在长期核苷/核苷酸类似物治疗期间监测患者的血清HBV RNA，HBc

StephenW

Antivir Ther. 2018 Dec 4. doi: 10.3851/IMP3280. [Epub ahead of print]
Monitoring of serum HBV RNA, HBcrAg, HBsAg and anti-HBc levels in patients during long-term nucleoside/nucleotide analogue therapy.
Liao H1, Liu Y2, Li X2, Wang J1, Chen X1, Zou J1, Li Q2, Liu L2, Wang J2,3, Huang B2, Lu F1, Xu D2,3.
Author information

1
    Department of Microbiology & Infectious Disease Center, School of Basic Medical Sciences, Peking University Health Science Center, Beijing, China.
2
    Institute of Infectious Diseases, Beijing 302 Hospital, Beijing, China.
3
    Peking University 302 Clinical Medical School, Beijing, China.

Abstract
BACKGROUND:

This study was aimed at evaluating the clinical significance of serum hepatitis B virus (HBV) RNA, HBcrAg, and anti-HBc levels in chronic hepatitis B patients with undetectable HBV DNA during nucleoside/nucleotide analog (NA) treatment.
METHODS:

Fifty-seven patients who received long-term NA treatment of median 5.83 (4.67, 7.75) years were enrolled, and 285 serum samples at five time points for each patient were quantitatively analyzed for the three serum markers together with serum HBV DNA and HBsAg levels.
RESULTS:

The HBV RNA level significantly correlated with HBcrAg (r = 0.629, P < 0.001) but not HBsAg levels (P = 0.1460). Nonetheless, the HBcrAg level significantly correlated with the HBsAg level (r = 0.469, P < 0.001). HBeAg-positive samples showed higher HBV RNA, HBcrAg, and HBsAg levels than HBeAg-negative samples did (all P < 0.05). Nine patients with HBeAg loss manifested a significantly greater decline in HBV RNA and HBcrAg levels [1.84 (0.2, 3.19) log10 copies/mL, 1.14 (0.21, 2.76) log10 U/mL, respectively] compared to those in seven patients without HBeAg loss [0.74 (0.03, 1.34) log10 copies/mL and 0.41 (0.18, 0.73) log10 U/mL, respectively]. Overall, serum HBV RNA, HBcrAg, HBsAg, and anti-HBc levels gradually decreased with time during NA treatment. At the end of observation, HBV RNA and HBcrAg reached an undetectable level in 26 and six (46% and 11%) patients, respectively.
CONCLUSIONS:

Monitoring of HBV RNA and HBcrAg levels is useful for NA-treated patients with undetectable HBV DNA. The attainment of HBV RNA undetectability usually occurs prior to HBcrAg undetectability.

PMID:
    30511941
DOI:
    10.3851/IMP3280

StephenW

Antivir Ther。 2018年12月4日doi：10.3851 / IMP3280。 [提前打印]
在长期核苷/核苷酸类似物治疗期间监测患者的血清HBV RNA，HBcrAg，HBsAg和抗-HBc水平。
廖H1，刘Y2，李X2，王J1，陈X1，邹J1，李Q2，刘二，王J2,3，黄B2，吕F1，徐D2,3。
作者信息

1
    北京大学医学部基础医学院微生物与传染病中心，北京
2
    北京302医院感染科学研究所，北京
3
    北京大学302临床医学院，北京，中国。

抽象
背景：

本研究旨在评估核苷/核苷酸类似物（NA）治疗期间检测不到HBV DNA的慢性乙型肝炎患者血清乙型肝炎病毒（HBV）RNA，HBcrAg和抗-HBc水平的临床意义。
方法：

招募了57名接受长期NA治疗，中位数为5.83（4.67,7.75）年的患者，对每位患者的5个时间点的285份血清样本进行了三种血清标志物的血清HBV DNA和HBsAg水平的定量分析。 。
结果：

HBV RNA水平与HBcrAg显着相关（r = 0.629，P <0.001），但与HBsAg水平无显着相关（P = 0.1460）。尽管如此，HBcrAg水平与HBsAg水平显着相关（r = 0.469，P <0.001）。 HBeAg阳性样本显示出比HBeAg阴性样本更高的HBV RNA，HBcrAg和HBsAg水平（均P <0.05）。 9例HBeAg丢失患者的HBV RNA和HBcrAg水平显着下降[1.84（0.2,3.19）log10拷贝/ mL，分别为1.14（0.21,2.76）log10 U / mL]与7例无HBeAg丢失的患者相比[0.74（0.03,1.34）log10拷贝/ mL和0.41（0.18,0.73）log10U / mL，分别]。总体而言，在NA治疗期间，血清HBV RNA，HBcrAg，HBsAg和抗-HBc水平随时间逐渐降低。在观察结束时，HBV RNA和HBcrAg分别在26例和6例（46％和11％）患者中达不到检测水平。
结论：

监测HBV RNA和HBcrAg水平对于NA治疗的HBV DNA检测不到的患者非常有用。 HBV RNA不可检测性的获得通常发生在HBcrAg检测不到之前。

结论：
    30511941
DOI：
    10.3851 / IMP3280

neilhbver

非常有意义，文章说明对于广大大三阳免疫耐受阶段的携带者来说，治疗总是好的。