Biomarkers of transfusion transmitted occult hepatitis B virus infection: Where are we and what next?

Fu, Michael X.; Simmonds, Peter; Andersson, Monique; Harvala, Heli

doi:10.1002/rmv.2525

Cited by 6 publications

(2 citation statements)

References 154 publications

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“…Serum anti-HBc is generally positive but has low specificity for detecting OBI. In other words, it may produce many false positives for OBI [ 45 ].…”

Section: Occult Hepatitis Bmentioning

confidence: 99%

Prospects for Controlling Hepatitis B Globally

Soriano,

Moreno-Torres,

Treviño

et al. 2024

Pathogens

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Infection with the hepatitis B virus (HBV) is highly prevalent globally. Over 250 million people suffer from chronic hepatitis B, and more than 800,000 patients die each year due to hepatitis B complications, including liver cancer. Although protective HBV vaccines are recommended for all newborns, global coverage is suboptimal. In adults, sexual transmission is by far the most frequent route of contagion. The WHO estimates that 1.5 million new HBV infections occur annually. Oral nucleos(t)ide analogues entecavir and tenofovir are the most frequent antivirals prescribed as HBV therapy. Almost all patients adherent to the medication achieve undetectable plasma viremia beyond 6 months of monotherapy. However, less than 5% achieve anti-HBs seroconversion, and viral rebound occurs following drug discontinuation. Therefore, nucleos(t)ide analogues need to be lifelong. New long-acting formulations of tenofovir and entecavir are being developed that will maximize treatment benefit and overcome adherence barriers. Furthermore, new antiviral agents are in development, including entry inhibitors, capside assembly modulators, and RNA interference molecules. The use of combination therapy pursues a functional HBV cure, meaning it is negative for both circulating HBV-DNA and HBsAg. Even when this goal is achieved, the cccDNA reservoir within infected hepatocytes remains a signal of past infection, and HBV can reactivate under immune suppression. Therefore, new gene therapies, including gene editing, are eagerly being pursued to silence or definitively disrupt HBV genomes within infected hepatocytes and, in this way, ultimately cure hepatitis B. At this time, three actions can be taken to push HBV eradication globally: (1) expand universal newborn HBV vaccination; (2) perform once-in-life testing of all adults to identify susceptible HBV persons that could be vaccinated (or re-vaccinated) and unveil asymptomatic carriers that could benefit from treatment; and (3) provide earlier antiviral therapy to chronic HBV carriers, as being aviremic reduces the risk of both clinical progression and transmission.

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“…Serum anti-HBc is generally positive but has low specificity for detecting OBI. In other words, it may produce many false positives for OBI [ 45 ].…”

Section: Occult Hepatitis Bmentioning

confidence: 99%

Prospects for Controlling Hepatitis B Globally

Soriano,

Moreno-Torres,

Treviño

et al. 2024

Pathogens

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“…Functional cure has many similarities with occult HBV infection (OBI) [ 68 ]. Anti-HBc can be the only detectable serological marker of OBI, persisting during both HBV infection and recovery [ 69 ]. However, only a few anti-HBc-positive individuals belong to OBI [ 70 ].…”

Section: Evidence Of Serum Hbcrag In Predicting Discontinuing Antivir...mentioning

confidence: 99%

Quantitative Measurement of Serum HBcrAg Can Be Used to Assess the Feasibility of Safe Discontinuation of Antiviral Therapy for Chronic Hepatitis B

Wang,

Tang,

Chen

2024

Viruses

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Hepatitis B virus (HBV) infection is a serious global health problem, and chronic HBV infection significantly increases the risk of liver fibrosis, cirrhosis, and even hepatocellular carcinoma in patients. Current first-line therapeutics such as nucleos(t)ide analogues and interferons are unable to completely clear cccDNA, so the vast majority of patients need to take long-term or even lifelong medication. However, long-term virological and biochemical responses can be achieved in some patients after drug withdrawal. Successfully screening these patients with drug withdrawal advantages is difficult. Hepatitis-B-core-related antigen (HBcrAg) is a new HBV serological marker that which can reflect the level and transcription activity of cccDNA in hepatocytes. Therefore, HBcrAg has potential value in guiding patients in drug withdrawal. This review summarizes previous reports on HBcrAg and evaluates the application value of HBcrAg in safe drug discontinuation.

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