Wu I-Chin, Liu Wen-Chun, Chiu Yen-Cheng, Chiu Hung-Chih, Cheng Pin-Nan, Chang Ting-Tsung
Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan 70403, Taiwan.
Microorganisms. 2021 May 26;9(6):1146. doi: 10.3390/microorganisms9061146.
Serum hepatitis B virus (HBV) pregenomic RNA (pgRNA) is correlated with covalently closed circular DNA. We aimed to investigate the utility of serum HBV pgRNA in chronic hepatitis B patients receiving nucleos(t)ide analogue treatment and those achieving HBsAg loss. One hundred and eighty-five patients were enrolled for studying long-term HBV pgRNA kinetics during treatment. Twenty patients achieving HBsAg loss after treatment were enrolled for examining HBV pgRNA kinetics around HBsAg loss. HBV pgRNA significantly decreased in the high baseline HBV pgRNA (≥6 log copies/mL) group but significantly increased in the low baseline HBV pgRNA (<4 log copies/mL) group after 3-month entecavir treatment. Among the 20 patients achieving HBsAg loss, 13 (65%) patients had serum HBV pgRNA higher than the limit of detection (LOD, 1466 copies/mL) when they achieved HBsAg loss. Finally, all 20 patients had HBV pgRNA going below the LOD within 3 years after achieving HBsAg loss. In conclusion, baseline serum HBV pgRNA alone is insufficient for predicting the trajectory of HBV pgRNA. Most patients still had HBV pgRNA higher than the LOD when they achieved HBsAg loss. Further studies on HBV pgRNA kinetics around HBsAg loss would provide an enhanced basis for further applications of HBV pgRNA.
血清乙型肝炎病毒（HBV）前基因组RNA（pgRNA）与共价闭合环状DNA相关。我们旨在研究血清HBV pgRNA在接受核苷（酸）类似物治疗的慢性乙型肝炎患者以及实现HBsAg清除的患者中的应用价值。招募了185名患者用于研究治疗期间的长期HBV pgRNA动力学。招募了20名治疗后实现HBsAg清除的患者用于检查HBsAg清除前后的HBV pgRNA动力学。在高基线HBV pgRNA（≥6 log拷贝/mL）组中，恩替卡韦治疗3个月后HBV pgRNA显著下降，但在低基线HBV pgRNA（<4 log拷贝/mL）组中显著上升。在20名实现HBsAg清除的患者中，13名（65%）患者在实现HBsAg清除时血清HBV pgRNA高于检测下限（LOD，1466拷贝/mL）。最后，所有20名患者在实现HBsAg清除后的3年内HBV pgRNA均降至LOD以下。总之，仅基线血清HBV pgRNA不足以预测HBV pgRNA的变化轨迹。大多数患者在实现HBsAg清除时HBV pgRNA仍高于LOD。对HBsAg清除前后HBV pgRNA动力学的进一步研究将为HBV pgRNA的进一步应用提供更好的基础。
