Surrogate Markers for Hepatitis B Virus Covalently Closed Circular DNA

Abstract

Chronic infection with the Hepatitis B virus (HBV) is one of the most common causes of liver disease worldwide. Chronic HBV infection is currently incurable because of the persistence of the viral template for the viral transcripts, covalently closed circular (cccDNA). Detecting changes in cccDNA transcriptional activity is key to understanding fundamental virology, determining the efficacy of new therapies, and deciding the optimal clinical management of HBV patients. In this review, we summarize surrogate circulating biomarkers that have been used to infer cccDNA levels and activity in people with chronic hepatitis B. Moreover, we outline the current shortcomings of the current biomarkers and highlight the clinical importance in improving them and expanding their use.

Liver Carcinogenesis Suppression in Chronic Hepatitis B in the Nucleoside Analogues Era

“…The HBV genome, which has an incomplete doublestranded DNA structure of 3.2 kb, is subsequently transported to the nucleus, where it is converted into covalently closed circular DNA (cccDNA) by nuclear enzymes. The cccDNA, also called minichromosome, is thought to be almost as stable as the host DNA in the chromosome in the absence of cell division, and remains in the hepatocyte in an extremely stable state for a long time, which is the main reason why complete HBV elimination is difficult (3).…”