Hao Kun-Yan, Fan Ye, Zhang Yi-Qing, Yu Yue-Cheng
Center of Hepatology and Department of Infectious Disease, Jinling Hospital Affiliated to School of Medicine, Nanjing University, Nanjing, China.
State Key Laboratory of Organ Failure Research, Guangdong Province key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, China.
Front Med (Lausanne). 2025 Jan 8;11:1525476. doi: 10.3389/fmed.2024.1525476. eCollection 2024.
The study aimed to explore the coexisting patterns and assess the significance of serum hepatitis B virus (HBV) RNA and traditional virological biomarkers in patients with antiviral treatment-naïve chronic hepatitis B virus (HBV) infection.
Serum HBV RNA, HBV DNA, hepatitis B surface antigen (HBsAg), and hepatitis B envelope antigen (HBeAg) levels were measured and compared in patients with chronic hepatitis B virus infection. The HBV RNA levels were determined using a simultaneous amplification and testing assay.
In the HBeAg-negative (HBeAg [-]) patients, the serum HBV RNA detectable (HBV RNA [+]) rate (33.33%, 14/42) was significantly lower than the serum HBV DNA detectable (HBV DNA [+]) rate (95.24%, 40/42; < 0.001). However, there was no significant difference in the HBeAg-positive (HBeAg [+]) patients ( > 0.05). The HBV RNA (+) rate (33.33%, 14/42) was lower in the HBeAg-negative patients than in the HBeAg-positive patients (100%, 17/17, < 0.001), while the HBV DNA (+) rate (95.24%, 40/42 vs. 94.12%, 16/17) showed no significant difference ( > 0.05). The HBV RNA (+) rates showed a significant difference ( < 0.001) among the different HBsAg levels (10.00, 65.00, 84.21%, < 0.001), while the HBV DNA (+) rate showed no significant difference ( > 0.05). In all patients, serum HBV RNA correlated well with HBV DNA ( = 0.72, < 0.001), HBeAg ( = 0.68, < 0.001), and HBsAg ( = 0.66, < 0.001). However, the correlations between HBV RNA and other biomarkers varied across the different HBsAg and HBeAg levels.
The coexisting patterns of serum HBV RNA and HBV DNA varied with the levels of HBeAg and HBsAg in the patients with treatment-naïve chronic HBV infection. This further suggests that serum HBV RNA should be included in the key index panel to accurately evaluate the natural history of HBV infection and the effects of antiviral treatment.
本研究旨在探讨初治慢性乙型肝炎病毒（HBV）感染患者血清HBV RNA与传统病毒学标志物的共存模式，并评估其意义。
对慢性乙型肝炎病毒感染患者的血清HBV RNA、HBV DNA、乙型肝炎表面抗原（HBsAg）和乙型肝炎e抗原（HBeAg）水平进行检测和比较。采用同步扩增检测法测定HBV RNA水平。
在HBeAg阴性（HBeAg[-]）患者中，血清HBV RNA可检测到（HBV RNA[+]）率（33.33%，14/42）显著低于血清HBV DNA可检测到（HBV DNA[+]）率（95.24%，40/42；<0.001）。然而，在HBeAg阳性（HBeAg[+]）患者中无显著差异（>0.05）。HBeAg阴性患者的HBV RNA（+）率（33.33%，14/42）低于HBeAg阳性患者（100%，17/17，<0.001），而HBV DNA（+）率（95.24%，40/42 vs. 94.12%，16/17）无显著差异（>0.05）。不同HBsAg水平之间的HBV RNA（+）率存在显著差异（<0.001），而HBV DNA（+）率无显著差异（>0.05）。在所有患者中，血清HBV RNA与HBV DNA（=0.72，<0.001）、HBeAg（=0.68，<0.001）和HBsAg（=0.66，<0.001）均具有良好的相关性。然而，HBV RNA与其他生物标志物之间的相关性在不同的HBsAg和HBeAg水平上有所不同。
初治慢性HBV感染患者血清HBV RNA与HBV DNA的共存模式随HBeAg和HBsAg水平而变化。这进一步表明，血清HBV RNA应纳入关键指标组，以准确评估HBV感染的自然史和抗病毒治疗效果。
