CC BY-NC-ND 4.0 · Semin Liver Dis
DOI: 10.1055/a-1830-2741
Review Article

Surrogate markers for hepatitis B Virus covalently closed circular DNA

Thomas Tu
1   Centre for Infectious Diseases and Microbiology, The University of Sydney Marie Bashir Institute for Infectious Diseases and Biosecurity, Westmead, Australia (Ringgold ID: RIN442308)
2   Westmead Clinical School, The University of Sydney, Sydney, Australia (Ringgold ID: RIN4334)
3   Storr Liver Centre, Westmead Institute for Medical Research, Westmead, Australia (Ringgold ID: RIN107640)
Florian van Boemmel
4   Department of Medicine II, Leipzig University, Leipzig, Germany (Ringgold ID: RIN9180)
Thomas Berg
4   Department of Medicine II, Leipzig University, Leipzig, Germany (Ringgold ID: RIN9180)
› Author Affiliations
Supported by: National Health and Medical Research Council GNT2002565

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.

Publication History

Received: 02 February 2022

Accepted after revision: 11 April 2022

Accepted Manuscript online:
20 April 2022

© 2022. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (

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