Quantification of hepatitis B surface antigen: a new concept for the management of chronic hepatitis B

Abstract

HBsAg is a very important clinical test that might not only indicate active hepatitis B virus (HBV) infection but might also be used to predict clinical and treatment outcome. Clearance of HBsAg in patients with chronic HBV infection is associated with a much better clinical outcome, although surveillance for early detection of hepatocellular carcinoma (HCC) should continue. HBV DNA quantification is currently used for selecting candidates for therapy, monitoring response to therapy and detecting the emergence of drug resistance. Assays for HBsAg quantification are less expensive than HBV DNA and fully automated with a high throughput capacity. HBsAg titering may be a useful tool to manage patients with chronic HBV, to more clearly define which patients may, and more importantly, may not, benefit from treatment. Baseline and on-treatment HBsAg quantification may help to refine future treatment algorithms for both immune-modulator therapy and nucleos(t)ide analogues. Both HBV markers provide complementary information on the status of HBV infection. However, the relevance of serum HBsAg levels and its use as a reliable replacement for both covalently closed circular DNA and HBV DNA remain unclear.

Variable capacity of 13 hepatitis B virus surface antigen assays for the detection of HBsAg mutants in blood samples

“…Chronically infected patients are not a concern in this regard, except when the antiviral therapy response is monitored with HBsAg quantification, as recently recommended. [21][22][23] This is not the case for the screening of blood or organ donors, who can transmit undetected HBV variants. 24,25 Two parameters must be considered to evaluate the implication of variants in the prevention of HBV transmission: (i) their probability of occurrence and (ii) the measures taken to avoid transmission.…”

HBsAg Quantification in Clinical Practice

“…[40][41][42][43] While it is true that further studies are required to elucidate the levels of HBsAg, and the rate of its decline, HBsAg quantification is likely to change the rules of initiating therapy and the end points of response to therapy for HBV. Hence, how does one individualize the therapy of patients with The availability of standardized assays for qHBsAg have opened yet another exciting window in the field of hepatology.…”

Correlation between hepatitis B virus DNA levels and diagnostic tests for HBsAg, HBeAg, and PreS1-Ag in chronic hepatitis B

“…Evaluation of the relationship between the serum HBV DNA levels and hepatic pathology is a current hotspot in the diagnosis and treatment of CHB (Nguyen and Keeffe, 2009;Chien, 2010;Hansen et al, 2010). Quantification of the HBsAg levels has received renewed attention because of its diagnostic potential in predicting the response to antiviral treatment and identifying the infection status of an individual (Brunetto et al, 2010;Chan et al, 2011;Liaw, 2011;Moucari and Marcellin, 2011). Determination of the circulating levels of HBsAg could provide crucial information that could complement the measurement of HBV DNA.…”

“…Determination of the circulating levels of HBsAg could provide crucial information that could complement the measurement of HBV DNA. Studies of HBV infections conducted under various clinical settings have suggested that serum HBsAg could be used as a combinative or substitutive marker of HBV DNA levels (Chan et al, 2011;Moucari and Marcellin, 2011). The hepatitis B e antigen (HBeAg) is secreted by the HBV envelope and is believed to directly predict the replication and infectivity of HBV DNA.…”