Hepatitis B Pregenomic RNA is Present in Virions in Plasma and is Associated With Response to Peginterferon and Nucleos(t)ide Analogues + Author Affiliations - 1Department of Gastroenterology and Hepatology, Academic Medical Center (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
- 2Department of Experimental Immunology, AMC, UvA, The Netherlands
- 3Department of Clinical Virology, AMC, UvA, The Netherlands
- Contact information corresponding author: L. Jansen, MD, Department of Gastroenterology and Hepatology, Academic Medical Center, University of Amsterdam, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands, Phone: +31 20 56 65 728, Fax: +31 20 56 69 582, E-mail: [email protected]
Abstract Background. Treatment of chronic hepatitis B (CHB) patients with nucleos(t)ide analogues (NAs) suppresses HBV-DNA production, but does not affect synthesis of the RNA pregenome (HBV-RNA). Whether HBV-RNA containing particles continue to be secreted into the bloodstream remains controversial. Methods. We developed a sensitive PCR-assay to measure HBV-RNA, which was quantified in supernatant of NA-treated HepG2-2.2.15 cells, plasma of 20 CHB patients on NA-therapy, and 86 patients treated with peginterferon-alfa-2a and adefovir. Results. Treatment of HepG2-2.2.15 cells with NAs for 9 days reduced HBV-DNA levels (-1.98 log10C/mL), whereas HBV-RNA levels increased (+0.47 log10C/mL, p<0.05). During long-term NA-treatment of CHB patients, HBV-RNA levels remained higher than HBV-DNA. Peginterferon-based treatment induced a stronger HBV-RNA decline than NA-monotherapy, and this decline was more pronounced in responders than in non-responders. In HBeAg-negative patients, a lower baseline plasma HBV-RNA level was independently associated with response to peginterferon and adefovir (OR 0.44, p=0.019). Immunoprecipitation with HBcAg-specific antibodies after removal of the HBsAg envelope demonstrated the association of plasma HBV-RNA with virions. Conclusions. HBV-RNA is present in virions in plasma of CHB patients. HBV-RNA levels vary significantly from established viral markers during antiviral treatment, which highlights its potential as an independent marker in the evaluation of CHB patients.
- © The Author 2015. Published by Oxford University Press on behalf of the Infectious Diseases Society of America. All rights reserved. For Permissions, please e-mail: [email protected].
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