State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Antiviral Res. 2021 May;189:105037. doi: 10.1016/j.antiviral.2021.105037. Epub 2021 Mar 10.
Whether different serum HBV RNA detection assays can consistently predict treatment outcomes in patients with chronic hepatitis B remains controversial.
We enrolled 188 patients who had stopped nucleos(t)ide analogues (NAs) (STOP cohort-1, -2) and 78 receiving entecavir (ETV) therapy (ETV cohort) and used double-target (targeting both 5' and 3' ends of the HBV pregenome RNA [DT-RNA]) and three single-target (targeting the S-region [S-RNA], X-region [X-RNA], and poly-A tail of HBV RNA [PolyA-RNA]) assays to predict treatment outcomes.
In STOP cohorts, DT-RNA, S-RNA and X-RNA at NAs cessation showed higher predictive powers for clinical relapse (time-dependent areas under the curve [AUCs] for years 1, 2, 3, and 4 ranged between 0.724 and 0.772 in cohort-1, and between 0.741 and 0.824 in cohort-2) than the PolyA-RNA (AUCs between 0.604 and 0.611 in cohort-1; and between 0.530 and 0.584 in cohort-2). The predictive power for 2-year HBeAg loss of the four targeted RNAs in the ETV cohort at 6 months were similar (AUCs, 0.848, 0.838, 0.825, and 0.801), and superior to that of the HBV DNA level at 6 months (AUC, 0.721).
The outcome prediction performance of serum HBV RNAs is methodology-dependent. PolyA-RNA detection was not recommended to predict off-treatment relapses.
不同的血清 HBV RNA 检测方法是否能一致预测慢性乙型肝炎患者的治疗结局仍存在争议。
我们纳入了 188 例停止核苷（酸）类似物（NAs）治疗的患者（STOP 队列-1、-2）和 78 例接受恩替卡韦（ETV）治疗的患者，并使用双靶（靶向 HBV 前基因组 RNA 的 5'和 3'末端[DT-RNA]）和三种单靶（靶向 S 区[S-RNA]、X 区[X-RNA]和 HBV RNA 的 poly-A 尾[PolyA-RNA]）检测方法来预测治疗结局。
在 STOP 队列中，NA 停药时的 DT-RNA、S-RNA 和 X-RNA 对临床复发的预测能力较高（第 1、2、3 和 4 年的时间依赖性曲线下面积[AUCS]在队列-1 中为 0.724 至 0.772，在队列-2 中为 0.741 至 0.824），高于 PolyA-RNA（AUCS 在队列-1 中为 0.604 至 0.611，在队列-2 中为 0.530 至 0.584）。在 ETV 队列中，6 个月时四种靶向 RNA 预测 2 年 HBeAg 丢失的能力相似（AUCS 分别为 0.848、0.838、0.825 和 0.801），优于 6 个月时的 HBV DNA 水平（AUCS 为 0.721）。
血清 HBV RNA 的结局预测性能取决于方法学。不建议使用 PolyA-RNA 检测来预测停药后复发。
