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The role of quantitative hepatitis b surface antigen revisited.

Abstract
In the past 10 years, there are a lot of enthusiasms on the use of serum hepatitis B surface antigen (HBsAg) quantification to predict disease activity and monitor treatment response in chronic hepatitis B. The measurement of HBsAg level has been standardized in IU/mL and nowadays it is almost mandatory with the development of new antiviral treatments as HBsAg seroclearance, i.e. functional cure of hepatitis B, is now considered the goal of therapy. Recently, improved understanding on molecular virology of HBsAg, particularly on the relative roles of covalently closed circular DNA and integrated HBV DNA, has shed new lights on the interpretation of HBsAg level in different phases of chronic hepatitis B. HBsAg level can assist the differentiation of immune tolerance and immune clearance in hepatitis B e antigen (HBeAg)-positive patients, and it can predict inactive disease and spontaneous HBsAg seroclearance in HBeAg-negative patients. The determination of HBsAg level is pivotal to individualize peginterferon treatment; it is the key investigation to decide early termination of peginterferon among non-responders. Among patients treated by nucleos(t)ide analogues, responders tend to have dramatic reduction of HBsAg to low levels, which may be followed by HBsAg seroclearance. With newer data on combination treatment of peginterferon and nucleos(t)ide analogues as well as emerging new antiviral agents, HBsAg quantification is expected to become increasingly important to monitor and guide antiviral therapy for chronic hepatitis B.

PMID: 27575311 [Pubmed - Publisher]

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