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Among HBV-infected persons, there is a group of people with hepatitis B surface antigen (HBsAg) showing persistently low levels of expression. The production of low-level HBsAg does not mean a good outcome of chronic HBV infection. Patients still have virus replication and sustained liver damage, and they have the potential to transmit the infection. This risk poses a challenge to clinical diagnosis and blood transfusion safety and is a major concern of experts. However, the mechanism behind persistent low-level HBsAg expression in serum is not completely clear, and complete virus clearance by the host is vital. In this review, we summarize the research progress on the mechanism behind low-level expression of HBsAg in patients with chronic HBV infection in recent years.
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http://dx.doi.org/10.1155/2022/1372705 | DOI Listing |
Front Med (Lausanne)
August 2025
The First Department of Liver Disease Center, Beijing You'an Hospital, Capital Medical University, Beijing, China.
Introduction: Low-level viremia (LLV) is associated with the progression of liver fibrosis and a high risk of hepatocellular carcinoma in patients with chronic hepatitis B (CHB). The present study aimed to compare the efficacy between nucleos(t)ide analogs (NAs) therapy and combination therapy of NAs and pegylated interferon-α (pegIFN-α) in entecavir (ETV)-treated CHB patients with LLV.
Methods: This was a retrospective cohort study.
Braz J Infect Dis
August 2025
Universidade Federal do Rio Grande do Sul, Programa de Pós-Graduação em Ciências Médicas, Porto Alegre, RS, Brazil; Universidade Federal do Rio Grande do Sul, Departamento de Medicina Interna, Porto Alegre, RS, Brazil.
Hepatitis B remains a global health concern due its high prevalence and association with chronic liver disease. Although vaccination is safe and effective in immunocompetent individuals, patients with hematological malignancies often exhibit immune dysfunction and reduced vaccine responses, increasing their susceptibility to vaccine-preventable infections. This study aimed to assess the hepatitis B vaccination status and immunoprotection in pediatric oncology patients treated at a tertiary public hospital in southern Brazil.
View Article and Find Full Text PDFZhonghua Gan Zang Bing Za Zhi
June 2025
Department of Infection Disease, the Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an 710004,China.
To investigate and explore the expressional condition and therapeutic role of PD-1 and CD161 in the peripheral blood of patients treated with PEG-IFN-α for chronic hepatitis B (CHB), and their correlation with the degree of decrease in hepatitis B surface antigen (HBsAg). A retrospective cohort study was conducted. CHB patients who visited the Second Affiliated Hospital of Xi'an Jiaotong University from July 2022 to December 2023 and healthy controls during the same period were included.
View Article and Find Full Text PDFZhonghua Gan Zang Bing Za Zhi
June 2025
Department of Infectious Diseases, the First Hospital of Shanxi Medical University, Taiyuan 030000, China.
Hepatitis B virus infection is a global public health issue, and there exist many controversies about the antiviral treatment strategies for patients with low-level hepatitis B surface antigen. This article reviews the definition, clinical significance, and current controversial focus of treatment strategies for low-level hepatitis B surface antigen, including treatment timing, drug selection, treatment course determination, and other aspects, while also suggesting future research directions.
View Article and Find Full Text PDFClin Res Hepatol Gastroenterol
August 2025
The Precision Medical Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, No. 1-1 Zhongfu Road, Gulou District, Nanjing, Jiangsu Province, 210003, China. Electronic address:
Background And Objective(s): HBV RNA serve as a downstream transcriptional product of cccDNA within the liver. This study is the first to investigate the diagnostic significance of serum HBV RNA in HBV low-level viremia (LLV) patients, elucidating the interrelationships among serum HBV RNA, HBV DNA, and HBsAg.
Methods: A cohort of 514 HBV LLV patients was collected from The Second Hospital of Nanjing and divided into four groups: asymptomatic HBV carriers (ASC), chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC).