Precision Management of Patients with HBV Infection

The strategies of precision management in chronic hepatitis B (CHB) are focused on prediction and action. Currently, several hepatitis B viral biomarkers are discovered to serve as predictors for disease progression, risk of hepatocellular carcinoma (HCC) occurrence, and responses to nucleos(t)ide analogue (NA) therapy. In this narrative review, three serum biomarkers, quantitative HBsAg, HBcrAg, and HBV RNA, for the precision management of patients with CHB will be summarized and discussed.

Quantitative HBsAg provides prediction in staging clinical phases, HBsAg seroclearance, relapse after cessation of NA therapy, and risk of HCC development. Several studies highlight the potential role of HBcrAg as a biomarker for predicting functional cure, risk of HCC development, and relapse after NA withdrawal. HBV RNA may predict HCC risk and relapse after NA withdrawal; however, the data remain limited.

Novel HBV biomarkers are promising to predict clinical outcomes of untreated and treated CHB patients, including antiviral therapy response, relapse after cessation of therapy, risk of HCC development, and functional cure.