| セッション情報 |
Hepatitis B i)Hepatitis B and HCC
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| タイトル |
IF4b-3 qHBsAg in the Natural History and Nucleos(t)ide Analogue Treatment
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| 演者 |
Jia-Horng Kao（Graduate Institute of Clinical MedicineNational Taiwan University College of MedicineTaiwan） |
| 共同演者 |
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| 抄録 |
Using commercial quantitative assaysqHBsAg has been shown to be helpfu1 in the understanding andmanagement of chronic hepatitis B （CHB）． Studies consistently showed that HBsAg level is highest in im－mune tolerant phase （4．5－5．0 logio IU／mL）starts to decline during immune clearance phase （3．04．5 logioIU／mL）and decreases slowly and progressively after HBeAg seroconversion． HBsAg level is lowest （1．5－3．0 logio IU／mL） in inactive carriers but higher （2．5－4．0 logio IU／mL） in those with HBeAg－negative hepa－titis． Longitudinal studies further suggested that HBsAg level remained stable in HBeAg－positive patientsand tended to reduce slowly in HBeAg－negative patients and reduction of HBsAg for ＞1 log IU／mL eouldreflect improved immune controL Combination of single point of HBsAg〈 1000 IU／mL and HBV－DNA ：｛2000 IU／mL may identify inactive carriers with up tQ 900／o PPV and 970／o NPV in genotype D HBeAg－negative patients． ln genotype B and C HBeAg－negative carriers with normal ALTthe lower the HBsAglevel＜10001U／m：Lthe higher the chance of spontaneous HBsAg lossand an且BsAg level of≦1001U／mL is a cut－off fo． r predicting HBsAg loss over time． TakJ’ng these lines of evidence togetherqHBsAgcould be used together withbut not as a substitute forHBV－DNA in the clinical practice．Although qHBsAg has been use’d CHB patients receiving peg－interferon therapyHBsAg decline is slowand does not correlate with HBV DNA levels during nucleos（t）ide analogues （NAs） treatment． Howevera rapid HBsAg decline during NA therapyideally after virological response is achievedmay identify pa－tients who will clear HBsAg finally． A 6－12 monthly assessment of qHBsAg level can be considered tomonitor NA therapy． Among Asian patients infected with HBV genotype B and Can HBsAg level of 〈100 IU／ml might predict lower risk of relapse and stopping treatment can be considered． Howeverfur－ther studies are needed to validate these findings． |
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