Abstract
HBsAg has been an important serological marker for the diagnosis of hepatitis B virus (HBV) infection. Recently, HBsAg quantification has been utilized to predict the disease activity and the response to antiviral treatment. This review aims to update the clinical utility of HBsAg quantification in the management of chronic hepatitis B (CHB). HBsAg level varies across different phases of the natural history of CHB, highest in the immune-tolerant phase and lowest in inactive carriers. HBsAg level is useful to stratify the risk of hepatocellular carcinoma in low-viremic patients. HBsAg level also helps predict the HBsAg loss in HBeAg-negative patients. Moreover, baseline level and on-treatment kinetics of HBsAg are associated with the treatment response to pegylated interferon and nucleos(t)ide analogs in both HBeAg-positive and HBeAg-negative patients. Finally, HBsAg level can serve as a therapeutic endpoint marker for evaluating novel curative agents against HBV infection. HBsAg quantification can help guide the management of CHB.
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