Ye Feng, Zhao Wenjuan, Yang Xueliang, Zhang Xi, An Xiaocui, Zhu Ruixue, Chen Yunru, Liu Xiaojing, Li Jianzhou, Li Kang, Zheng Jie, Lin Shumei, Shi Lei
Department of Infectious Diseases, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
Ann Transl Med. 2022 Aug;10(16):897. doi: 10.21037/atm-22-3265.
Whether the decline of hepatitis B virus (HBV) RNA was associated with antiviral efficacy in chronic hepatitis B (CHB) patients receiving long-term nucleos(t)ide analogues (NAs) therapy remains unclear. We observed the levels of serum HBV RNA in CHB patients treated with entecavir (ETV) for 10 years and explored the clinical significance of HBV RNA during long-term antiviral treatment.
A total of 33 hepatitis B surface antigen (HBsAg)-positive CHB patients treated with ETV for up to 10 years were recruited for this study. Liver function, HBsAg, hepatitis B envelope antigen (HBeAg), HBV DNA, and HBV RNA were measured at the baseline and each follow-up points. Antiviral efficacy was defined as negative HBV DNA (<20 IU/mL) and HBV RNA (<300 Copies/mL).
(I) Serum HBV DNA and HBV RNA declined with the duration of antiviral treatment over 10 years (P<0.001). (II) There were positive correlations between serum HBV DNA and HBV RNA at each follow-up point (r=0.62 and P<0.001 at baseline, r=0.77 and P<0.001 at week 24, r=0.71 and P<0.001 at week 48, r=0.81 and P<0.001 at week 96, r=0.60 and P<0.01 at year 5 and r=0.77 and P<0.001 at year 10). (III) HBeAg and HBsAg levels at baseline and 10th year after ETV treatment have significant difference (P<0.05 and P<0.01). (IV) The decline of HBV RNA after ETV treatment was associated with HBeAg seroconversion, the area under the ROC curves (AUROCs) of the declines of HBV RNA were 0.25 at the baseline, 0.62 at week 24, 0.78 at week 48 and 0.86 at week 96, respectively. (V) The decline of HBV RNA after ETV treatment was associated with antiviral efficacy, the AUROCs of the declines of HBV RNA were 0.33 at the baseline, 0.74 at week 24, 0.83 at week 48 and 0.86 at week 96, respectively.
Serum HBV DNA and HBV RNA declined with the duration of antiviral treatment over 10 years. The decline of HBV RNA was associated with HBeAg seroconversion and antiviral efficacy in CHB patients receiving long-term ETV therapy, and the earliest prediction point was week 24.
在接受长期核苷（酸）类似物（NA）治疗的慢性乙型肝炎（CHB）患者中，乙型肝炎病毒（HBV）RNA的下降是否与抗病毒疗效相关尚不清楚。我们观察了接受恩替卡韦（ETV）治疗10年的CHB患者的血清HBV RNA水平，并探讨了长期抗病毒治疗期间HBV RNA的临床意义。
本研究共纳入33例接受ETV治疗长达10年的乙型肝炎表面抗原（HBsAg）阳性CHB患者。在基线和每个随访点测量肝功能、HBsAg、乙型肝炎e抗原（HBeAg）、HBV DNA和HBV RNA。抗病毒疗效定义为HBV DNA阴性（<20 IU/mL）和HBV RNA阴性（<300拷贝/mL）。
（I）血清HBV DNA和HBV RNA随着10年抗病毒治疗时间的延长而下降（P<0.001）。（II）在每个随访点，血清HBV DNA与HBV RNA之间均呈正相关（基线时r=0.62，P<0.001；第24周时r=0.77，P<0.001；第48周时r=0.71，P<0.001；第96周时r=0.81，P<0.001；第5年时r=0.60，P<0.01；第10年时r=0.77，P<0.001）。（III）ETV治疗基线时和第10年时的HBeAg和HBsAg水平有显著差异（P<0.05和P<0.01）。（IV）ETV治疗后HBV RNA的下降与HBeAg血清学转换相关，HBV RNA下降的ROC曲线下面积（AUROCs）在基线时为0.25，第24周时为0.62，第48周时为0.78，第96周时为0.86。（V）ETV治疗后HBV RNA的下降与抗病毒疗效相关，HBV RNA下降的AUROCs在基线时为0.33，第24周时为0.74，第48周时为0.83，第96周时为0.86。
血清HBV DNA和HBV RNA随着10年抗病毒治疗时间的延长而下降。在接受长期ETV治疗的CHB患者中，HBV RNA的下降与HBeAg血清学转换和抗病毒疗效相关，最早的预测点为第24周。
