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Clinical significance of high-sensitive HB core-related antigen assay in patients with resolved HBV infection after HBV reactivation
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Shinya Hagiwara1,
Shigeru Kusumoto1,
Yasuhito Tanaka2 |
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1Department of Hematology and Oncology, Nagoya City University Graduate School of Medical Sciences, 2Department of Virology and Liver Unit, Nagoya City University Graduate School of Medical Sciences |
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| [Aim] HBV DNA monitoring-guided preemptive antiviral therapy can prevent HBV related hepatitis. In this study, we examine clinical usefulness of newly developed high-sensitive HB core-related antigen (iTACT-HBcrAg) assay during preemptive antiviral therapy.[Methods] We retrospectively analyzed 22 patients with resolved HBV infection who experienced HBV reactivation (1.3 log IU/mL or more), who received systemic chemotherapies for hematological malignancies between 2008 and 2018. The iTACT-HBcrAg assay was based on chemiluminescence enzyme immunoassay.iTACT-HBcrAg was measured using stored samples after HBV reactivation.Tentative limit of quantification for iTACT-HBcrAg was set at 2.0 log U/mL.[Results] HBV reactivation was diagnosed at median HBV DNA levels of 1.9 log IU/mL (range:1.4-3.5), and then all patients received entecavir. No patient had HBV-related hepatitis with peak HBV DNA levels of 2.1 log IU/mL. iTACT-HBcrAg was detected in 17 (85%) of 20 evaluable patients at HBV reactivation. After HBV reactivation,21 (95%) were seropositive for iTACT-HBcrAg. Importantly, median interval from starting of entecavir to HBV DNA loss and iTACT-HBcrAg loss were 34 and 166 days, respectively. Recurrence of HBV reactivation after cessation of entecavir was not observed in 5 of 6 patients who achieved iTACT-HBcrAg loss during follow-up.[Conclusion] iTACT-HBcrAg could be a useful surrogate marker to stop preemptive antiviral therapy safely. |
Index Term 1: HBV reactivation
Index Term 2: HBcrAg
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