乙型肝炎病毒的基因组RNA状态可以揭示使用核苷酸（t）ide类

StephenW

Hepatitis B virus pregenomic RNA status can reveal the long‐term prognoses of chronic hepatitis B patients treated with nucleos(t)ide analogues
Hao Luo
Ning Tan
Qian Kang
Jiali Pan
Hongyu Chen
Hongli Xi
Min Yu
Xiaoyuan Xu
First published: 31 October 2019
https://doi.org/10.1111/jvh.13227

Funding information:

The 13th Five‐Year Plan (No. 2017ZX10302201‐004‐009, No. 2017ZX10203202‐003, No. 2018ZX09206005‐002), Beijing Municipal Science and Technology Commission of Major Projects (No. D161100002716002, No. D161100002716003, No. D161100003117005).
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Abstract

We examined whether the hepatitis B virus (HBV) pregenomic RNA (pgRNA) status after nucleos(t)ide (NA) treatment can predict the long‐time prognoses of chronic hepatitis B patients. Patients with chronic hepatitis B (98) who were treatment‐naïve and had begun a 7‐year NA therapy regimen were enrolled in this study. Biochemical indicators and serological markers of HBV infection were performed during therapy. HBV pgRNA was quantified by real‐time quantitative PCR with specific primers. During treatment, HBV DNA undetectable rates increased. The aminotransferase (ALT) normalization (ALT < 50 IU/L) and HBeAg‐negative rates also increased. After 48 weeks’ NA treatment, 48.28% (28/58) of HBV DNA undetectable patients still had HBV pgRNA‐positive. After 7 years of treatment, more HBV pgRNA‐negative patients (n = 35) achieved HBeAg clearance than the patients who were HBV pgRNA‐positive (n = 63) (19/23 vs 19/56, P < .00). HBV pgRNA‐positive patients also had an increased risk of failing to achieve HBeAg clearance (OR = 9.25, 95% CI: 2.75‐31.08). The median time to HBeAg clearance in the HBV pgRNA‐positive patients was longer than that of the HBV pgRNA‐negative patients (152 weeks vs 72 weeks). The HBV pgRNA‐positive patients also required more time to achieve HBV DNA undetectable (124 weeks, 95% CI: 103.33‐144.67 vs 48 weeks, 95% CI: 34.80‐61.20). The HBV pgRNA status after NA treatment can predict the long‐term prognoses of patients with chronic HBV. Patients who remain HBV pgRNA‐positive after 48 weeks of NA treatment have an increased risk of not achieving HBeAg clearance, need more time to achieve HBeAg clearance and undetectable HBV DNA load.
Abbreviations

ADV
    adefovir
ALT
    aminotransferase
CHB
    chronic hepatitis B
ELISA
    enzyme‐linked immunosorbent assay
ETV
    entecavir
HBV
    hepatitis B virus
HCV
    hepatitis C virus
HIV
    human immunodeficiency virus
LAM
    lamivudine
NA
    nucleos(t)ide
pgRNA
    pregenomic RNA

StephenW

乙型肝炎病毒的基因组RNA状态可以揭示使用核苷酸（t）ide类似物治疗的慢性乙型肝炎患者的长期预后
郝洛
谭宁
千康
潘佳丽
陈宏宇
红丽
敏瑜
徐小元
首次发布：2019年10月31日
https://doi.org/10.1111/jvh.13227

资金信息：

北京市重大项目科学技术委员会``十三五''计划（No.2017ZX10302201-004-009，No.2017ZX10203202-003，No.2018ZX09206005-002）（No.D161100002716002，No.D161100002716003，No.D161100003117005） 。
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我们检查了核苷酸（NA）治疗后乙型肝炎病毒（HBV）前基因组RNA（pgRNA）的状态是否可以预测慢性乙型肝炎患者的长期预后。初治且已开始7年NA治疗方案的慢性乙型肝炎（98）患者参加了本研究。治疗期间进行了HBV感染的生化指标和血清学指标。 HBV pgRNA使用特定引物通过实时定量PCR进行定量。在治疗过程中，HBV DNA的检出率升高。氨基转移酶（ALT）正常化（ALT <50 IU / L）和HBeAg阴性率也有所增加。 NA治疗48周后，未检测到48.28％（28/58）的HBV DNA患者仍具有HBV pgRNA阳性。经过7年的治疗，与HBV pgRNA阳性的患者（n = 63）相比，更多的HBV pgRNA阴性患者（n = 35）实现了HBeAg清除（19/23 vs 19/56，P <.00）。 HBV pgRNA阳性患者未达到HBeAg清除的风险也增加（OR = 9.25，95％CI：2.75-31.08）。 HBV pgRNA阳性患者的HBeAg清除中位时间比HBV pgRNA阴性患者的中位时间长（152周对72周）。 HBV pgRNA阳性患者还需要更多的时间来实现无法检测到的HBV DNA（124周，95％CI：103.33-144.67 vs 48周，95％CI：34.80-61.20）。 NA治疗后的HBV pgRNA状态可以预测慢性HBV患者的长期预后。 NA治疗48周后仍保持HBV pgRNA阳性的患者，未达到HBeAg清除的风险增加，需要更多时间来达到HBeAg清除和无法检测到的HBV DNA负荷。
缩略语

ADV
阿德福韦
ALT
氨基转移酶
CHB
慢性乙型肝炎
ELISA法
酶联免疫吸附测定
电子电视
恩替卡韦
乙肝病毒
乙肝病毒
丙型肝炎病毒
丙型肝炎病毒
艾滋病毒
人类免疫缺陷病毒
我是
拉米夫定
不适用
核苷（t）
核糖核酸
前基因组RNA

StephenW

https://onlinelibrary.wiley.com/doi/full/10.1111/jvh.13227?af=R