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| 1 | Serum hepatitis B surface antigen levels predict treatment response to nucleos(t)ide analogues显示文摘Quantification of hepatitis B surface antigen(HBsAg)has been suggested to be helpful in the management of chronic hepatitis B(CHB)patients.Nucleos(t)ide analogs(NAs)are the therapy of choice for CHB and are used in the majority of CHB patients.NAs are able to induce hepatitis B virus(HBV)viral suppression,normalization of alanine aminotransferase(ALT)levels,and improvement in liver histology.Automated quantitative assays for serum HBsAg have recently become available,facilitating standardized quantification of serum HBsAg.This has led to increased interest in the clinical application of quantitative serum HBsAg for predicting therapeutic response to NAs.Recent studies have shown that a decline in serum HBsAg levels in patients receiving peginterferon may signal successful induction of immune control over HBV,and can therefore be used to predict therapeutic response.NA treatment typically induces a less rapid decline in HBsAg than interferon treatment;it has been estimated that full HBsAg clearance can require decades of NA treatment.However,a rapid HBsAg decline during NA therapy may identify patients who will show clearance of HBsAg.Currently,there is no consensus on the clinical utility of serum HBsAg monitoring for evaluating patient responses to NA therapy.This review focuses on recent findings regarding the potential application of HBsAg quantification in the management of CHB patients receiving NA therapy. | Chien-Hung Chen Yi-Chun Chiu Sheng-Nan Lu Chuan-Mo Lee Jing-Houng Wang Tsung-Hui Hu Chao-Hung Hung | 2014 | World Journal of Gastroenterology2014，20，24： | 6 |
| 2 | When to stop nucleos(t)ide analogues treatment for chronic hepatitis B? Durability of antiviral response显示文摘Introduction of nucleos(t)ide analogues(NAs)for oral antiviral therapy has dramatically improved the clinical outcome in patients with chronic hepatitis B(CHB).Although current international guidelines for the management of CHB provide information regarding when to begin the antiviral therapy with NAs,there is no clear consensus on when to stop the treatment,especially for those who respond to the therapy.Hepatitis B surface antigen loss has been regarded as an ideal endpoint of oral antiviral therapy with NAs,however since this is rarely achieved,practical endpoints have been suggested by the international guidelines.Despite the stopping rules recommended by the international guidelines,whether oral antiviral therapy with NAs can be safely discontinued is of major concern.While attention has been drawn to whether antiviral treatment with NAs can be a finite therapy,there is lack of sufficient data on off-treatment durability of highly potent NAs.Based on the available evidences,current guidelines for stopping NA therapy seems to be inadequate in terms of off-treatment durability,with relapse rates of more than 40%for both hepatitis Be antigen(HBeAg)-positive and HBeAg-negative patients.Therefore,further studies are required to accumulate data on off-treatment durability of highly potent NAs,and future studies are warranted to identify adequate predictive markers that could provide supplementary information to guide the timing of stopping NA therapy. | Wonseok Kang Jun Yong Park | 2014 | World Journal of Gastroenterology2014，20，23： | 3 |
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