Advances in treatment and prevention of hepatitis B

Table 1 Studies addressing hepatitis B testing and diagnosis

Ref.	Study type	Findings
Gao et al[32], 2017	Prospective trial	Higher HBV RNA levels, in NA-treated patients are a predictor of response
		HBV RNA has a strong linear correlation with HBV DNA and HBsAg titer
		HBcrAg and HBV RNA can predict long-term off-therapy HBV virological control in NA-treated patients
Zhang et al[14], 2018	Randomized, controlled, double-blind clinical trial	HBcrAg titers were significantly higher (P < 0.0001) in patients with HBeAg positive HBV. HBsAg titers were directly proportional to necro-inflammatory activity, and inversely proportional to fibrosis
Walsh et al[15], 2019	Prospective trial	HBsAg clearance profile has positive association with HBsAg loss, seroconversion, and response to treatment in patients treated chronically with Adefovir or Tenofovir
Chang et al[34], 2019	Prospective trial	HBcrAg levels reflect liver parenchymal fibrosis progression, and have utility in monitoring hepatic histological changes
Liao et al[35], 2019	Prospective trial	Demonstrated utility of monitoring HBV RNA and HBcrAg levels for NA-treated patients with undetectable HBV DNA
Multiple authors	Prior Studies	HBcrAg has a superior correlation to the decline in HBV DNA levels with anti-viral therapies, and with intrahepatic HBV cccDNA levels[20-23]
		HBcrAg can predict HBV reactivation in immunosuppressed individuals and the development of Hepatocellular Carcinoma[24-28]
		HBV RNA is a pregenomic RNA containing virion that has a similar profile to HBcrAg[16]. Treatment naïve patients with CHB have lower (1-2 logs lower) serum levels of HBV RNA compared to HBV DNA[29,30]

HBsAg: Hepatitis B surface antigen; HBeAg: Hepatitis B e antigen; ALT: Alanine aminotransferase; NA: Nucleos(t)ide analogs; HBV: Hepatitis B virus; HBcrAg: Hepatitis b core-related antigen; cccDNA: Covalently closed circular DNA; CHB: Chronic Hepatitis B.