HBV感染“新型”生物标志物的“前世今生”

The development history of new biomarkers for hepatitis B virus infection

慢性乙型肝炎抗病毒治疗的目标是最大限度的长期抑制HBV复制,减轻肝细胞炎症及肝纤维化,延缓和减少肝衰竭、肝硬化失代偿、肝细胞癌及其他并发症的发生。目前可能用于临床抗病毒疗效评价的生物学标志物除了应用时间较长的血清HBVDNA外,近年来肝细胞内的HBVcccDNA、血清乙型肝炎核心相关抗原定量、血清HBVRNA定量、血清HBsAg定量和血清抗-HBc定量等"新型"生物标志物的临床价值也逐步得到广泛关注,特别是在监测与评价抗病毒疗效、预测停药后病毒反弹风险以及预测肝癌发生风险等方面具有重要的临床意义。

The objective of antiviral therapy for chronic hepatitis B is to maximize the long-term inhibition of hepatitis B virus (HBV) replication,reduce hepatocyte inflammation and liver fibrosis,and delay and reduce liver failure,decompensated cirrhosis,hepatocellular carcinoma,and other complications.In addition to serum HBV DNA which has been used for a long time,new biomarkers such as intrahepatic HBV cccDNA,serum HBcrAg,serum HBV RNA,serum HBsAg,and serum anti-HBc are commonly used in recent years to evaluate antiviral response in clinical practice,and their clinical value has attracted more and more attention.Such biomarkers have important clinical significance in monitoring and evaluating antiviral response and predicting the risk of viral rebound after drug withdrawal and the risk of hepatocellular carcinoma.