Abstract
The natural course of chronic hepatitis B virus (HBV) infection is well known. Acute exacerbation, hepatic decompensation, cirrhosis and hepatocellular carcinoma may develop during different phases. The improvement of polymerase chain reaction assay for measuring HBV DNA has facilitated our understanding of this natural history. Recent newly available automated quantitative assays of hepatitis B surface antigen (HBsAg) further bring new data and emerging studies of serum HBsAg level in the natural course of chronic hepatitis B. Combination of serum HBV DNA and HBsAg levels can help differentiate the different phases of the natural course and inactive carriers from active chronic hepatitis B. Using the HBsAg level can predict disease progression, development of hepatocellular carcinoma and HBsAg seroclearance with high positive and negative predictive values. In this review, we will illustrate the clinical utility of HBsAg quantification in the natural course of chronic hepatitis B.
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