AASLD2018[557]血清HBV前基因组的意义 慢性乙型肝炎低HBs患者的RN

StephenW

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.

StephenW

557
血清HBV前基因组的意义
慢性乙型肝炎低HBs患者的RNA
继Peg-Interferon Alfa之后的乙型肝炎
治疗
王梦兰1，陈有明2，林炳良2，东营
谢2，洪登2，林朝双2，谢奇峰1，肖红
Zhang2和Zhiliang Gao1，（1）感染科
疾病，孙中山第三附属医院
中国广州大学，（2）传染病系
疾病，孙中山第三附属医院
大学
背景：乙型肝炎病毒前基因组RNA（HBV
pgRNA）是慢性乙型肝炎患者血清中存在的HBV RNA
乙型肝炎（CHB）患者。最近的研究揭示了它
是cccDNA活性的标志物。在这项研究中，我们讨论过
血清HBV pgRNA在CHB治疗中的意义
方法：入组标准：CHB患者达到
HBsAg <1500IU / mL，HBeAg阴性，HBV DNA <100IU / mL
与先前的核（t）ide模拟（NA）治疗切换
peg-interferon alfa（peg-IFNα）治疗。最长的
疗程为96周。治疗的终点是
的HBsAg <0.05IU / mL的。应对所有这些患者进行随访
停止治疗后至少24周。我们收集了
从peg-IFNα基线起每12周一次的血清样品
治疗和检测血清HBV pgRNA的高度敏感性
聚合酶链反应试验。结果：根据
随访期间是否有HBV DNA> 2000IU / mL
期间，我们将患者分为病毒性反弹（VR）组
没有病毒反弹（NVR）组。我们比较了临床
两组背景，发现HBsAg水平
VR组明显高于NVR组。在
第12周和治疗结束时，血清HBV的数量
pgRNA阳性患者分别为12（12/12），8（8/11），
在VR组中，只有6（6/14），1（1/17）的患者可以
检测NVR组血清HBV pgRNA。它建议
第12周的血清HBV pgRNA和停止时间接近
与治疗后病毒反弹的关系（p <0.05，p <0.001）。
分析基线血清HBV pgRNA，第12周，
第24周，peg-IFNα治疗第36周，我们发现了这个水平
HBV pgRNA在基线，第12周和第周时较高
在VR组中36。我们将患者分为四组：
第1组（0-10copies / mL），第2组（10-100copies / mL），组
3（100-1000copies / mL），第4组（> 1000copies / mL）依据
到基线HBV pgRNA水平，没有差异
在第1组和第2组之间，第3组和第4组，但是
第2组和第2组之间存在显着差异
3（p <0.05，图1）。结论：血清HBV pgRNA
戒烟可以预测治疗后病毒反弹的风险。
符合标准的患者：HBsAg <1500IU / mL，HBeAg
阴性，HBV DNA <200IU / mL，HBV pgRNA <100copies / mL
与先前的核（t）ide模拟（NA）治疗切换
peg-IFNα治疗具有较低的病毒复发率。后
12周peg-IFNα治疗，HBV pgRNA丢失也是如此
与病毒反弹风险降低显着相关。
应该对更多的患者进行进一步的研究
追求验证这些结论。