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World J Gastroenterol. Jun 28, 2014; 20(24): 7686-7695
Published online Jun 28, 2014. doi: 10.3748/wjg.v20.i24.7686
Serum hepatitis B surface antigen levels predict treatment response to nucleos(t)ide analogues
Chien-Hung Chen, Yi-Chun Chiu, Sheng-Nan Lu, Chuan-Mo Lee, Jing-Houng Wang, Tsung-Hui Hu, Chao-Hung Hung
Chien-Hung Chen, Yi-Chun Chiu, Sheng-Nan Lu, Chuan-Mo Lee, Jing-Houng Wang, Tsung-Hui Hu, Chao-Hung Hung, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 833, Taiwan
Author contributions: Chen CH performed the literature review and wrote the paper; Chiu YC, Lu SN, Lee CM, Wang JH and Hu TH contributed to acquisition of data; and Hung CH performed the critical revision.
Correspondence to: Chao-Hung Hung, MD, Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung 833, Taiwan. chh4366@yahoo.com.tw
Telephone: +886-7-7317123 Fax: +886-7-7318762
Received: October 24, 2013
Revised: January 1, 2014
Accepted: May 23, 2014
Published online: June 28, 2014
Core Tip

Core tip: Patients receiving nucleos(t)ide analog (NA) treatment typically exhibit slow declines in serum hepatitis B surface antigen (HBsAg), with many patients requiring decades of treatment to achieve HBsAg clearance. However, a low baseline HBsAg level or a rapid reduction in HBsAg during NA therapy may identify patients who will show HBsAg clearance, and predict virological response or hepatitis B e antigen (HBeAg) loss/seroconversion in HBeAg-positive patients. Viral breakthrough due to drug resistance can increase HBsAg titers. Among Asian patients, HBsAg levels of < 100-200 IU/mL at the end of treatment may predict lower risk of hepatitis B virus relapse and cessation of treatment can be considered in HBeAg-negative patients.