Hepatitis B core-related antigen serum levels may be a predictor of acute flare of chronic hepatitis B among pregnant women in the immune-tolerant phase of chronic HBV infection after short-course antiviral therapy

References

• Polaris Observatory C. Global prevalence, treatment, and prevention of hepatitis B virus infection in 2016: a modelling study. Lancet Gastroenterol Hepatol. 2018;3(6):383–10.
   PubMed Web of Science ®Google Scholar
• Zhou Q, Li X, Wang Q, et al. Retracted: ‘hepatitis b virus infection in preconception period among women of reproductive age in rural China - a nationwide study’. Paediatr Perinat Epidemiol. 2017;31(5):484. DOI:10.1111/ppe.12371
   Web of Science ®Google Scholar
• Terrault NA, Lok ASF, McMahon BJ, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: aASLD 2018 hepatitis B guidance. Hepatology. 2018;67(4):1560–1599. DOI:10.1002/hep.29800
   PubMed Web of Science ®Google Scholar
• European Association for the Study of the Liver. Electronic address eee, European association for the study of the L. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370–398. doi: 10.1016/j.jhep.2017.03.021.
   PubMed Web of Science ®Google Scholar
• Chang CY, Aziz N, Poongkunran M, et al. Serum alanine aminotransferase and hepatitis B DNA flares in pregnant and postpartum women with chronic hepatitis B. Am J Gastroenterol. 2016;111(10):1410–1415. DOI:10.1038/ajg.2016.296
   PubMed Web of Science ®Google Scholar
• Kushner T, Shaw PA, Kalra A, et al. Incidence, determinants and outcomes of pregnancy-associated hepatitis B flares: a regional hospital-based cohort study. Liver Int. 2018;38(5):813–820. DOI:10.1111/liv.13594
   PubMed Web of Science ®Google Scholar
• Trehanpati N, Hissar S, Shrivastav S, et al. Immunological mechanisms of hepatitis B virus persistence in newborns. Indian J Med Res. 2013;138(5):700–710.
   PubMedGoogle Scholar
• Terrault NA, Bzowej NH, Chang KM, et al. AASLD guidelines for treatment of chronic hepatitis B. Hepatology. 2016;63(1):261–283. DOI:10.1002/hep.28156
   PubMed Web of Science ®Google Scholar
• Shrivastava S, TrehanPati N, Patra S, et al. Increased regulatory T cells and impaired functions of circulating CD8 T lymphocytes is associated with viral persistence in Hepatitis B virus-positive newborns. J Viral Hepat. 2013;20(8):582–591. DOI:10.1111/jvh.12078
   PubMed Web of Science ®Google Scholar
• Fede G, Spadaro L, Privitera G, et al. Hypothalamus-pituitary dysfunction is common in patients with stable cirrhosis and abnormal low dose synacthen test. Dig Liver Dis. 2015;47(12):1047–1051. DOI:10.1016/j.dld.2015.08.006
   PubMedGoogle Scholar
• Chang ML, Liaw YF. Hepatitis B flares in chronic hepatitis B: pathogenesis, natural course, and management. J Hepatol. 2014;61(6):1407–1417.
   PubMed Web of Science ®Google Scholar
• Sirilert S, Tongsong T. Hepatitis B virus infection in pregnancy: immunological response, natural course and pregnancy outcomes. J Clin Med. 2021;10(13):2926.
   PubMed Web of Science ®Google Scholar
• Nassal M. HBV cccDNA: viral persistence reservoir and key obstacle for a cure of chronic hepatitis B. Gut. 2015;64(12):1972–1984.
   PubMed Web of Science ®Google Scholar
• Inoue T, Tanaka Y. The role of hepatitis B core-related antigen. Genes (Basel). 2019;10(5):357.
   PubMed Web of Science ®Google Scholar
• Wong DK, Seto WK, Cheung KS, et al. Hepatitis B virus core-related antigen as a surrogate marker for covalently closed circular DNA. Liver Int. 2017;37(7):995–1001. DOI:10.1111/liv.13346
   PubMed Web of Science ®Google Scholar
• Yoshida K, Desbiolles A, Feldman SF, et al. Hepatitis B core-related antigen to indicate high viral load: systematic review and meta-analysis of 10,397 individual participants. Clin Gastroenterol Hepatol. 2021;19(1):46–60 e48. DOI:10.1016/j.cgh.2020.04.045
   PubMed Web of Science ®Google Scholar
• Testoni B, Lebosse F, Scholtes C, et al. Serum hepatitis B core-related antigen (HBcrAg) correlates with covalently closed circular DNA transcriptional activity in chronic hepatitis B patients. J Hepatol. 2019;70(4):615–625. DOI:10.1016/j.jhep.2018.11.030
   PubMed Web of Science ®Google Scholar
• To WP, Mak LY, Wong DK, et al. Hepatitis B core-related antigen levels after HBeAg seroconversion is associated with the development of hepatocellular carcinoma. J Viral Hepat. 2019;26(12):1473–1480. DOI:10.1111/jvh.13191
   PubMed Web of Science ®Google Scholar
• Wang G, Duan Z. Guidelines for prevention and treatment of chronic hepatitis B. J Clin Transl Hepatol. 2021;9(5):769–791.
   PubMed Web of Science ®Google Scholar
• Kumar M, Abbas Z, Azami M, et al. Asian Pacific association for the study of liver (APASL) guidelines: hepatitis B virus in pregnancy. Hepatol Int. 2022;16(2):211–253. DOI:10.1007/s12072-021-10285-5
   PubMed Web of Science ®Google Scholar
• Brook G, Bhagani S, Kulasegaram R, et al. United Kingdom national guideline on the management of the viral hepatitides A, B and C 2015. Int J STD AIDS. 2016;27(7):501–525. DOI:10.1177/0956462415624250
   PubMed Web of Science ®Google Scholar
• Chinese Society of H, Chinese Society of Infectious Diseases CMA. Guidelines for the prevention and treatment of hepatitis C (2019 version). Zhonghua Gan Zang Bing Za Zhi. 2019;27(12):962–979. doi: 10.3760/cma.j.issn.1007-3418.2019.12.008.
   PubMedGoogle Scholar
• Saag MS. HIV infection - screening, diagnosis, and treatment. N Engl J Med. 2021;384(22):2131–2143.
   PubMed Web of Science ®Google Scholar
• Ferrante ND, Lo Re V. 3rd. epidemiology, natural history, and treatment of hepatitis delta virus infection in HIV/hepatitis B virus coinfection. Curr HIV/AIDS Rep. 2020;17(4):405–414.
   PubMed Web of Science ®Google Scholar
• Su GL, Altayar O, O’shea R, et al. AGA clinical practice guideline on systemic therapy for hepatocellular carcinoma. Gastroenterology. 2022;162(3):920–934. DOI:10.1053/j.gastro.2021.12.276
   PubMed Web of Science ®Google Scholar
• Li M, Luo Q, Tao Y, et al. Pharmacotherapies for drug-induced liver injury: a current literature review. Front Pharmacol. 2021;12:806249.
   PubMed Web of Science ®Google Scholar
• National Workshop on Fatty L. Alcoholic liver disease CSoHCMA, fatty liver expert committee CMDA. Guidelines of prevention and treatment for alcoholic liver disease: a 2018 update. Zhonghua Gan Zang Bing Za Zhi. 2018;26(3):188–194.
   PubMedGoogle Scholar
• National Workshop, On Fatty L. Alcoholic liver disease CSoHCMA, fatty liver expert committee cmdA. Guidelines of prevention and treatment for nonalcoholic fatty liver disease: a 2018 update. Zhonghua Gan Zang Bing Za Zhi. 2018;26(3):195–203.
   PubMedGoogle Scholar
• Chinese Society of Hepatology CMA. Guidelines on the diagnosis and management of autoimmune hepatitis (2021). Zhonghua Gan Zang Bing Za Zhi. 2022;30(5):482–492. doi: 10.3760/cma.j.cn112138-20211112-00796.
   PubMedGoogle Scholar
• Chinese Society of Hepatology CMA. Guidelines on the diagnosis and management of primary biliary cholangitis (2021). Zhonghua Gan Zang Bing Za Zhi. 2022;30(3):264–275. doi: 10.3760/cma.j.cn112138-20211112-00794-1.
   PubMedGoogle Scholar
• Chinese Society of Hepatology CMA. Guidelines on the diagnosis and management of primary sclerosing cholangitis (2021). Zhonghua Gan Zang Bing Za Zhi. 2022;30(2):169–189. doi: 10.3760/cma.j.cn112138-20211109-00786.
   PubMedGoogle Scholar
• Chinese Society of Hepatology CMA. Chinese guidelines on the management of liver cirrhosis. Zhonghua Gan Zang Bing Za Zhi. 2019;27(11):846–865. doi: 10.3760/cma.j.issn.1007-3418.2019.11.008.
   PubMedGoogle Scholar
• Nelson DB, Byrne JJ, Cunningham FG. Acute fatty liver of pregnancy. Clin Obstet Gynecol. 2020;63(1):152–164.
   PubMed Web of Science ®Google Scholar
• Smith DD, Rood KM. Intrahepatic cholestasis of pregnancy. Clin Obstet Gynecol. 2020;63(1):134–151.
   PubMed Web of Science ®Google Scholar
• European Association for the Study of the Liver. Electronic address eee, European Association for the Study of the Liver. EASL clinical practice guidelines on hepatitis E virus infection. J Hepatol. 2018;68(6):1256–1271. doi: 10.1016/j.jhep.2018.03.005.
   PubMed Web of Science ®Google Scholar
• Minakami H, Morikawa M, Yamada T, et al. Differentiation of acute fatty liver of pregnancy from syndrome of hemolysis, elevated liver enzymes and low platelet counts. J Obstet Gynaecol Res. 2014;40(3):641–649.
   PubMed Web of Science ®Google Scholar
• Perez Botero J, Reese JA, George JN, et al. Severe thrombocytopenia and microangiopathic hemolytic anemia in pregnancy: a guide for the consulting hematologist. Am J Hematol. 2021;96(12):1655–1665.
   PubMed Web of Science ®Google Scholar
• Liu R, Li M, Lu Y, et al. Hepatitis B core-related antigen serum levels are associated with significant liver fibrosis in treatment-naive chronic HBV infection patients. J Viral Hepat. 2022;29(6):438–446. DOI:10.1111/jvh.13674
   PubMed Web of Science ®Google Scholar
• Pan CQ, Duan Z, Dai E, et al. Tenofovir to Prevent hepatitis B transmission in mothers with high viral load. N Engl J Med. 2016;374(24):2324–2334. DOI:10.1056/NEJMoa1508660
   PubMed Web of Science ®Google Scholar
• Guidelines for the Prevention, Care and Treatment of Persons with Chronic Hepatitis B Infection. Guidelines for the prevention, care and treatment of persons with chronic hepatitis B infection. Geneva2015.
   Google Scholar
• Mak LY, Seto WK, Fung J, et al. New biomarkers of chronic hepatitis B. Gut Liver. 2019;13(6):589–595.
   PubMed Web of Science ®Google Scholar
• Tada T, Kumada T, Toyoda H, et al. Hepatitis B virus core-related antigen levels predict progression to liver cirrhosis in hepatitis B carriers. J Gastroenterol Hepatol. 2018;33(4):918–925.
   PubMed Web of Science ®Google Scholar
• Chang XJ, Sun C, Chen Y, et al. On-treatment monitoring of liver fibrosis with serum hepatitis B core-related antigen in chronic hepatitis B. World J Gastroenterol. 2019;25(32):4764–4778. DOI:10.3748/wjg.v25.i32.4764
   PubMed Web of Science ®Google Scholar
• Li M, Sun F, Bi X, et al. Effects of antiviral therapy and drug withdrawal on postpartum hepatitis in pregnant women with chronic HBV infection. Hepatol Int. 2022;17(1):42–51. DOI:10.1007/s12072-022-10412-w
   PubMed Web of Science ®Google Scholar
• Hsu YC, Mo LR, Chang CY, et al. Association between serum level of hepatitis b surface antigen at end of entecavir therapy and risk of relapse in E antigen-negative patients. Clin Gastroenterol Hepatol. 2016;14(10):1490–1498. e1493.
   PubMed Web of Science ®Google Scholar
• Chen CH, Hung CH, Hu TH, et al. Association between level of hepatitis b surface antigen and relapse after entecavir therapy for chronic hepatitis B virus infection. Clin Gastroenterol Hepatol. 2015;13(11):1984–1992. e1981.
   PubMed Web of Science ®Google Scholar
• Hsu YC, Nguyen MH, Mo LR, et al. Combining hepatitis B core-related and surface antigens at end of nucleos(t)ide analogue treatment to predict off-therapy relapse risk. Aliment Pharmacol Ther. 2019;49(1):107–115. DOI:10.1111/apt.15058
   PubMed Web of Science ®Google Scholar
• Rokuhara A, Tanaka E, Matsumoto A, et al. Clinical evaluation of a new enzyme immunoassay for hepatitis B virus core-related antigen; a marker distinct from viral DNA for monitoring lamivudine treatment. J Viral Hepat. 2003;10(4):324–330. DOI:10.1046/j.1365-2893.2003.00437.x
   PubMed Web of Science ®Google Scholar