Qiu Y, Tang Q, Liu XQ, Xue YL, Zeng Y, Hu P. Hepatitis B core-related antigen as a promising serological marker for monitoring hepatitis B virus cure. World J Hepatol 2025; 17(1): 98658 [DOI: 10.4254/wjh.v17.i1.98658]
Corresponding Author of This Article
Peng Hu, Doctor, Professor, Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China. hp_cq@163.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Minireviews
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
World J Hepatol. Jan 27, 2025; 17(1): 98658 Published online Jan 27, 2025. doi: 10.4254/wjh.v17.i1.98658
Hepatitis B core-related antigen as a promising serological marker for monitoring hepatitis B virus cure
Yue Qiu, Qiao Tang, Xiao-Qing Liu, Yun-Ling Xue, Yi Zeng, Peng Hu
Yue Qiu, Qiao Tang, Xiao-Qing Liu, Yun-Ling Xue, Yi Zeng, Peng Hu, Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, Chongqing 400010, China
Author contributions: Qiu Y and Hu P contributed to conceptualization, writing—original draft preparation; Qiu Y, Tang Q, Liu XQ, Xue YL, Zeng Y, and Hu P contributed to writing—review and editing. All authors have read and agreed to the published version of the manuscript.
Supported by The Chongqing Talents Project, No. cstc2021ycjh-bgzxm0150; The First Batch of Key Disciplines on Public Health in Chongqing, The Health Commission of Chongqing, No. 2022 (72); The Remarkable Innovation–Clinical Research Project, The Second Affiliated Hospital of Chongqing Medical University; and The Scientific and Technological Research Program of Chongqing Municipal Education Commission, the Second Affiliated Hospital of Chongqing Medical University, No. KJZD-K202300404.
Conflict-of-interest statement: There is no conflict of interest associated with any of the senior author or other coauthors contributed their efforts in this manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Peng Hu, Doctor, Professor, Department of Infectious Diseases, Institute for Viral Hepatitis, The Key Laboratory of Molecular Biology for Infectious Diseases, Chinese Ministry of Education, The Second Affiliated Hospital of Chongqing Medical University, No. 76 Linjiang Road, Yuzhong District, Chongqing 400010, China. hp_cq@163.com
Received: July 2, 2024 Revised: November 25, 2024 Accepted: December 13, 2024 Published online: January 27, 2025 Processing time: 188 Days and 6.7 Hours
Abstract
Hepatitis B virus (HBV) infection is a global health concern. The current sequential endpoints for the treatment of HBV infection include viral suppression, hepatitis B e antigen (HBeAg) seroconversion, functional cure, and covalently closed circular DNA (cccDNA) clearance. Serum hepatitis B core-related antigen (HBcrAg) is an emerging HBV marker comprising three components: HBeAg, hepatitis B core antigen, and p22cr. It responds well to the transcriptional activity of cccDNA in the patient's liver and is a promising alternative marker for serological testing. There is a strong correlation, and a decrease in its level corresponds to sustained viral suppression. In patients with chronic hepatitis B (CHB), serum HBcrAg levels are good predictors of HBeAg seroconversion (both spontaneous and after antiviral therapy), particularly in HBeAg-positive patients. Both low baseline HBcrAg levels and decreasing levels early in antiviral therapy favored HBsAg seroconversion, which may serve as a good surrogate option for treatment endpoints. In this review, we summarize the role of serum HBcrAg in the treatment of CHB. Therefore, long-term continuous monitoring of serum HBcrAg levels contributes to the clinical management of patients with CHB and optimizes the choice of treatment regimen, making it a promising marker for monitoring HBV cure.
Core Tip: Elimination of hepatitis B virus (HBV) infection by 2030 is a common global goal proposed by the World Health Organization, and the challenge of HBV cure is the persistence of viral replication driven by the covalently closed circular DNA (cccDNA) pool. Currently, clinical markers of HBV DNA and hepatitis B surface antigen have limited utility in predicting HBV cure, either alone or in combination. In this review, we concentrate on the serum hepatitis B core-related antigen, an emerging serologic marker that correlates well with cccDNA, the continued monitoring of which during long-term therapy may aid in clinical management and facilitate the achievement of a complete cure in patients with chronic hepatitis B.
