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Chronic hepatitis B: current testing strategies.
Robert G Gish1, Stephen A Locarnini
1Division of Hepatology and Complex GI, Physician Foundation, California Pacific Medical Center, San Francisco, California, USA. gishr@sutterhealth.org
Summary
Accurate diagnosis and monitoring of hepatitis B virus (HBV) infection are crucial. Testing for HBV DNA and serologic markers guides treatment and predicts patient outcomes, aiming for durable viral suppression.
Area of Science:
- Hepatology
- Virology
- Infectious Diseases
Background:
- Hepatitis B virus (HBV) infection presents a significant global health challenge.
- Accurate diagnosis and evidence-based treatment are essential for managing HBV.
- HBV infection involves viral DNA and protein products, necessitating specific diagnostic markers.
Purpose of the Study:
- To review the clinical utility of advanced serologic and nucleic acid tests for HBV.
- To highlight the importance of HBV DNA and serologic markers in disease management.
- To discuss the role of viral load in assessing disease activity and treatment response.
Main Methods:
- Review of current state-of-the-art serologic and nucleic acid testing methodologies.
- Analysis of hepatitis B e antigen/antibody and HBV DNA as disease activity markers.
- Evaluation of viral load's role in distinguishing disease states and predicting outcomes.
Main Results:
- Serologic and nucleic acid tests are critical for prevention, treatment, and understanding HBV natural history.
- HBV DNA levels are key indicators of disease activity, treatment response, and antiviral resistance.
- High viral load is linked to increased risk of cirrhosis and hepatocellular carcinoma.
Conclusions:
- Durable suppression of HBV DNA is the emerging primary therapeutic goal.
- Monitoring HBV DNA aids in tailoring treatment strategies and assessing therapeutic efficacy.
- Understanding viral markers is vital for optimal patient management and improved outcomes in hepatitis B.