Hepatitis B core-related antigen assay is useful for monitoring the antiviral effects of nucleoside analogue therapy.
OBJECTIVE
The clinical significance of the hepatitis B virus core-related antigen (HBcrAg) assay in monitoring the antiviral effects of lamivudine is reviewed.


METHODS
The HBcrAg assay simultaneously measured serum levels of hepatitis B core (HBc) and e (HBe) antigens using monoclonal antibodies which recognize common epitopes of these two denatured antigens.


RESULTS
Although serum HBcrAg levels correlated linearly with those of hepatitis B virus (HBV) DNA in natural course, the decrease in HBcrAg was significantly slower than in HBV DNA after initiation of lamivudine administration. We analyzed the clinical significance of HBV DNA and HBcrAg levels to predict the occurrence of lamivudine resistance. HBV DNA measurement may be useful to identify patients who are at high risk of developing lamivudine resistance, and HBcrAg measurement may help to detect patients who are at low risk of drug resistance. The measurement of HBcrAg was also found to be a useful prognosticator for reactivation of hepatitis after cessation of lamivudine administration.


CONCLUSIONS
The HBcrAg assay is indeed useful for monitoring the antiviral effects of lamivudine, and we propose that it be adopted as a serum marker which reflects the amount of HBV covalently closed circular DNA in hepatocytes.
Tanaka
Eiji
E
Department of Medicine, Shinshu University School of Medicine, Matsumoto, Japan. etanaka@shinshu-u.ac.jp
Matsumoto
Akihiro
A
Yoshizawa
Kaname
K
Maki
Noboru
N
D000998:Antiviral Agents / Q000494:pharmacology / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D024882:Drug Resistance, Viral; D006509:Hepatitis B / Q000188:drug therapy / Q000821:virology*; D006512:Hepatitis B Core Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000187:drug effects*; D006801:Humans; D019259:Lamivudine / Q000494:pharmacology* / Q000627:therapeutic use*; D016896:Treatment Outcome
D000998:Antiviral Agents; D015415:Biomarkers; D006512:Hepatitis B Core Antigens; D019259:Lamivudine