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2 Current available antiviral therapies including pegylated interferon (PEG-IFN) and nucleos(t)ide analogues (NA) 3 are effective in controlling or suppressing viral replication.
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Up to 15%–40% of them will progress to cirrhosis, decompensated liver disease, hepatocellular carcinoma (HCC) or death, and liver transplantation may be required in patients with advanced liver disease. 1 Most patients with chronic HBV (CHB) infection acquire the virus via vertical/early-age horizontal transmission. It infects human livers and exerts necroinflammatory, fibrotic and carcinogenic effects. Hepatitis B virus (HBV) is the only hepatotropic virus which exists in DNA form. Both HBcrAg and HBV RNA may be helpful for predicting off-therapy sustained virological control in patients who stop long-term NA treatment. A significant decline in serum RNA was observed in patients receiving novel antiviral therapies, including core protein allosteric modulators and RIG-1/NOD2 agonists. In contrast, its level is higher than HBV DNA in patients receiving nucleos(t)ide analogues (NAs). HBV RNA is present in serum at lower levels than HBV DNA in treatment-naïve patients by 1–2 logs.
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Its profile differs between patients in different disease phases in a similar manner to that of HBcrAg. Another emerging measurable serum marker, HBV RNA, exists in the form of pregenomic RNA-containing virions. HBcrAg may be helpful for predicting hepatocellular carcinoma development and hepatitis B virus (HBV) reactivation in immunosuppressed patients. Its profile differs drastically in patients in different disease phases, and the level declines with antiviral therapies. It showed good correlation with intrahepatic covalently closed-circular DNA. Hepatitis B core-related antigen (HBcrAg) is a novel serum composite viral protein whose performance has been proven to be superior to that of existing viral markers. Different viral markers are utilized to monitor treatment effects and predict risk of complications in patients with CHB. For a number of reasons, the author has considered it important to investigate the phenomena and mechanisms involved in the interaction of foreign DNA with mammalian cells and organisms in detail.Chronic hepatitis B (CHB) infection leads to clinically heterogeneous disease outcomes. At least in cells growing in culture, the uptake and genomic fixation by integration of foreign DNA can readily be demonstrated. So far, next to nothing is known about defense mechanisms in mammals against the intrusion of foreign DNA. By necessity, the gastrointestinal tract also of all mammalian organisms is constantly in contact with foreign DNA. The natural environment is heavily «contaminated» with such foreign DNA, and mammals, like other organisms, are frequently exposed to foreign DNA in their environment, notably by ingesting their daily food supply. Foreign DNA is defined as genetic material that derives from another organism of the same or a different species. It is conceivable that foreign DNA can gain entry into individual cells of an organism. It is unlikely that the established genomes of present day organisms remain stable forever.