Diagnosis of hepatitis B virus infection through serological and virological markers
Journal
Expert Review of Gastroenterology and Hepatology
Journal Volume
2
Journal Issue
4
Pages
553-562
Date Issued
2008
Author(s)
Abstract
Hepatitis B virus (HBV) infection is an important health problem and the major cause of chronic hepatitis, cirrhosis and hepatocellular carcinoma (HCC) worldwide. The natural history of chronic HBV infection can be divided into four dynamic phases in HBV carriers who acquire the virus early in life. Diagnosis of HBV infection is usually through serological and virological markers. Hepatitis B surface antigen (HBsAg) is the hallmark of HBV infection and is the first serological marker to appear in acute hepatitis B, and persistence of HBsAg for more than 6 months suggests chronic HBV infection. Hepatitis B e antigen (HBeAg) usually indicates active HBV replication and risk of transmission of infection. Recently, occult HBV infection is recognized as the absence of circulating HBsAg in individuals positive for serum or tissue HBV DNA, irrespective of other HBV serological markers. Meanwhile, monitoring the serum HBV DNA level is valuable for assessing liver disease activity, differentiating other etiologies of hepatitis activity in HBV carriers, predicting risk of HCC development or liver-related mortality, deciding to administer antiviral therapy, determination of the response to antiviral treatment, predicting the risk of developing drug resistance, and detecting the emergence of drug-resistant mutants. On the other hand, HBV genotype C, basal core promoter mutant and pre-S deletion mutant are reported to be associated with increased risk of HCC development. The roles of quantitative HBV serology and intrahepatic HBV covalently closed circular (ccc) DNA deserve further studies. In conclusion, it is particularly important for physicians to screen for HBV infection in HBV-endemic areas and to monitor liver disease progression in HBV carriers by using both serological and virological markers, so that effective treatment can be initiated early before the development of advanced liver disease. ? 2008 Expert Reviews Ltd.
Subjects
cccDNA; Genotype; HBeAg; HBsAg; HBV DNA; Hepatitis B virus; Mutant; Pre-S deletion; Precore/core promoter; Serology
SDGs
Other Subjects
circular DNA; hepatitis B core antibody; hepatitis B surface antibody; hepatitis B surface antigen; hepatitis B(e) antibody; hepatitis B(e) antigen; immunoglobulin G; immunoglobulin M; virus DNA; acute hepatitis; blood analysis; cancer risk; diagnostic accuracy; diagnostic value; disease activity; disease course; disease marker; drug response; gene deletion; genotype; hepatitis B; Hepatitis B virus; human; matrix assisted laser desorption ionization time of flight mass spectrometry; medical decision making; mortality; nonhuman; polymerase chain reaction; prediction; promoter region; protein blood level; quantitative analysis; restriction fragment length polymorphism; review; risk assessment; serology; virology; virus carrier; virus mutant; virus replication; virus resistance; virus transmission; Disease Progression; DNA, Viral; Hepatitis B; Hepatitis B Surface Antigens; Hepatitis B virus; Humans; Viral Core Proteins; Virus Replication
Type
review