Analysis of serum hepatitis B virus RNA levels among HBsAg and HBsAb copositive patients and its correlation with HBV DNA
Yu Xiang 1 , Yang Yang 1 , Pu Chen 1 , Xiaofei Lai 1 , Shan Shi 1 , Shuang Li 2 , Wenxian You 3
Affiliations
Affiliations
1
Department of Laboratory Medicine, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
2
Department of General Surgery, Jinshan Hospital, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
3
Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
PMID: 34622857 DOI: 10.1097/MD.0000000000027433
Abstract
There are approximately 2 billion HBV-infected individuals worldwide, and approximately 1.87% to 7% of these individuals are copositive for HBsAg and HBsAb.Our study detected hepatitis B virus pgRNA (HBV RNA) levels in HBsAg and HBsAb copositive patients and then analyzed the correlation with HBV DNA, HBsAg, ALT, and AST levels. A total of 149 HBsAg and HBsAb copositive patients were identified from 66,617 outpatients.HBV RNA, HBV DNA, HBsAg, ALT, and AST serum levels were significantly different in different natural phases of HBV infection (immune tolerance phase, immune clearance phase, low replication phase, and reactivation phase) with statistical significance (P < .01). HBV RNA levels were positively correlated with HBV DNA, HBsAg, ALT, and AST levels. HBV RNA and HBV DNA levels were significantly increased in the HBeAg-positive group (66 patients) compared with the HBeAg-negative group (83 patients) (P < .01). In the HBeAg-positive group, HBV RNA levels were positively correlated with HBV DNA and HBsAg levels. In the HBeAg-negative group, HBV RNA levels were positively correlated with HBV DNA. Serum HBV RNA levels were positively correlated with HBV DNA, HBsAg, ALT, and AST levels.HBV RNA could be used as a virological indicator for antiviral therapy in HBsAg and HBsAb copositive hepatitis B patients.
The coexistence of HBsAg and anti-HBs in patients with CHB infection has been reported. Various factors can lead to the coexistence of HBsAgs and anti-HBs[17–20]: genetic mutation in the S or pre-S region of HBV causes a change in the immunogenicity of the “a” determinant of surface antigen; infection of the mutant HBV strain or double infection or successive infection of different subtypes of HBV; and genetic mutation induced by long-term medication. A total of 66,617 samples of HBV serological markers were screened in this study, and 149 that were HBsAg and HBsAb copositive were selected for analysis.