Clinical implications of HBsAg quantification in patients with chronic hepatitis B

ABSTRACT

Quantification of serum hepatitis B surface antigen [HBsAg] helps the management of patients with chronic hepatitis B virus [HBV] infection. Median HBsAg levels differ significantly during the natural history of HBV infection, progressively declining from immune tolerance to inactive phase. The combination of an HBsAg <1000 lU/mL and HBV DNA <2000 lU/mL at a single time point accurately identifies true inactive carriers. During antiviral treatment, HBsAg levels decline more rapidly in patients under peg-interferon [Peg-IFN] than in those under nucleos[t]ide analogues [NUC], and in responders to peg-IFN compared to non responders suggesting that a response-guided therapy in both HBeAg-positive and -negative patients treated with Peg-IFN could improve to cost-effectiveness of this therapeutic approach. Given the low rates of HBsAg clearance on NUC therapy, new studies to test whether Peg-IFN and NUC combination fosters HBsAg decline in long-term responders to NUC, are being explored