Clin Mol Hepatol.  2016 Dec;22(4):423-431. 10.3350/cmh.2016.0069.

New perspectives of biomarkers for the management of chronic hepatitis B

Affiliations
  • 1Department of Gastroenterology, Renai branch, Taipei City Hospital, Taipei, Taiwan.
  • 2Department of Psychology, National Chengchi University, Taipei, Taiwan.
  • 3Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan. kaojh@ ntu.edu.tw
  • 4Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
  • 5Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan.
  • 6Department of Medical Research, National Taiwan University, National Taiwan University Hospital, Taipei, Taiwan.

Abstract

With recent advances in molecular and genomic investigations, the impact of hepatitis B viral and host factors on the progression of chronic HBV infection has been explored. For viral factors, hepatitis B viral load is a strong predictor for liver disease progression. Hepatitis B viral kinetics appear to be important for successful anti-viral therapy. Serum HBsAg level serves as a complementary marker to viral load for the prediction of HBV-related adverse outcomes in patients with low viral load. In those with low viral load, high serum HBsAg level is associated with higher risks of cirrhosis and HCC. Hepatitis B core-related antigen (HBcrAg) induces host immune responses, and the reduction of the HBcrAg level as well as the increment of total anti-HBc level are significantly associated with favorable outcomes. HBV genotypes (genotype C/D) and mutants (basal core promoter and deletion mutation in pre-S genes) are well known viral genetic markers to predict disease progression. For host factors, serum inflammatory biomarkers have been developed to evaluate the HBV-associated hepatic necroinflammation and fibrosis. Host single nucleotide polymorphism on sodium taurocholate cotransporting polypeptide (NTCP, an HBV entry receptor) may be associated with a decreased risk for cirrhosis and HCC. In conclusion, patients with chronic hepatitis B should be evaluated with relevant viral and host markers to identify those who are at a higher risk of liver disease progression and then receive timely antiviral therapy.

Keyword

Chronic hepatitis B; HBV DNA; HBsAg; HBcrAg; Total anti-HBc

MeSH Terms

Biomarkers/*blood
DNA, Viral/blood
Hepatitis B Surface Antigens/blood
Hepatitis B e Antigens/blood
Hepatitis B virus/genetics
Hepatitis B, Chronic/complications/*diagnosis/prevention & control
Humans
Liver Cirrhosis/etiology
Organic Anion Transporters, Sodium-Dependent/genetics
Polymorphism, Single Nucleotide
Risk Factors
Symporters/genetics
Biomarkers
DNA, Viral
Hepatitis B Surface Antigens
Hepatitis B e Antigens
Organic Anion Transporters, Sodium-Dependent
Symporters
Full Text Links
  • CMH
Actions
Cited
CITED
export Copy
Close
Share
  • Twitter
  • Facebook
Similar articles
Copyright © 2024 by Korean Association of Medical Journal Editors. All rights reserved.     E-mail: koreamed@kamje.or.kr