Gut Liver.  2019 Nov;13(6):589-595. 10.5009/gnl18425.

New Biomarkers of Chronic Hepatitis B

• Mak LY
• Seto WK
• Fung J
• Yuen MF

• KMID: 2464306
• DOI: http://doi.org/10.5009/gnl18425

Abstract

Chronic hepatitis B (CHB) infection leads to clinically heterogeneous disease outcomes. Different viral markers are utilized to monitor treatment effects and predict risk of complications in patients with CHB. Hepatitis B core-related antigen (HBcrAg) is a novel serum composite viral protein whose performance has been proven to be superior to that of existing viral markers. It showed good correlation with intrahepatic covalently closed-circular DNA. Its profile differs drastically in patients in different disease phases, and the level declines with antiviral therapies. HBcrAg may be helpful for predicting hepatocellular carcinoma development and hepatitis B virus (HBV) reactivation in immunosuppressed patients. Another emerging measurable serum marker, HBV RNA, exists in the form of pregenomic RNA-containing virions. Its profile differs between patients in different disease phases in a similar manner to that of HBcrAg. HBV RNA is present in serum at lower levels than HBV DNA in treatment-naive patients by 1-2 logs. In contrast, its level is higher than HBV DNA in patients receiving nucleos(t)ide analogues (NAs). A significant decline in serum RNA was observed in patients receiving novel antiviral therapies, including core protein allosteric modulators and RIG-1/NOD2 agonists. Both HBcrAg and HBV RNA may be helpful for predicting off-therapy sustained virological control in patients who stop long-term NA treatment.

Keyword

Hepatitis B core-related antigen; Hepatitis B virus RNA; Biomarkers

MeSH Terms

Biomarkers*
Carcinoma, Hepatocellular
DNA
Hepatitis B
Hepatitis B virus
Hepatitis B, Chronic*
Hepatitis, Chronic*
Humans
RNA
Virion
Biomarkers
DNA
RNA