Rao X, Shi H H, Wu Z P, Li X P, Liu X Y, Zhang L L
Department of Infectious Diseases, the First Affiliated Hospital of Nanchang University, Nanchang 330006, China.
Department of Critical Medicine, the First Affiliated Hospital of Zhejiang University, Hangzhou 310003 ,China.
Zhonghua Gan Zang Bing Za Zhi. 2021 Aug 20;29(8):766-770. doi: 10.3760/cma.j.cn501113-20200303-00083.
To study the relationship between serum HBV pgRNA and antigen status in patients with chronic hepatitis B treated with long-term nucleotide analogues, and to elucidate the reason and possible mechanism of high relapse rate in antiviral therapy of nucleotide analogues in chronic hepatitis B. 94 patients with chronic hepatitis B who had been treated with long-term antiviral therapy with nucleotide analogues (more than 2 years) were divided into 5 groups according to their HBeAg and HBsAg levels: e antigen positive group(group1), e antigen negative and HBsAg > 1 500 IU/L group(group2), e antigen negative and 100 IU/L< HBsAg < 1 500 IU/L group(group3), e antigen negative and HBsAg < 100 IU/L group(group4), e antigen negative and HBsAg negative group(group5). The level and detection rate of HBVpgRNA in different antigen states groups were analyzed and compared. In addition, in order to exclude the influence of other factors on the results of this study. The study was divided into groups according to age, gender and treatment time. The detection rate of HBVpgRNA was 95.0% in patients with e antigen positive, while 43.2% in patients with e antigen seroconversion, which was significantly lower than that in patients with e antigen positive ( < 0.05). The detection rate of serum HBVpgRNA was 95.0% in e antigen positive group, 75.0% in group 2, 65.0% in e antigen negative with group 3, 15.0% in group 4 and 0% in group 5. Among them, group 1, group 2 and group 3 was significantly higher than that in group 4 and group 5. There was significant difference between the two groups ( < 0.05). However, there was no difference in the positive rate of serum HBV pgRNA among group 1, group 2 and group 3 ( > 0.05). Similarly, there was no difference in the positive rate of serum HBV pgRNA between group 4 and group 5 ( > 0.05). Moreover, the detection rate of serum HBV pgRNA was not correlated with age, gender and treatment time of nucleotide analogues ( > 0.05). There is a significant correlation between the serological antigen status and the presence of HBV pgRNA in chronic hepatitis B after long-term treatment of nucleotide analogues. The persistence of HBV pgRNA is closely related to the low seroconversion rate of e antigen and the high level of HBsAg. HBV pgRNA can be used as one of the biomarkers to judge the transcription activity and replication status of HBV cccDNA in liver.
研究长期应用核苷类似物治疗的慢性乙型肝炎患者血清HBV pgRNA与抗原状态的关系，阐明慢性乙型肝炎核苷类似物抗病毒治疗高复发率的原因及可能机制。将94例长期应用核苷类似物抗病毒治疗（超过2年）的慢性乙型肝炎患者，根据其HBeAg和HBsAg水平分为5组：e抗原阳性组（组1）、e抗原阴性且HBsAg＞1 500 IU/L组（组2）、e抗原阴性且100 IU/L＜HBsAg＜1 500 IU/L组（组3）、e抗原阴性且HBsAg＜100 IU/L组（组4）、e抗原阴性且HBsAg阴性组（组5）。分析比较不同抗原状态组HBVpgRNA的水平及检出率。此外，为排除其他因素对本研究结果的影响。研究还根据年龄、性别及治疗时间进行分组。e抗原阳性患者HBVpgRNA检出率为95.0%，而e抗原血清学转换患者为43.2%，明显低于e抗原阳性患者（P＜0.05）。e抗原阳性组血清HBVpgRNA检出率为95.0%，组2为75.0%，e抗原阴性的组3为65.0%，组4为15.0%，组5为0%。其中，组1、组2和组3明显高于组4和组5。两组间差异有统计学意义（P＜0.05）。然而，组1、组2和组3血清HBV pgRNA阳性率差异无统计学意义（P＞0.05）。同样，组4和组5血清HBV pgRNA阳性率差异无统计学意义（P＞0.05）。此外，血清HBV pgRNA检出率与核苷类似物的年龄、性别及治疗时间均无相关性（P＞0.05）。长期核苷类似物治疗后慢性乙型肝炎血清学抗原状态与HBV pgRNA的存在有显著相关性。HBV pgRNA的持续存在与e抗原低血清学转换率及高HBsAg水平密切相关。HBV pgRNA可作为判断肝脏中HBV cccDNA转录活性及复制状态的生物标志物之一。
