Key Laboratory of Molecular Biology for Infectious Diseases, Ministry of Education, Institute for Virus Hepatitis and Department of Infectious Diseases, The Second Affiliated Hospital of Chongqing Medical University, 76 Linjiang Road, Yuzhong, Chongqing 400010, China.
Can J Gastroenterol Hepatol. 2022 Sep 13;2022:8422242. doi: 10.1155/2022/8422242. eCollection 2022.
Serum HBV-RNA levels can predict antiviral response in chronic hepatitis B (CHB) patients; however, its role in HBV-related ACLF (HBV-ACLF) remains unclear. Here, we determined its implications for HBV-ACLF.
Baseline serum HBV-RNA levels were retrospectively detected in HBV-ACLF and CHB patients. The association of serum HBV-RNA level with clinical outcomes was evaluated by performing multiple logistic regression. A nomogram was developed to formulate an algorithm incorporating serum HBV-RNA for predicting the survival of HBV-ACLF patients. After being discharged from the hospital, the HBV-ACLF patients were followed up for 36 weeks.
In this study, 82 HBV-ACLF patients and 33 CHB patients were included. Serum HBV-RNA levels were significantly higher in CHB patients than in HBV-ACLF patients (4.15 ± 2.63 log10 copies/mL VS 5.37 ± 2.02 log10 copies/mL) ( < 0.05). Among the HBV-ACLF cases, patients with poor outcomes had lower serum HBV-RNA levels, but the difference was not significant. The area under the receiver operating characteristic curve of the serum HBV-RNA inclusive model was 0.745, superior to 0.66 from MELD scores ( < 0.05). During the follow-up for four weeks, the serum HBV-RNA levels, especially in the survival group, were found to be lower than the baseline levels.
Serum HBV-RNA levels were associated with disease severity and might predict the long-term clinical outcome of HBV-ACLF patients.
血清 HBV-RNA 水平可预测慢性乙型肝炎（CHB）患者的抗病毒反应；然而，其在 HBV 相关慢加急性肝衰竭（HBV-ACLF）中的作用尚不清楚。本研究旨在探讨其在 HBV-ACLF 中的意义。
回顾性检测 HBV-ACLF 和 CHB 患者的基线血清 HBV-RNA 水平。采用多因素逻辑回归分析血清 HBV-RNA 水平与临床结局的关系。建立列线图，纳入血清 HBV-RNA 构建算法，预测 HBV-ACLF 患者的生存情况。患者出院后随访 36 周。
本研究共纳入 82 例 HBV-ACLF 患者和 33 例 CHB 患者。CHB 患者的血清 HBV-RNA 水平明显高于 HBV-ACLF 患者（4.15±2.63 log10 拷贝/ml 比 5.37±2.02 log10 拷贝/ml）（ < 0.05）。在 HBV-ACLF 患者中，预后不良患者的血清 HBV-RNA 水平较低，但差异无统计学意义。包含血清 HBV-RNA 的模型的受试者工作特征曲线下面积为 0.745，优于 MELD 评分（0.66）（ < 0.05）。在为期四周的随访中，血清 HBV-RNA 水平，尤其是在生存组中，均低于基线水平。
血清 HBV-RNA 水平与疾病严重程度相关，可能预测 HBV-ACLF 患者的长期临床结局。
