Gheorghiţă V. 1, Căruntu Fl. Al. 2, 3, Curescu Manuela 4, 5, Ion Şt. 1, Colţan G. 2, Olaru Ioana 2, Răşcanu Aida 2, Streinu-Cercel A. 2, 3
1 Central Military Emergency Hospital Dr Carol Davila, Bucureşti
2 National Institute of Infectious Diseases Prof Dr Matei Balş, Bucureşti
3 University of Medicine and Pharmacy Carol Davila, Bucureşti
4 Clinical Hospital of Infectious Diseases and Pneumology Dr Victor Babeş, Timişoara
5 University of Medicine and Pharmacy Victor Babeş, Timişoara
Abstract
Today’s major concern in chronic HBV infections is quantitative serum HBsAg. Numerous data demonstrate its usefulness in determining the evolutionary stage of disease and the predictability of response to antiviral therapy. HBsAg production originates in two distinct viral DNA structures: intranuclear and extrachromosomal cccDNA and viral DNA sequences integrated in the host cell chromosome. At present, there are two tests available for commercial use in order to asses the HBsAg quantification: Architect QT assay (Abbott Laboratories) and Elecsys HBsAg II Quant assay (Roche Diagnostic). Serum HBV DNA levels and HBsAg decrease progressively during the natural evolution of chronic HBV infection, the lowest values being recorded in inactive carriers patients. Quantitative HBsAg decline at week 12 and 24 of Peg-IFN treatment can be used as a surrogate marker for predicting sustained response in patients with HBeAg-positive chronic HBV hepatitis. In general, a poor HBsAg decline at week 12 may predict lack of response, and a significant reduction in HBsAg at week 24 may predict response to peginterferon therapy. In conclusion, quantitative HBsAg is a topical issue in chronic HBV infections because seems to be a surrogate marker for immune control of disease. Perhaps, in the next therapeutic guidelines will be introduced the quantitative HBsAg kinetics with other established markers, especially when it is required for response-guided therapy.