Hepatology. 2018 Mar 7. doi: 10.1002/hep.29872. [Epub ahead of print]
Host and viral factors associated with serum hepatitis B virus RNA levels among patients in need for treatment.
Van Campenhout MJH1, van Bömmel F2, Pfefferkorn M2, Fischer J2, Deichsel D2, Boonstra A1, van Vuuren AJ1, Berg T2, Hansen BE1, 3, 4, Janssen HLA1, 4.
Author information
1
Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
2
University Hospital Leipzig, Department of Gastroenterology and Rheumatology, Section of Hepatology, Leipzig, Germany.
3
Institute of Health Policy, Management and Evaluation, University of Toronto.
4
Toronto Center for Liver Disease, Toronto Western and General Hospital, University Health Network, Toronto, Canada.
Abstract
The use of RACE PCR technique (lower limit of detection 800 copies/ mL [c/mL]), serum HBV RNA levels were measured in samples of 488 untreated individuals with chronic HBV infection who were eligible to treatment according to currently used recommendations. We explored the association of serum levels of HBV RNA with patient and virus associated Factors. HBV genotype distribution was 21/10/20/46/3% for A/B/C/D/other. Mean HBV RNA serum level was 5.9 (1.6) log10 c/mL (HBeAg-positive CHB: 6.5 [1.2 ] log c/mL, HBeAg-negative CHB: 4.1 [1.2] log c/mL; p<0.001). By multivariable linear regression, factors associated with lower HBV RNA level were HBeAg-negativity (β=-0.69, p<0.001 ), HBV genotypes A (β=-0.13, p=0.002), B (β=-0.07, p=0.049) and C (β=-0.61, p<0.001) in comparison to D, and presence Of HBV basal core promoter mutation alone alone (β=-0.14, p=0.001) or in combination with precore mutation (β=-0.22, p<0.001). Higher serum ALT was associated with higher HBV RNA (β=0.23, p <0.001). HBV RNA staining strongly with HBV DNA (HBeAg-pos: r=0.72, p<0.001; HBeAg-neg: r=0.78, p<0.001), and moderately with qHBsAg (HBeAg-pos: r=0.54, p<0.001; HBeAg-neg: r=0.19, p=0.04) and qHBeAg (r=0.41, p<0.001).
CONCLUSION:
In this multi-ethnic cohort of 488 untreated individuals with chronic hepatitis B, factors associated with serum HBV RNA level were HBeAg status, serum ALT, HBV genotype, and presence of basal core promotor mutations. For the future use of serum HBV RNA as a Clinical marker it seems mandatory to take these factors in consideration. This article is protected by copyright. All rights reserved.