Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.
Department of Gastroenterology, Capital Medical University Beijing Tiantan Hospital, Beijing 100070, China.
World J Gastroenterol. 2019 Feb 14;25(6):719-728. doi: 10.3748/wjg.v25.i6.719.
Characteristics of alterations of serum hepatitis B virus (HBV) RNA in different chronic hepatitis B (CHB) patients still cannot be fully explained. Whether HBV RNA can predict HBeAg seroconversion is still controversial.
To investigate whether HBV RNA can predict virological response or HBeAg seroconversion during entecavir (ETV) treatment when HBV DNA is undetectable.
The present study evaluated 61 individuals who were diagnosed and treated with long-term ETV monotherapy at the Department of Infectious Diseases of Peking University First Hospital (China) from September 2006 to December 2007. Finally, 30 treatment-naive individuals were included. Serum HBV RNA were extracted from 140 μL serum samples at two time points. Then they were reverse transcribed to cDNA with the HBV-specific primer. The product was quantified by real-time quantitative PCR (RT-PCR) using TAMARA probes. Statistical analyses were performed with IBM SPSS 20.0.
Level of serum HBV RNA at baseline was 4.15 ± 0.90 log copies/mL. HBV RNA levels showed no significant difference between the virological response (VR) and partial VR (PVR) groups at baseline ( = 0.940). Serum HBV RNA significantly decreased among patients who achieved a VR during ETV therapy ( < 0.001). The levels of HBV RNA in both HBeAg-positive patients with seroconversion group and those with no seroconversion increased after 24 wk of treatment. Overall, HBV RNA significantly but mildly correlated to HBsAg ( = 0.265, = 0.041), and HBV RNA was not correlated to HBV DNA ( = 0.242, = 0.062). Furthermore, serum HBV RNA was an independent indicator for predicting HBeAg seroconversion and virological response. HBeAg seroconversion was more likely in CHB patients with HBV RNA levels below 4.12 log copies/mL before treatment.
The level of serum HBV RNA could predict HBeAg seroconversion and PVR during treatment. In the PVR group, the level of serum HBV RNA tends to be increasing.
不同慢性乙型肝炎（CHB）患者血清乙型肝炎病毒（HBV）RNA 变化的特征仍不能完全解释。HBV RNA 是否可以预测 HBeAg 血清学转换仍存在争议。
探讨当 HBV DNA 不可检测时，HBV RNA 是否可以预测恩替卡韦（ETV）治疗期间的病毒学应答或 HBeAg 血清学转换。
本研究评估了 2006 年 9 月至 2007 年 12 月在北京大学第一医院感染科接受长期 ETV 单药治疗的 61 例患者，最终纳入 30 例初治患者。从 140μL 血清样本中提取血清 HBV RNA，然后用 HBV 特异性引物逆转录为 cDNA。使用 TAMARA 探针通过实时定量 PCR（RT-PCR）定量。使用 IBM SPSS 20.0 进行统计分析。
基线时血清 HBV RNA 水平为 4.15±0.90log 拷贝/mL。基线时，病毒学应答（VR）和部分 VR（PVR）组之间的 HBV RNA 水平无显著差异（ = 0.940）。在 ETV 治疗期间达到 VR 的患者中，血清 HBV RNA 显著降低（ < 0.001）。在 HBeAg 阳性患者中，无论是否发生血清学转换，HBV RNA 水平在治疗 24 周后均升高。总体而言，HBV RNA 与 HBsAg 显著相关（ = 0.265， = 0.041），与 HBV DNA 不相关（ = 0.242， = 0.062）。此外，血清 HBV RNA 是预测 HBeAg 血清学转换和病毒学应答的独立指标。治疗前 HBV RNA 水平低于 4.12log 拷贝/mL 的 CHB 患者更有可能发生 HBeAg 血清学转换。
血清 HBV RNA 水平可预测治疗期间的 HBeAg 血清学转换和 PVR。在 PVR 组中，血清 HBV RNA 水平趋于升高。
