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[长期抗病毒治疗的慢性乙型肝炎患者血清乙肝病毒前基因组RNA谱]

[Serum hepatitis B virus pregenomic RNA profiles in patients with chronic hepatitis B on long-term antiviral therapy].

作者信息

Pan J L, Luo H, Zhang X X, Han Y F, Chen H Y, Zeng Z, Xu X Y

机构信息

Department of Infectious Diseases, Peking University First Hospital, Beijing 100034, China.

Department of Gastroenterology, National Center of Gerontology, Beijing Hospital, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing 100005, China.

出版信息

Zhonghua Gan Zang Bing Za Zhi. 2024 Jan 20;32(1):16-21. doi: 10.3760/cma.j.cn501113-20230814-00054.

Abstract

To explore the clinical changes in levels of the new clinical marker serum hepatitis B virus (HBV) pregenomic RNA (pgRNA) in patients with chronic hepatitis B (CHB) with long-term antiviral therapy. 100 CHB cases who were initially treated with nucleos(t)ide analogues (NAs) at Peking University First Hospital were included. The levels of alanine aminotransferase (ALT), HBV DNA, hepatitis B e-antigen (HBeAg), and hepatitis B surface antigen (HBsAg) during the follow-up period were measured. The TaqMan-based real-time quantitative PCR method was used to detect serum HBV pgRNA levels. The independent sample -test and Mann-Whitney test were used to compare continuous variables between groups, while Pearson's (2) test and Fisher's exact test were used to compare categorical variables. HBV pgRNA levels decreased significantly in patients who developed virological responses at 48 weeks ( = 54) during subsequent treatment compared to those who did not ( = 46). The HBV pgRNA level was lower in HBeAg-positive patients than in HBeAg-negative patients ( < 0.05 or < 0.01). Patients with higher HBV DNA and HBeAg-positivity levels at baseline had a higher HBV pgRNA level following antiviral therapy. There was no statistically significant difference in HBV pgRNA levels in patients with different HBV pgRNA levels at baseline after antiviral therapy. There was no correlation between serum HBV pgRNA and HBsAg at baseline, but there was a correlation after long-term antiviral therapy, while there was a weak correlation between HBV pgRNA and HBsAg at the fifth and ninth years of antiviral therapy ( = 0.262, = 0.031; = 0.288, = 0.008). HBV pgRNA levels were higher with higher HBV activity in CHB patients with long-term antiviral therapy.

摘要

为探讨慢性乙型肝炎(CHB)患者长期抗病毒治疗过程中新型临床标志物血清乙型肝炎病毒(HBV)前基因组RNA(pgRNA)水平的临床变化。纳入100例最初在北京医科大学第一医院接受核苷(酸)类似物(NAs)治疗的CHB患者。检测随访期间丙氨酸氨基转移酶(ALT)、HBV DNA、乙型肝炎e抗原(HBeAg)和乙型肝炎表面抗原(HBsAg)水平。采用基于TaqMan的实时定量PCR方法检测血清HBV pgRNA水平。采用独立样本t检验和Mann-Whitney检验比较组间连续变量,采用Pearson卡方检验和Fisher精确检验比较分类变量。与未发生病毒学应答的患者(n = 46)相比,在后续治疗48周时发生病毒学应答的患者(n = 54)的HBV pgRNA水平显著下降。HBeAg阳性患者的HBV pgRNA水平低于HBeAg阴性患者(P < 0.05或P < 0.01)。基线时HBV DNA和HBeAg阳性水平较高的患者在抗病毒治疗后HBV pgRNA水平较高。抗病毒治疗后,基线时不同HBV pgRNA水平的患者的HBV pgRNA水平无统计学显著差异。基线时血清HBV pgRNA与HBsAg之间无相关性,但长期抗病毒治疗后存在相关性,而在抗病毒治疗的第5年和第9年HBV pgRNA与HBsAg之间存在弱相关性(r = 0.262,P = 0.031;r = 0.288,P = 0.008)。长期抗病毒治疗的CHB患者中,HBV活性越高,HBV pgRNA水平越高。

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