| Theme | Cutting Edge : Pathogenesis and Treatment of Hepatitis B | |
|---|---|---|
| Title | HBV Core-related Antigens and Treatment for Hepatitis B | |
| Publish Date | 2009/06 | |
| Author | Eiji Tanaka | Department of Medicine, Shinshu University School of Medicine |
| Author | Akihiro Matsumoto | Department of Medicine, Shinshu University School of Medicine |
| [ Summary ] | Measurement of HBV DNA in the serum is useful for monitoring the anti-viral effects of nucleoside or nucleotide analogue therapy. However, a negative result for HBV DNA does not necessarily indicate a good therapeutic outcome since drug resistance may occur even if HBV DNA levels remain undetectable during therapy. Reactivation of HBV replication may occur after therapy. Recently, a CLEIA was developed for the detection of hepatitis B core-related antigens (HBcrAg). HBcrAg consists of HBV core, e, and p 22cr antigens which are transcribed from the precore/core gene. Although serum HBcrAg levels correlated linearly with those of HBV DNA in natural courses, HBcrAg decreased significantly more slowly than HBV DNA after initiation of lamivudine administration. The clinical significance of HBV DNA and HBcrAg levels was analyzed and it was suggested that HBV DNA measurement was useful for identifying patients who are at high risk of developing lamivudine resistance. HBcrAg measurement was also considered valuable for identifying those who are at low risk. The measurement of HBcrAg was found to be useful for predicting reactivation of hepatitis after cessation of lamivudine administration as well. Elevated levels of HBV cccDNA in hepatocytes are considered to be associated with both more frequent occurrence of lamivudine resistance during lamivudine administration and more severe reactivation of hepatitis after halting lamivudine administration. Thus, a serum marker which reflects HBV cccDNA levels is needed. Results so far, including ours, suggest that serum HBcrAg levels reflect HBV cccDNA in hepatocytes more accurately than serum HBV DNA. |
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