乙型肝炎表面抗原定量水平对慢性乙型肝炎临床应用价值的研究进展

Research Advances in the Clinical Value of HBsA g Levels in Chronic Hepatitis B

慢性乙型肝炎感染自然病程各期并不都需要治疗。免疫耐受期患者病毒水平虽高但免疫应答不佳不需立即治疗,乙型肝炎e抗原(HBeAg)阴性的HBsAg携带者病毒水平低,也不需治疗。慢性乙型肝炎感染患者面临的最大挑战是治疗策略以及治疗开始和终止时机的把握。除乙型肝炎病毒(HBV)-DNA外,HBsAg定量水平可作为慢性乙型肝炎感染分期以及血清转换的预测和治疗终点的评估,尤其是在应用干扰素治疗HBeAg阴性慢性乙型肝炎患者时,较低的HBsAg基线水平和治疗后显著的下降,预示患者治疗效果较好。

The patients in different natural courses of chronic hepatitis B virus（ HBV） infection do not all require treatment. Virus levels in patients with the immune-tolerant phase are high but have poor response to antiviral therapy immediately,and the patients with hepatitis Be antigen（ HBeAg） negative state have low HBsAg level,in which treatment is not necessarily needed. The greatest challenges for clinical patients with chronic HBV infection are which therapeutic regimen to use,and master the timing to begin and stop treatment. Besides HBV-DNA,HBsAg levels are also proved to be useful to help judge the natural course,and be used as seroconversion prediction and treatment endpoints assessment,especially in the application of interferon therapy in HBeAg-negative chronic HBV patients： lower baseline and post-treatment significantly decreased HBsAg,indicating better therapeutic effect.