Li-Jun Sun Yin-Yin Li Cui-Hong Zhang Dong-Ping Xu Yong-Ping Chen Qin Li Yong-Ping Yang Chinese PLA Medical School Chinese PLA General HospitalBeijing 100853China Department of Therapeutic Research for Liver Cancer the Fifth Medical Center of Chinese PLA General HospitalBeijing 100039China Peking University 302 Clinical Medical School Beijing 100039China Department of Research for Clinical Medicine the Fifth Medical center of Chinese PLA General HospitalBeijing 100039China Department of Infectious Disease the First Affiliated Hospital of Zhengzhou UniversityZhengzhou 450052Henan ProvinceChina Department of Infectious and Liver Diseases Liver Research Centerthe First Affiliated Hospital of Wenzhou Medical UniversityWenzhou 325000Zhejiang ProvinceChina Fuzhou Infectious Diseases Hospital Fuzhou 350025Fujian ProvinceChina Medical Department Training Graduate Office Chinese PLA General HospitalBeijing 100853China Department of Microbiology&Infectious Disease Center School of Basic Medical SciencesPeking University Health Science CenterBeijing 100191China

BACKGROUND Non-invasive evaluation for liver fibrosis is clinically important,especially in patients with undetectable hepatitis B virus(HBV)DNA treated with nucleoside *** To clarify the monitoring power of hepatitis B core-related antigen(HBcrAg)for hepatic histologic changes in patients with chronic hepatitis B(CHB)treated with *** This prospective multicenter study used multiple ordinal and multivariate logistics regression analysis to assess variables associated with Ishak fibrosis score and regression for fibrosis regression,respectively,in 403 CHB patients,including 374 with entecavir for 72 weeks(291 underwent paired liver biopsy)and 29 as *** Level of HBcrAg correlated negatively with liver fibrosis staging(γ=-0.357,Pcore promoter/precore(BCP/PC)mutant,quantitation of HBsAg(qHBsAg)and platelet counts were independently associated with Ishak fibrosis score on multiple ordinal *** DNA was undetectable in 88.37%of patients treated with entecavir at week 72,while their level of HBcrAg was still detectable.A greater reduction in post-treatment HBcrAg concentration was associated with the regression of hepatic fibrosis and histological *** concentration>6.33 log IU/mL at baseline and logarithmic reduction>1.03 log IU/mL at week 72 were associated with a higher chance of regression of liver fibrosis and histological improvement,*** HBcrAg level is associated with liver fibrosis *** is an excellent monitor of hepatic histological changes,especially in CHB patients treated with nucleoside analogs.

关键词： Hepatitis B core-related antigen Liver fibrosis Cirrhosis On-treatment monitoring

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Progression and status of antiviral monitoring in patients with chronic hepatitis B:From HBsAg to HBV RNA

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World Journal of Hepatology 2018年第9期10卷 603-611页

作者： Ya-Yun Liu Xue-Song Liang Department of Infectious Diseases Changhai Hospital of Second Military Medical University

As alternative indexes of hepatitis B virus(HBV),co-valently closed circular DNA(cccDNA) transcriptional activity,hepatitis B surface antigen(HBsAg),hepatitis B core-related antigen(HBcrAg),and peripheral blood RNA known as pgRNA,have been advocated as novel serum markers for prediction of prognosis and treatment response in chronic hepatitis B(CHB). Since the availability of commercial quantitative assays of HBsAg in 2011,HBsAg has been widely used for predicting treatment response of patients with CHB. Patients who received interferon therapy have shown a sharper reduction of HBsAg level than those who received nucleoside drug(NAs) therapy. Upon peginterferon treatment,sustained responders have presented a larger reduction of HBsAg level than the non-responders. An absence of HBsAg decline,together with related proteins sharing an identical 149 amino acid sequence,including HbcAg,hepatitis B e antigen(HBeAg),and a truncated 22-kDa precore protein,is still detectable in situations where serum HBV DNA levels become undetectable or HBsAg loss is achieved. Therefore,HBcrAg remains a measurable serum marker to correlate with cccDNA in this situation. The decline in HBcrAg has been observed with NAs therapy and the pattern of decline might provide prognostic information on the risk of HBV posttreatment reactivation. Peripheral blood RNA,which is known as pgRNA,directly derives from cccDNA and reflects intrahepatic cccDNA level. Quantitative pgRNA has been suggested to be helpful in CHB management. However,commercial quantitative assays are lacking. Additionally,the use of simultaneous and continuous clearance of HBV RNA and HBV DNA in serum has been suggested to be a safe stopping rule of NAs the

关键词： Hepatitis B core-related antigen Response prediction Chronic hepatitis B Interferon Nucleos(t)ide analogs Hepatitis B surface antigen Progenome RNA

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Mutations of pre-core and basal core promoter before and after hepatitis B e antigen seroconversion

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World Journal of Gastroenterology 2015年第2期21卷 541-548页

作者： Nozomi Kamijo Akihiro Matsumoto Takeji Umemura Soichiro Shibata Yuki Ichikawa Takefumi Kimura Michiharu Komatsu Eiji Tanaka Department of Medicine Shinshu University School of MedicineMatsumoto 390-8621Japan

AIM: To investigate the role of pre-core and basal core promoter(BCP) mutations before and after hepatitis Be antigen(HBe Ag) ***: The proportion of pre-core(G1896A) and basal core promoter(A1762T and G1764A) mutant viruses and serum levels of hepatitis B virus(HBV) DNA, hepatitis B surface antigen(HBs Ag), and HB core-related antigen were analyzed in chronic hepatitis B patients before and after HBe Ag seroconversion(n = 25), in those who were persistently HBe Ag positive(n = 18), and in those who were persistently anti-HBe positive(n = 43). All patients were infected with HBV genotype C and were followed for a median of 9 ***: Although the pre-core mutant became predominant(24% to 65%, P = 0.022) in the HBe Ag seroconversion group during follow-up, the proportion of the basal core promoter mutation did not change. Median HBV viral markers were significantly higher in patients without the mutations in an HBe Ag positive status(HBV DNA: P = 0.003; HBs Ag: P core-related antigen: P = 0.001). In contrast, HBV DNA(P = 0.012) and HBs Ag(P = 0.041) levels were significantly higher in patients with the pre-core mutation in an anti-HBe positive ***: There is an opposite association of the pre-core mutation with viral load before and after HBe Ag seroconversion in patients with HBV infection.

关键词： Seroconversion Hepatitis B core-related antigen Pr

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