Zuo Zhongbao, Wu Jing, Wang Miaochan, Wu Rui, Zhang Xiaojing, Hu Lanlan, Cui Huaizhong, Feng Ting, Xu Aifang, Liu Shourong
Department of Clinical Laboratory, Hangzhou Xixi Hospital, Zhejiang, 310023, People's Republic of China.
Department of Hepatology, Hangzhou Xixi Hospital, Zhejiang, 310023, People's Republic of China.
Int J Gen Med. 2024 Oct 15;17:4669-4680. doi: 10.2147/IJGM.S480283. eCollection 2024.
This study aimed to explore serum HBV pre-genomic RNA (pgRNA) levels and its associated factors among HBV-infected patients in the real world.
This retrospective cohort study was conducted from May 10, 2023, to January 15, 2024. Univariate logistic analysis for positive serum HBV pgRNA was performed first, and variables with statistical significance were included in a multivariate logistic model. A decreasing trend of serum HBV pgRNA and HBV DNA levels was also detected first by univariate logistic regression and then by multivariate logistic regression.
482 patients were included in our analysis at baseline, and 191 patients were followed up. Multivariate logistic regression revealed that positive HBV DNA (AOR: 2.63, 95% CI: 1.46-4.75, P=0.001), ≥1000 hBsAg (AOR: 2.29, 95% CI: 1.08-4.89, P=0.03), positive HBeAg (AOR: 28.26, 95% CI: 15.2-52.55, P<0.001), and ALP (AOR: 1.01, 95% CI: 1.001-1.02, P=0.03) were positively correlated with positive HBV pgRNA at baseline. Two independent multivariate logistic regression models were constructed for the decreasing trend of serum HBV pgRNA and HBV DNA for the 191 follow-up patients. Results showed that the decreasing trend of HBV pgRNA was positively correlated with positive baseline HBV DNA (AOR: 4.60, 95% CI: 1.84-11.51, P=0.001), baseline HBsAg ≥1000 IU/mL (AOR: 8.74, 95% CI: 1.09-70.10, P=0.04), and HDL (AOR: 5.01, 95% CI: 1.28-19.66, P=0.02). The decreasing trend of HBV DNA was positively correlated with positive baseline HBV pgRNA (AOR: 3.80, 95% CI: 2.00-8.83, P<0.001) and AST (AOR: 1.06, 95% CI: 1.03-1.08, P<0.001).
Our study revealed that HBV DNA, HBsAg, HBeAg, and ALP were significantly correlated with positive HBV pgRNA at baseline. The baseline HBV DNA, HBsAg, and HDL were significantly correlated with decreasing levels of HBV pgRNA. A decreasing trend of HBV DNA significantly correlated with patients' baseline HBV pgRNA and AST.
本研究旨在探讨真实世界中乙肝病毒（HBV）感染患者的血清乙肝病毒前基因组RNA（pgRNA）水平及其相关因素。
本回顾性队列研究于2023年5月10日至2024年1月15日进行。首先对血清HBV pgRNA阳性进行单因素逻辑回归分析，将具有统计学意义的变量纳入多因素逻辑模型。先通过单因素逻辑回归，再通过多因素逻辑回归检测血清HBV pgRNA和HBV DNA水平的下降趋势。
482例患者纳入基线分析，191例患者接受随访。多因素逻辑回归显示，基线时HBV DNA阳性（比值比[AOR]：2.63，95%置信区间[CI]：1.46 - 4.75，P = 0.001）、HBsAg≥1000（AOR：2.29，95% CI：1.08 - 4.89，P = 0.03）、HBeAg阳性（AOR：28.26，95% CI：15.2 - 52.55，P < 0.001）和碱性磷酸酶（ALP）（AOR：1.01，95% CI：1.001 - 1.02，P = 0.03）与HBV pgRNA阳性呈正相关。为191例随访患者构建了两个独立的多因素逻辑回归模型，用于分析血清HBV pgRNA和HBV DNA的下降趋势。结果显示，HBV pgRNA的下降趋势与基线时HBV DNA阳性（AOR：4.60，95% CI：1.84 - 11.51，P = 0.001）、基线HBsAg≥1000 IU/mL（AOR：8.74，95% CI：1.09 - 70.10，P = 0.04）和高密度脂蛋白（HDL）（AOR：5.01，95% CI：1.28 - 19.66，P = 0.02）呈正相关。HBV DNA的下降趋势与基线时HBV pgRNA阳性（AOR：3.80，95% CI：2.00 - 8.83，P < 0.001）和谷草转氨酶（AST）（AOR：1.06，95% CI：1.03 - 1.08，P < 0.001）呈正相关。
我们的研究表明，基线时HBV DNA、HBsAg、HBeAg和ALP与HBV pgRNA阳性显著相关。基线HBV DNA、HBsAg和HDL与HBV pgRNA水平下降显著相关。HBV DNA的下降趋势与患者基线时的HBV pgRNA和AST显著相关。
