妊娠慢性乙型肝炎患者多民族队列血清乙型肝炎病毒RNA水平

StephenW

J Clin Virol. 2019 Jan 7;111:42-47. doi: 10.1016/j.jcv.2019.01.002. [Epub ahead of print]
Analysis of serum hepatitis B virus RNA levels in a multiethnic cohort of pregnant chronic hepatitis B carriers.
Patel NH1, Joshi SS2, Lau KCK2, Castillo E1, Coffin CS3.
Author information

1
    Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
2
    Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada.
3
    Department of Medicine, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada; Department of Microbiology, Immunology and Infectious Diseases, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada. Electronic address: [email protected].

Abstract
BACKGROUND:

Hepatitis B virus (HBV) flares have been reported due to alterations in the immune system during pregnancy. Recent studies in non-pregnant chronic hepatitis B (CHB) carriers have indicated that serum HBV RNA is a novel viral marker to assess treatment response and risk of disease flares.
OBJECTIVES:

To analyze serum HBV RNA levels in association with established HBV markers in pregnant and/or post-partum CHB carriers.
STUDY DESIGN:

In this prospective cohort study, serum and plasma were collected from 46 pregnant and/or post-partum CHB patients. Clinical data included demographics, hepatitis B e antigen (HBeAg) status (Abbott), quantitative hepatitis B s antigen (qHBsAg) levels (Abbott), HBV DNA (Abbott, sensitivity 10 IU/mL), alanine aminotransferase (ALT), liver stiffness measurement (LSM, post-partum), and treatment regime. Serum HBV total RNA and pre-genomic (pg)RNA were quantified using in-house assays, and HBV genotype was determined by direct population sequencing of HBV surface gene. Parametric and non-parametric statistical methods were used for analysis.
RESULTS:

In this study, we found that serum HBV total RNA levels correlated with the HBeAg status, HBV DNA, qHBsAg, ALT, and LSM while serum HBV pgRNA levels did not (p < 0.05, N = 46). Additionally, HBV total RNA & pgRNA levels increased, HBV DNA levels decreased, and qHBsAg levels remained unchanged throughout tenofovir disoproxil fumarate (TDF) treatment (N = 2).
CONCLUSIONS:

The associations between serum HBV total RNA with other validated markers indicates it may be a complementary HBV marker to monitor liver disease and HBV replication during pregnancy.

Copyright © 2019 Elsevier B.V. All rights reserved.
KEYWORDS:

CHB; MTCT; Pregnancy; Serum HBV RNA

PMID:
    30639847
DOI:
    10.1016/j.jcv.2019.01.002

StephenW

J Clin Virol。 2019年1月7日; 111：42-47。 doi：10.1016 / j.jcv.2019.01.002。 [提前打印]
妊娠慢性乙型肝炎患者多民族队列血清乙型肝炎病毒RNA水平分析。
Patel NH1，Joshi SS2，Lau KCK2，Castillo E1，Coffin CS3。
作者信息

1
    加拿大卡尔加里卡尔加里大学卡明医学院医学系。
2
    加拿大卡尔加里卡尔加里大学卡明医学院医学系;加拿大卡尔加里卡尔加里大学卡明医学院微生物学，免疫学和传染病系。
3
    加拿大卡尔加里卡尔加里大学卡明医学院医学系;加拿大卡尔加里卡尔加里大学卡明医学院微生物学，免疫学和传染病系。电子地址：[email protected]。

抽象
背景：

由于怀孕期间免疫系统的改变，已报道乙型肝炎病毒（HBV）突发。最近对非妊娠慢性乙型肝炎（CHB）携带者的研究表明，血清HBV RNA是评估治疗反应和疾病发作风险的新型病毒标记物。
目的：

分析怀孕和/或产后CHB携带者中与已建立的HBV标志物相关的血清HBV RNA水平。
学习规划：

在该前瞻性队列研究中，从46名孕妇和/或产后CHB患者中收集血清和血浆。临床数据包括人口统计学，乙型肝炎e抗原（HBeAg）状态（雅培），定量乙型肝炎抗原（qHBsAg）水平（雅培），HBV DNA（雅培，敏感性10 IU / mL），丙氨酸氨基转移酶（ALT），肝硬度测量（LSM，产后）和治疗方案。使用内部测定法定量血清HBV总RNA和前基因组（pg）RNA，并通过HBV表面基因的直接群体测序确定HBV基因型。参数和非参数统计方法用于分析。
结果：

在这项研究中，我们发现血清HBV总RNA水平与HBeAg状态，HBV DNA，qHBsAg，ALT和LSM相关，而血清HBV pgRNA水平则没有（p <0.05，N = 46）。此外，在替诺福韦地索普西富马酸盐（TDF）治疗中，HBV总RNA和pgRNA水平升高，HBV DNA水平降低，qHBsAg水平保持不变（N = 2）。
结论：

血清HBV总RNA与其他验证标志物之间的关联表明它可能是一种互补的HBV标志物，用于监测妊娠期间的肝脏疾病和HBV复制。

版权所有©2019 Elsevier B.V.保留所有权利。
关键词：

CHB;母婴传播;怀孕;血清HBV RNA

结论：
    30639847
DOI：
    10.1016 / j.jcv.2019.01.002