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[血清HBV RNA对慢性乙型肝炎患者恩替卡韦治疗效果的预测价值]

[Predictive value of serum HBV RNA for therapeutic effect of entecavir in patients with chronic hepatitis B].

作者信息

Zhu Y, Luo Y, Guo F, Yang K, Fan H, Liu C, Huang B, Tang X, Guan Y

机构信息

Department of Hepatology, Guangzhou Eighth People's Hospital Affiliated to Guangzhou Medical University, Guangzhou 510060, China.

Guangzhou Hailite Biotechnoloty Co.Ltd, Guangzhou 510530, China.

出版信息

Nan Fang Yi Ke Da Xue Xue Bao. 2022 Aug 20;42(8):1250-1255. doi: 10.12122/j.issn.1673-4254.2022.08.19.

Abstract

OBJECTIVE

To investigate the value of HBV RNA for predicting the therapeutic effect of long-term entecavir (ETV) antiviral therapy in patients with chronic hepatitis B (CHB).

METHODS

Serum samples were collected from 59 CHB patients treated with ETV for 96 or 108 months. HBV RNA levels, HBV DNA levels, and serological marker (HBeAg) levels were measured at baseline and 3, 6, 9, 12, 36, 72, and 96 (or 108) months during the therapy.

RESULTS

Although HBV RNA level decreased after 12 and 36 months of ETV antiviral therapy, no significance changes occurred in HBV RNA negative conversion rate (>0.05). After 72 months of treatment or longer, 33 patients had HBV RNA levels lower than 100 copies/mL, and among them 29 patients had HBV RNA levels lower than the detection limit, and HBV RNA negative conversion rate was statistically significant ( < 0.05). A lower HBV RNA level was associated with a higher HBeAg negative conversion rate ( < 0.05). Age and HBV RNA level were positively correlated with HBeAg negative conversion rate ( < 0.05).

CONCLUSION

Prolonged ETV antiviral therapy results in better clearance of HBV RNA and a higher negative conversion rate in CHB patients. The length of antiviral therapy and age are positively correlated with the negative conversion rate of HBV RNA, and earlier administration of the antiviral treatment achieves better therapeutic effect. Serum HBV RNA level can be used as an indicator for predicting conversion to negative HBeAg in CHB patients receiving ETV therapy.

摘要

目的

探讨乙肝病毒核糖核酸(HBV RNA)对预测慢性乙型肝炎(CHB)患者长期恩替卡韦(ETV)抗病毒治疗疗效的价值。

方法

收集59例接受ETV治疗96或108个月的CHB患者的血清样本。在治疗的基线期以及第3、6、9、12、36、72和96(或108)个月时检测HBV RNA水平、乙肝病毒脱氧核糖核酸(HBV DNA)水平和血清学标志物(HBeAg)水平。

结果

ETV抗病毒治疗12个月和36个月后,虽然HBV RNA水平有所下降,但HBV RNA阴转率无显著变化(>0.05)。治疗72个月及更长时间后,33例患者的HBV RNA水平低于100拷贝/毫升,其中29例患者的HBV RNA水平低于检测下限,HBV RNA阴转率具有统计学意义(<0.05)。较低的HBV RNA水平与较高的HBeAg阴转率相关(<0.05)。年龄和HBV RNA水平与HBeAg阴转率呈正相关(<0.05)。

结论

延长ETV抗病毒治疗可使CHB患者的HBV RNA清除效果更好,阴转率更高。抗病毒治疗时长和年龄与HBV RNA阴转率呈正相关,早期进行抗病毒治疗可取得更好的治疗效果。血清HBV RNA水平可作为预测接受ETV治疗的CHB患者HBeAg转阴的指标。

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