核苷类似物治疗的慢性乙型肝炎高病毒血症患者的血清乙肝

StephenW

Serum Hepatitis B Virus RNA Levels Predict HBeAg Seroconversion and Virological Response in Chronic Hepatitis B Patients With High Viral Load Treated With Nucleos(t)ide Analog
Xin Ji #  1 , Muye Xia #  1 , Bin Zhou  1 , Shi Liu  1 , GuiChan Liao  1 , Shaohang Cai  1 , Xiaoyong Zhang  1 , Jie Peng  1
Affiliations
Affiliation

    1
    State Key Laboratory of Organ Failure Research, Guangdong Provincial Key Laboratory of Viral Hepatitis Research, Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou, People's Republic of China.

#
Contributed equally.

    PMID: 32606837 PMCID: PMC7319510 DOI: 10.2147/IDR.S252994

Abstract

Background and aim: Hepatitis B virus (HBV) RNA has attracted increasing attention as a novel serum marker for intrahepatic HBV replication. However, the predictive value of the serum level of HBV RNA for hepatitis B e-antigen (HBeAg) seroconversion and viral response among patients with a high viral load (HVL) is unclear. We evaluated the role of the serum level of HBV RNA as a predictor of treatment response in chronic HBV (CHB) patients with an HVL.

Patients and methods: The study cohort was 66 HBeAg-positive CHB patients with an HVL (serum HBV DNA >1.9×106 IU/mL) at baseline from our previous prospective cohort study treated with lamivudine (LAM) and adefovir dipivoxil(ADV) (N=31) or entecavir alone (N=35) for ≤96 weeks. The serum HBV RNA level was quantified by TaqMan® probe-based reverse transcription real-time quantitative polymerase chain reaction at four time points.

Results: The baseline serum HBV RNA level (in log10 copies/mL) in patients treated with LAM+ADV and ETV monotherapy was 8.97±1.22 and 9.15±0.92, respectively. After nucleos(t)ide analog (NA) therapy, the serum HBV RNA level decreased steadily in all patients (week 0 vs week 12, p<0.001; week 12 vs week 24, p=0.010; week 24 vs week 48, p<0.001). Fifty-three (80.3%) patients achieved a virologic response (VR), and 12 (18.2%) achieved HBeAg seroconversion after 96 weeks. Multivariate analyses revealed that the serum HBV RNA level at week 12 could predict HBeAg seroconversion (OR 3.560, 95% CI: 1.39-9.110, p=0.008) and VR (1.908, 1.115-3.265, 0.018) at 96 weeks. Analyses of receiver operating characteristic curves indicated that the serum HBV RNA level 12 weeks after NA treatment had predictive value for HBeAg seroconversion (AUC=0.847, p<0.001) and VR (AUC=0.736, p=0.011).

Conclusion: The serum level of HBV RNA at 12 weeks could predict HBeAg seroconversion and a VR during NA treatment in CHB patients with an HVL.

Keywords: HBV RNA; HBeAg seroconversion; high viral load; nucleos(t)ide analogs; virological response.

StephenW

核苷类似物治疗的慢性乙型肝炎高病毒血症患者的血清乙肝病毒RNA水平预测HBeAg血清转化和病毒学应答
辛集＃1，牧业下＃1，滨州1，石柳1，桂蝉辽1，邵杭菜1，张晓勇1，揭鹏1
隶属关系
联系

    1个
    南方医科大学附属南方医院传染病科，器官衰竭研究国家重点实验室，广东省病毒性肝炎研究重点实验室，广州。

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贡献均等。

    PMID：32606837 PMCID：PMC7319510 DOI：10.2147 / IDR.S252994

抽象

背景和目的：乙型肝炎病毒（HBV）RNA作为肝内HBV复制的新型血清标志物已引起越来越多的关注。然而，目前尚不清楚血清HBV RNA水平对高病毒载量（HVL）患者的乙型肝炎e抗原（HBeAg）血清转化和病毒反应的预测价值。我们评估了血清HBV RNA水平在慢性HBV（CHB）HVL患者中作为治疗反应预测指标的作用。

患者和方法：本研究队列为66例HBeAg阳性CHB患者，基线为HVL（血清HBV DNA> 1.9×106 IU / mL），该基线来自我们先前接受拉米夫定（LAM）和阿德福韦酯（ADV）治疗的前瞻性队列研究（ N = 31）或单独使用恩替卡韦（N = 35）≤96周。通过基于探针的逆转录实时定量聚合酶链反应在四个时间点对血清HBV RNA水平进行定量。

结果：LAM + ADV和ETV单药治疗的患者血清HBV RNA基线水平（log10拷贝/ mL）分别为8.97±1.22和9.15±0.92。核苷酸类似物（NA）治疗后，所有患者的血清HBV RNA水平稳定下降（第0周vs第12周，p <0.001；第12周vs第24周，p = 0.010；第24周vs第48周，p <0.001）。 96周后，有53（80.3％）位患者实现了病毒学应答（VR），其中12位（18.2％）实现了HBeAg血清转化。多因素分析显示，在第12周时，血清HBV RNA水平可以预测96周时的HBeAg血清转化（OR 3.560，95％CI：1.39-9.110，p = 0.008）和VR（1.908，1.115-3.265，0.018）。接受者工作特征曲线的分析表明，NA治疗12周后血清HBV RNA水平对HBeAg血清转化（AUC = 0.847，p <0.001）和VR（AUC = 0.736，p = 0.011）具有预测价值。

结论：12周时HBV RNA水平可预测CHB慢性乙型肝炎患者的HBeAg血清学转换和VR。

关键字：HBV RNA； HBeAg血清转化；高病毒载量；核苷（核苷酸）类似物;病毒学应答。

StephenW

https://www.dovepress.com/front_ ... eag-seroconvers.pdf