Chronic hepatitis B (CHB) infection is one of the main causes of end-stage liver disease and hepatocellular carcinoma (HCC).
the best goal of antiviral therapy is to achieve a continuous post-drug response to reduce the incidence of HCC and limit the progression of liver disease.
, however, it is still difficult to achieve because co-priced closed ring DNA (cccDNA) of the hepatitis B virus (HBV) is still present in liver cells.
despite the emergence of new compounds, current treatment options are limited to nucleotide analogophobics (NAs) and polyglycolin interferons (PEG-IFN).
nucleoside analogs have good tolerance and can effectively inhibit HBV replication.
, however, nucleotide analogophobics do not directly affect cccDNA, so the continuous response rate after treatment is limited.
the elimination of cccDNA in liver cells is considered a key step in the removal of the hepatitis B virus (HBV), there is a strong need to monitor drug dynamics during treatment.
, however, cccDNA can only be accurately and invasly quantified through liver biopsies.
, it is clinically necessary to use non-invasive serological markers associated with the replication activity in the HBV liver to assess the efficacy of antiviral drugs in CHB patients.
New antiviral drugs showed a decline in RNA in effective HBV and no decrease in hepatitis B surface antigens (HBsAg), and the researchers conducted a study to study the extent to which viral antigens declined in treatment with patients with continuous post-treatment response and HBsAg loss and HBV RNA decline.
patients with chronic hepatitis B who were treated with polyglycol interferon, the researchers quantitatively tested their HBV RNA, HBsAg and hepatitis B core-related antigens (HBcrAg).
to assess continuous responses (HBV DNA slt;2000 IU / mL) and/or HBsAg loss in patients with or without treatment for HBV RNA responses 2 log HBV RNA drop or 1 log drop) and the HBsAg drop is layered according to .lt;0.5, 0.5-1, and 1 log.
the study recruited a total of 279 patients; 176 positive hepatitis B e antigen (HBeAg) and 103 HBeAg negative.
20.4% of patients achieved continuous remission.
in the 24th week of treatment, the HBV RNA response was associated with a higher sustained response rate (27.4% VS non-responders 13.0%, P=0.004).
, however, in patients with an HBV RNA response (n s 135), 56.4% of patients had no HBsAg drop.
in HBV RNA respondents, 47.6% of patients with HBsAg declined by 1 log (n s 20/42) achieved a continuous response, while a decrease of 0.5 log (n s 12/75, P s 0.001) was only 16.0%.
study found that many patients who experienced HBV RNA reactions during treatment based on polyglycol interferon did not experience HBsAg and/or HBcrAg decline.
the accompanying decline in these viral antigen deficiencies is associated with low treatment response rates and HBsAg loss.