AASLD2018[2108]血清HBV RNA的关系 自然界中的水平和其他病毒标记

StephenW

2108
The Relationship between Serum HBV RNA
Levels and Other Viral Markers in the Natural
History of Chronic HBV Infection
Umaporn Limothai1, Natthaya Chuaypen1, Yong Poovorawan2
and Pisit Tangkijvanich1, (1)Center of Excellence in Hepatitis
and Liver Cancer, Faculty of Medicine, Chulalongkorn
University, (2)Center of Excellence in Clinical Virology, Faculty
of Medicine, Chulalongkorn University
Background: Hepatitis B virus (HBV) RNA quantification is
a novel serum marker reflecting the activity of intrahepatic
covalently closed circular DNA (cccDNA). The aim of this
study was to examine the relationship between serum HBV
RNA and other viral markers in different phases of the natural
history of chronic HBV infection. Methods: Serum HBV
markers at initial presentation of 423 treatment-naïve patients
were retrospectively analyzed. Patients were classified into
4 groups based on the AASLD guideline as following: phase
1; Immune-tolerant phase (N=47), phase 2; HBeAg-positive
immune-active phase (N=91), phase 3; Inactive CHB phase
(N=158) and phase 4; HBeAg-negative immune reactivation
phase (N=127). Serum HBV RNA was quantified by a droplet
digital PCR amplification. Results: Serum levels of HBV
DNA, HBV RNA and HBsAg were lowest in phase 3 and
highest in phase 1. The mean levels of serum HBV RNA in the
respective 4 phases were 6.70±0.68, 6.44±1.78, 2.14±0.65
and 3.45±1.46 (log10 copies/ml). Serum HBV RNA levels
were positively correlated with serum HBV DNA in phase 1
(Pearson, r=0.586, P<0.001), phase 2 (r=0.475, P<0.001)
and phase 4 (r=0.771, P<0.001) but not in phase 3 (r=0.090,
P=0.262). The correlations between serum HBV RNA and
HBsAg were found only in phase 1 (r=0.536, P<0.001) and
phase 2 (r=0.438, P<0.001). Among patients undergoing liver
biopsy, the data showed that serum HBV RNA correlated with
intrahepatic cccDNA in phase 2 (n=20, r=0.499, P=0.025) and
in phase 4 (r=0.338, P=0.004). However, serum HBsAg levels
correlated with intrahepatic cccDNA only in phase 2 (r=0.456,
P=0.043) but not in phase 4 (r=0.049, P=0.685). Conclusion:
Serum HBV RNA levels varied among different phases of
chronic HBV infection. Compared with HBsAg quantification,
serum HBV RNA levels exhibited a better surrogate serum
marker reflecting the amount of intrahepatic cccDNA.
These findings suggest that serum HBV RNA quantification
represents a useful marker for disease monitoring in patients
with chronic HBV infection.

StephenW

2108
血清HBV RNA的关系
自然界中的水平和其他病毒标记
慢性HBV感染史
Umaporn Limothai1，Natthaya Chuaypen1，Yong Poovorawan2
和Pisit Tangkijvanich1，（1）肝炎卓越中心
和朱拉隆功的医学院肝癌
大学，（2）临床病毒学卓越中心，学院
朱拉隆功大学医学院
背景：乙型肝炎病毒（HBV）RNA定量分析
一种反映肝内活动的新型血清标志物
共价闭合环状DNA（cccDNA）。这个目的
研究是为了检查血清HBV之间的关系
RNA和其他病毒标记物在天然的不同阶段
慢性HBV感染史。方法：血清HBV
最初呈现423名未接受过治疗的患者的标记物
进行回顾性分析。患者被分类为
4组基于AASLD指南如下：阶段
1;免疫耐受期（N = 47），第2阶段; HBeAg阳性
免疫活性期（N = 91），第3阶段;无活性的CHB期
（N = 158）和第4阶段; HBeAg阴性免疫再激活
阶段（N = 127）。通过液滴定量血清HBV RNA
数字PCR扩增。结果：血清HBV水平
DNA，HBV RNA和HBsAg在3期和3期最低
第1阶段最高。血清HBV RNA的平均水平
相应的4个阶段分别为6.70±0.68,6.44±1.78,2.14±0.65
和3.45±1.46（log10拷贝/ ml）。血清HBV RNA水平
与1期血清HBV DNA呈正相关
（Pearson，r = 0.586，P <0.001），第2阶段（r = 0.475，P <0.001）
和阶段4（r = 0.771，P <0.001）但不在阶段3（r = 0.090，
P = 0.262）。血清HBV RNA与肝细胞癌的相关性
HBsAg仅在第1阶段发现（r = 0.536，P <0.001）和
第2阶段（r = 0.438，P <0.001）。在接受肝脏的患者中
活检，数据显示血清HBV RNA与之相关
2期肝内cccDNA（n = 20，r = 0.499，P = 0.025）和
在第4阶段（r = 0.338，P = 0.004）。但是，血清HBsAg水平
仅在第2阶段与肝内cccDNA相关（r = 0.456，
P = 0.043）但不在第4阶段（r = 0.049，P = 0.685）。结论：
不同时期血清HBV RNA水平不同
慢性HBV感染。与HBsAg定量相比，
血清HBV RNA水平表现出更好的替代血清
标记反映了肝内cccDNA的数量。
这些发现提示血清HBV RNA定量
代表了患者疾病监测的有用标志物
患有慢性HBV感染。