[HBsAg trajectories and key thresholds toward functional cure of hepatitis B]

Zhonghua Gan Zang Bing Za Zhi. 2024 Nov 6:32:961-964. doi: 10.3760/cma.j.cn501113-20240902-00466. Online ahead of print.
[Article in Chinese]

Abstract

Chronic hepatitis B virus (HBV) infection remains a pivotal global health challenge. The pursuit of a functional cure for hepatitis B remains an ardent and intricate issue in clinical settings, as the current arsenal of nucleos(t)ide analogues (NAs) primarily achieves sustained suppression of HBV DNA but falls short in fully addressing clinical needs. The standalone use of Peg-interferon (PEG-IFN) or its combination with NAs still fails to satisfy the pressing clinical demands for functional cure. However, groundbreaking advancements in hepatitis B treatment have emerged through the research and development of antiviral agents with novel mechanisms, notably small nucleic acid drugs, which have ushered in a new era for functional cure prospects. Leveraging longitudinal data spanning multiple time points of HBsAg levels, we can now delineate the trajectory leading towards HBV functional cure and devise predictive models that refine clinical treatment protocols. Two pivotal thresholds of HBsAg levels emerge as crucial milestones, facilitating the selection of eligible participants for clinical trials. This refinement in screening enhances the personalized management of hepatitis B, tailoring interventions to individual patient needs and maximizing outcomes.

慢性乙型肝炎病毒(HBV)感染是全球重要的公共卫生问题。乙型肝炎功能性治愈的实现仍是临床亟待解决的热点和难点。现有的核苷(酸)类似物(NAs)可持续抑制HBV DNA,聚乙二醇干扰素(PEG-IFN)单药或联用NAs的治疗方案的功能性治愈率尚未满足临床需求。新机制HBV抗病毒药物的研发,尤其小核酸新药,为乙型肝炎功能性治愈带来突破性进展。基于乙型肝炎表面抗原(HBsAg)多时间点纵向数据描绘功能性治愈轨迹的预测模型可指导临床治疗策略。不同HBsAg水平可作为关键分水岭辅助临床试验中受试者的筛选,从而优化对乙型肝炎患者的个性化管理。.

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  • English Abstract