PDF(Pubmed)
Abstract：
Hepatitis B core-related antigen (HBcrAg) reflects the activity of intrahepatic covalently closed circular DNA. HBcrAg can be detected even in chronic hepatitis B patients in whom serum HBV DNA or hepatitis B surface antigen is undetectable. The HBcrAg measurement system was developed based on two concepts. One is a fully-automated and highly-sensitive HBcrAg assay (iTACT-HBcrAg) and the other is a point-of-care testing (POCT) that can be used in in resource-limited areas. iTACT-HBcrAg is an alternative to HBV DNA for monitoring HBV reactivation and predicting the development of hepatocellular carcinoma. This validated biomarker is available in routine clinical practice in Japan. Currently, international guidelines for the prevention of mother-to-child transmission recommend anti-HBV prophylaxis for pregnant women with high viral loads. However, over 95% of HBV-infected individuals live in countries where HBV DNA quantification is widely unavailable. Given this situation, a rapid and simple HBcrAg assay for POCT would be highly effective. Long-term anti-HBV therapy may have potential side effects and appropriate treatment should be provided to eligible patients. Therefore, a simple method of determining the indication for anti-HBV treatment would be ideal. This review provides up-to-date information regarding the clinical value of HBcrAg in HBV management, based on iTACT-HBcrAg or POCT.
摘要：
乙型肝炎核心相关抗原（HBcrAg）反映肝内共价闭合环状DNA的活性。即使在血清HBVDNA或乙型肝炎表面抗原检测不到的慢性乙型肝炎患者中，也可以检测到HBcrAg。基于两个概念开发了HBcrAg测量系统。一种是全自动和高度敏感的HBcrAg测定（iTACT-HBcrAg），另一种是可以在资源有限的地区使用的即时检测（POCT）。iTACT-HBcrAg是HBVDNA的替代方法，用于监测HBV再激活和预测肝细胞癌的发展。这种经过验证的生物标志物在日本的常规临床实践中是可用的。目前,预防母婴传播的国际指南建议对病毒载量高的孕妇进行抗HBV预防。然而,超过95%的HBV感染者生活在HBVDNA定量普遍不可用的国家.鉴于这种情况,用于POCT的快速和简单的HBcrAg测定将是非常有效的。长期抗HBV治疗可能有潜在的副作用，适当的治疗应提供给符合条件的患者。因此,确定抗HBV治疗适应症的简单方法将是理想的。这篇评论提供了关于HBcrAg在HBV管理的临床价值的最新信息，基于ITACT-HBcrAg或POCT。
