血清HBV RNA定量：用于监测慢性乙型肝炎感染的自然史

StephenW

BMC Gastroenterol. 2019 Apr 16;19(1):53. doi: 10.1186/s12876-019-0966-4.
Serum HBV RNA quantification: useful for monitoring natural history of chronic hepatitis B infection.
Liu Y1, Jiang M1, Xue J1, Yan H2, Liang X3.
Author information

1
    Department of Infectious Diseases, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China.
2
    Department of Reproductive Medicine Center, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China. [email protected].
3
    Department of Infectious Diseases, Changhai Hospital, Second Military Medical University, 168 Changhai Road, Shanghai, 200433, China. [email protected].

Abstract
BACKGROUND:

As an alternative biomarker of intrahepatic covalently closed circular DNA (cccDNA) transcriptional activity, hepatitis B virus (HBV) RNA may evolve during long-lasting virus-host interactions during chronic hepatitis B viral infection. The distribution pattern of serum HBV RNA levels in the natural course of chronic HBV infection remains unclear. The aim of this study was to evaluate the levels of HBV RNA during the natural course of CHB and the role in distinguishing the natural history of HBV infection.
METHODS:

A total of 291 treatment-naïve chronic HBV carriers were enrolled. Based on the clinical, biochemical, serological, and histological data as well as HBV DNA levels, patients were classified into the following four categories: the immune-tolerant phase (IT,n = 35), HBeAg-positive immune-active phase (EPIA,n = 121), inactive chronic hepatitis B(ICH,n = 58) and HBeAg-negative immune reactive hepatitis (ENH,n = 77). The parameters and distribution patterns of serum HBV RNA were evaluated in relation to viral replication status, immune phase, disease category and Child-Pugh class. The relationships between serum HBV RNA and other serum hepatitis B viral markers were also analyzed.
RESULTS:

Serum HBV RNA levels were significantly lower in the HBeAg-negative patients compared to those in the HBeAg-positive patients, with the lowest levels seen in inactive carriers. In HBeAg-negative patients, serum HBV RNA levels increased if there is reactivation to active hepatitis and showed obvious superiority for the combination of serum HBV DNA (cutoff>3.39 Log copies/mL) and HBsAg (cutoff>2.74 Log IU/mL) in discriminating between 'HBeAg-negative immune reactive' phase and inactive chronic hepatitis B phases of HBeAg-negative chronic HBV infection. Serum HBV RNA levels were positively correlated with serum HBV DNA and HBsAg levels in all chronic HBV-infected patients. A stratified analysis revealed that a correlation between serum HBV RNA and HBV DNA or HBsAg was present in HBeAg-positive patients; however, in HBeAg-negative patients, serum HBV RNA was positively correlated with HBV DNA only.
CONCLUSION:

During the natural course of chronic HBV infection, serum HBV RNA levels vary. Serum HBV RNA can act as a biomarker to predict the natural history of disease in chronic hepatitis B patients. In treatment-naïve HBeAg-negative chronic HBV-infected individuals, serum HBV RNA shows superiority in differentiating the 'HBeAg-negative reactive' phase.
KEYWORDS:

Hepatitis B e antigen (HBeAg); Hepatitis B surface antigen (HBsAg); Hepatitis B virus (HBV); Natural history; Pregenomic RNA (pgRNA)

PMID:
    30991954
DOI:
    10.1186/s12876-019-0966-4

StephenW

BMC Gastroenterol。 2019年4月16日; 19（1）：53。 doi：10.1186 / s12876-019-0966-4。
血清HBV RNA定量：用于监测慢性乙型肝炎感染的自然史。
刘Y1，江M1，薛继1，严H2，梁X3。
作者信息

1
    第二军医大学长海医院感染科，上海市长海路168号，200433
2
    第二军医大学长海医院生殖医学中心，上海市长海路168号，200433 [email protected]。
3
    第二军医大学长海医院感染科，上海市长海路168号，200433 [email protected]。

抽象
背景：

作为肝内共价闭合环状DNA（cccDNA）转录活性的替代生物标志物，乙型肝炎病毒（HBV）RNA可在慢性乙型肝炎病毒感染期间的长期病毒 - 宿主相互作用期间进化。慢性HBV感染自然过程中血清HBV RNA水平的分布模式尚不清楚。本研究的目的是评估CHB自然过程中HBV RNA的水平以及区分HBV感染自然史的作用。
方法：

共招募了291名未接受过治疗的慢性HBV携带者。根据临床，生化，血清学和组织学数据以及HBV DNA水平，将患者分为以下四类：免疫耐受期（IT，n = 35），HBeAg阳性免疫活性期（EPIA） ，n = 121），非活动性慢性乙型肝炎（ICH，n = 58）和HBeAg阴性免疫反应性肝炎（ENH，n = 77）。评估血清HBV RNA的参数和分布模式与病毒复制状态，免疫期，疾病类别和Child-Pugh类的关系。还分析了血清HBV RNA与其他血清乙型肝炎病毒标志物之间的关系。
结果：

与HBeAg阳性患者相比，HBeAg阴性患者的血清HBV RNA水平显着降低，而非活动性携带者的血清HBV RNA水平最低。在HBeAg阴性患者中，如果活动性肝炎再次活化，血清HBV RNA水平升高，并且血清HBV DNA（截止值> 3.39 Log拷贝/ mL）和HBsAg（截止值> 2.74 Log IU / mL）的组合显示出明显的优势。区分HBeAg阴性免疫反应'期和HBeAg阴性慢性HBV感染的无活动慢性乙型肝炎期。所有慢性HBV感染患者血清HBV RNA水平与血清​​HBV DNA和HBsAg水平呈正相关。分层分析显示，HBeAg阳性患者血清HBV RNA与HBV DNA或HBsAg之间存在相关性;然而，在HBeAg阴性患者中，血清HBV RNA仅与HBV DNA呈正相关。
结论：

在慢性HBV感染的自然过程中，血清HBV RNA水平不同。血清HBV RNA可作为预测慢性乙型肝炎患者疾病自然史的生物标志物。在未接受过治疗的HBeAg阴性慢性HBV感染者中，血清HBV RNA在区分'HBeAg阴性反应'阶段方面表现出优势。
关键词：

乙型肝炎e抗原（HBeAg）;乙型肝炎表面抗原（HBsAg）;乙型肝炎病毒（HBV）;自然历史;前基因组RNA（pgRNA）

结论：
    30991954
DOI：
    10.1186 / s12876-019-0966-4

StephenW

https://bmcgastroenterol.biomedc ... 6/s12876-019-0966-4