摘要
作为新近发现的血清学标志物，乙型肝炎核心相关抗原(Hepatitis B core-related antigen, HBcrAg)由乙型肝炎核心抗原(Hepatitis core antigen, HBcAg)、乙型肝炎e抗原(Hepatitis e antigen, HBeAg)、p22cr组成。血清HBcrAg可反映肝内共价闭合环状DNA的水平及转录活性，并在一定程度上预测慢性乙型肝炎(简称乙肝)患者自然转归或核苷(酸)类似物、干扰素的疗效与预后，包括复发、功能性治愈等临床结局的发生率等，从而为临床抗病毒治疗起点与终点的确定、治疗方案的选择提供指导。同时，HBcrAg水平与乙肝相关的肝细胞肝癌(Hepatocellular carcinoma, HCC)的发生率亦有关联，可识别潜在的HCC高危患者。因此，HBcrAg在慢性乙肝诊治中有着重要的临床应用价值。
Abstract
As a recently discovered serological marker, hepatitis B core-related antigen (HBcrAg) consists of hepatitis B core antigen (HBcAg), hepatitis B e antigen (HBeAg) and p22cr. Serum HBcrAg can reflect the level and transcriptional activity of intrahepatic covalently closed circular DNA, as well as predict the natural history of patients with chronic hepatitis B or the efficacy and prognosis of nucleos(t)ide analogues and interferons, including the incidence of clinical outcomes such as relapse and functional cure, thus providing guidance for the determination of the starting point and endpoint of clinical antiviral therapy and the selection of treatment regimens. HBcrAg levels are also associated with the incidence of HBV-associated hepatocellular carcinoma(HCC), which can identify potential high-risk patients for HCC. Therefore, HBcrAg has important clinical application value in the diagnosis and treatment of chronic hepatitis B.
关键词
乙型肝炎核心相关抗原 /
慢性乙型肝炎 /
抗病毒治疗 /
肝细胞肝癌
Key words
Hepatitis B core-related antigen /
Chronic hepatitis B /
Antiviral treatment /
Hepatocellular carcinoma
章申琰*，沈忠良*，张继明.
乙型肝炎核心相关抗原的分子基础与临床应用[J]. 微生物与感染. 2023, 18(1): 35-45 https://doi.org/10.3969/j.issn.1673-6184.2023.01.005
ZHANG Shenyan*，SHEN Zhongliang*，ZHANG Jiming.
Molecular basis and clinical application of hepatitis B core-related antigen[J]. Journal of Microbes and Infections. 2023, 18(1): 35-45 https://doi.org/10.3969/j.issn.1673-6184.2023.01.005
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基金
国家自然科学基金(82172255)，上海市启明星计划(20QA1401800)
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