title: Diagnosis and management of chronic viral hepatitis: antigens, antibodies and viral genomes.
abstract: Virological tools, including serological and molecular tools, are needed to diagnose chronic hepatitis B and C infections. They may also be useful to establish their prognosis, but they have found their principal application in guiding treatment decisions and assessing the virological responses to therapy. The goal of chronic hepatitis B therapy is to prevent progression of liver disease. This is achieved if HBV replication is durably abolished or significantly reduced. In HBeAg-positive patients, HBeAg clearance followed by the HBe seroconversion phase can be achieved. In HBeAg-negative patients, long-term antiviral suppression of viral replication is needed. The loss of HBsAg, eventually associated with an HBs seroconversion, is the most desirable endpoint of therapy but is rarely achieved. The efficacy endpoint of chronic hepatitis C treatment is the sustained virological response, defined by an undetectable HCV RNA in serum with a sensitive assay 24 weeks after the end of treatment. The HCV genotype and on-treatment viral kinetics can be used to tailor treatment dosages and duration.
authors.affiliation: Department of Virology & INSERM U955, French National Reference Centre for Viral Hepatitis B, C and delta, Hôpital Henri Mondor, Université Paris, Créteil, France.
authors.forename: Stéphane
authors.initials: S
authors.lastname: Chevaliez
authors.forename: Jean-Michel
authors.initials: JM
authors.lastname: Pawlotsky
mesh_terms: D000998:Antiviral Agents / Q000627:therapeutic use; D018450:Disease Progression; D016679:Genome, Viral; D016174:Hepacivirus / Q000235:genetics; D006510:Hepatitis B Antibodies / Q000097:blood; D006511:Hepatitis B Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics; D018937:Hepatitis C Antibodies / Q000097:blood; D018936:Hepatitis C Antigens / Q000097:blood; D019698:Hepatitis C, Chronic / Q000097:blood / Q000175:diagnosis* / Q000188:drug therapy* / Q000235:genetics; D006801:Humans; D011379:Prognosis; D012367:RNA, Viral / Q000097:blood
chemical_list: D000998:Antiviral Agents; D006510:Hepatitis B Antibodies; D006511:Hepatitis B Antigens; D018937:Hepatitis C Antibodies; D018936:Hepatitis C Antigens; D012367:RNA, Viral