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557
The Significance of Serum HBV Pregenomic
RNA in Patients with Low HBsAg Chronic
Hepatitis B Following Peg-Interferon Alfa
Therapy
Menglan Wang1, Youming Chen2, Bingliang Lin2, Dongying
Xie2, Hong Deng2, Chaoshuang Lin2, Qifeng Xie1, Xiaohong
Zhang2 and Zhiliang Gao1, (1)Department of Infectious
Diseases, The Third Affiliated Hospital of Sun Yat-Sen
University,Guangzhou,China, (2)Department of Infectious
Diseases, The Third Affiliated Hospital of Sun Yat-Sen
University
Background: Hepatitis B virus pregenomic RNA(HBV
pgRNA) is the HBV RNA present in the serum of chronic
hepatitis B(CHB) patients. Recent research has revealed it
was a marker for cccDNA activity. In this study, we discussed
the significance of serum HBV pgRNA in CHB treatment.
Methods: Entry criteria: CHB patients who achieved
HBsAg<1500IU/mL, HBeAg negative, HBV DNA<100IU/mL
with previous nucleos(t)ide analogue(NA) therapy switched
to peg-interferon alfa(peg-IFN α) treatment. The longest
course of treatment is 96 weeks. The endpoint of treatment is
HBsAg<0.05IU/mL. All these patients should be followed up
at least 24 weeks after cessation of treatment. We collected
the serum samples each 12 weeks from baseline of peg-IFN α
therapy and detected serum HBV pgRNA by a highly sensitive
polymerase chain reaction assay. Results: According to
whether there was HBV DNA>2000IU/mL during the follow-up
period, we divided the patients into viral rebound(VR) group
and no viral rebound(NVR) group. We compared the clinical
background of the two groups and found the HBsAg level of
VR group was significantly higher than NVR group. At the
week 12 and the end of treatment, the number of serum HBV
pgRNA-positive patients were 12(12/12),8(8/11), respectively,
in VR group while there was only 6(6/14) ,1(1/17) patients can
detect the serum HBV pgRNA in NVR group. It suggested
that serum HBV pgRNA of week 12 and cessation had close
relationship with off-therapy viral rebound(p<0.05,p<0.001).
Analyzing with serum HBV pgRNA of baseline, week 12,
week 24, week 36 of peg-IFN α treatment, we found the level
of HBV pgRNA was higher at baseline, week 12 and week
36 in VR group. We divided the patients into four groups:
group 1(0-10copies/mL), group 2(10-100copies/mL), group
3(100-1000copies/mL), group 4 (>1000copies/mL) according
to the level of baseline HBV pgRNA, there were no difference
between group 1 and group 2, group 3 and group 4, but
there was significant difference between group 2 and group
3(p<0.05,Figure 1). Conclusion: Serum HBV pgRNA of
cessation can predict the risk of off-therapy viral rebound.
Patients who meet the criteria: HBsAg<1500IU/mL, HBeAg
negative, HBV DNA<200IU/mL, HBV pgRNA<100copies/mL
with previous nucleos(t)ide analogue(NA) therapy switched
to peg-IFN α treatment have lower rate of viral relapse. After
12 weeks peg-IFN α treatment, HBV pgRNA loss is also
dramatically associated with the lower risk of viral rebound.
Further studies with larger groups of patients should be
pursued to verify these conclusions. |
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