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Precision Management of Patients with HBV Infection

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Abstract

Purpose of Review

The strategies of precision management in chronic hepatitis B (CHB) are focused on prediction and action. Currently, several hepatitis B viral biomarkers are discovered to serve as predictors for disease progression, risk of hepatocellular carcinoma (HCC) occurrence, and responses to nucleos(t)ide analogue (NA) therapy. In this narrative review, three serum biomarkers, quantitative HBsAg, HBcrAg, and HBV RNA, for the precision management of patients with CHB will be summarized and discussed.

Recent Findings

Quantitative HBsAg provides prediction in staging clinical phases, HBsAg seroclearance, relapse after cessation of NA therapy, and risk of HCC development. Several studies highlight the potential role of HBcrAg as a biomarker for predicting functional cure, risk of HCC development, and relapse after NA withdrawal. HBV RNA may predict HCC risk and relapse after NA withdrawal; however, the data remain limited.

Summary

Novel HBV biomarkers are promising to predict clinical outcomes of untreated and treated CHB patients, including antiviral therapy response, relapse after cessation of therapy, risk of HCC development, and functional cure.

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Funding

This work was supported by grants from the National Taiwan University Hospital, the Ministry of Health and Welfare, and the Ministry of Science and Technology, Executive Yuan, Taiwan.

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Authors and Affiliations

  1. Department of Gastroenterology, Renai Branch, Taipei City Hospital, Taipei, Taiwan

    Chih-Lin Lin

  2. Department of Psychology, National Chengchi University, Taipei, Taiwan

    Chih-Lin Lin

  3. Graduate Institute of Clinical Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan

    Jia-Horng Kao

  4. Department of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan

    Jia-Horng Kao

  5. Hepatitis Research Center, National Taiwan University, Taipei, Taiwan

    Jia-Horng Kao

  6. Department of Medical Research, National Taiwan University, Taipei, Taiwan

    Jia-Horng Kao

  7. Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine, 1 Chang-Te St., Taipei, 10002, Taiwan

    Jia-Horng Kao

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  1. Chih-Lin Lin
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C-LL prepared the manuscript and approved the final manuscript.

J-HK provided critical revision of the manuscript and approved the final manuscript.

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Correspondence to Jia-Horng Kao.

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Lin, CL., Kao, JH. Precision Management of Patients with HBV Infection. Curr Hepatology Rep 23, 22–31 (2024). https://doi.org/10.1007/s11901-024-00632-z

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