血清HBsAg定量检测指导临床治疗的意义

Significance of HBsAg quantification in guiding clinical treatment of chronic hepatitis B

血清HBsAg定量可反映HBV复制水平，可作为评价感染细胞替代指标。近期研究表明，HBsAg定量有助于鉴别慢性乙型肝炎感染自然史、可预测HBsAg自发清除及进展性肝病的风险。HBsAg动态改变有助于预测干扰素及核苷类似物的疗效、持续病毒应答及指导停药，提高临床慢性乙型肝炎优化治疗策略，是近几年来研究的热点，但HBsAg水平在患者管理及不同治疗策略中的意义没有确定的临界值。现就近年来HBsAg定量水平在慢性乙型肝炎自然病史及优化治疗中的研究进展作一综述。

Serum hepatitis B surface antigen （HBsAg） quantification can reflect the level of HBV replication and can be used as a surrogate maker for the evaluation of infected cells. Recent studies have shown that I-IBsAg quantification can help to distinguish the nature history of chronic hepatitis B and predict spontaneous clearance of HBsAg and the risk of progressive liver diseases. The dynamic change in I-IBsAg helps to predict the therapeutic effects of interferon and nucleoside analogues and sustained virologic response, guide withdrawal, and improve and optimize the therapeutic strategy for chronic hepatitis B in clinical practice. These issues have become the hot topics in recent years. However, the cut-off values of HBsAg level in patient management and various therapeutic strategies have not been determined. This article reviews the research advances in the significance of HBsAg quantification in the natural history and optimized treatment of chronic hepatitis B.