抗病毒治疗5年后乙型肝炎病毒基因组RNA的因素及其病毒学意

StephenW

Factors and virological significance of hepatitis B virus pregenomic RNA after 5 years of antiviral therapy
Jiali Pan  1 , Jinghang Xu  2 , Hao Luo  3 , Ning Tan  4 , Qian Kang  5 , Hongyu Chen  6 , Ran Cheng  7 , Yifan Han  8 , Yuqing Yang  9 , Xiaoyuan Xu  10
Affiliations
Affiliations

    1
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    2
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    3
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    4
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    5
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    6
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    7
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    8
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    9
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].
    10
    Department of Infectious Diseases, Peking University First Hospital, Beijing, 100034, China. Electronic address: [email protected].

    PMID: 33676002 DOI: 10.1016/j.ijid.2021.02.116

Abstract

Objectives: To investigate the factors and the virological significance of serum hepatitis B virus (HBV) pgRNA after long-term antiviral therapy with nucleos(t)ide analogues (NAs) in chronic hepatitis B (CHB) patients.

Methods: In total, 51 treatment-naïve CHB patients were included in the study. Clinical data were collected at baseline and after 5 years and at year 10 of antiviral treatment. Serum HBV pregenomic RNA (pgRNA) status of 51 patients was detected at year 5.

Results: After 5 years of antiviral treatment, 45.10% of the patients were still positive for HBV pgRNA. There were significant differences in baseline hepatitis B e antigen (HBeAg) status, HBV DNA load and hepatitis B surface antigen (HBsAg) levels between patients positive and negative for HBV pgRNA at year 5. Serum HBV pgRNA status and serum HBV DNA load were correlated even after 5 years of treatment (r = 0.347, p = 0.013). Being HBV pgRNA positive at year 5 was an independent risk factor for sustainedly undetectable HBV DNA after 10 years of antiviral treatment (OR: 13.638, 95% CI: 1.32-140.81, p = 0.028). Furthermore, HBV pgRNA status at year 5 was associated with HBV DNA reappearance at year 10 (p = 0.009).

Conclusions: HBV pgRNA status at year 5 can reveal HBV covalently closed circular DNA (cccDNA) activity, and HBV pgRNA positivity after long-term antiviral therapy may indicate higher transcriptional activity of HBV cccDNA. Long-term dynamic monitoring of HBV pgRNA should be considered.

Keywords: DNA, Circular; Hepatitis B, Chronic; Transcription, Genetic; pgRNA.

Copyright © 2021. Published by Elsevier Ltd.

StephenW

抗病毒治疗5年后乙型肝炎病毒基因组RNA的因素及其病毒学意义
潘佳丽1，徐静航2，郝浩3，宁潭4，钱康5，陈洪宇6，冉成7，韩一凡8，杨玉清9，徐小元10
隶属关系
隶属关系

    1个
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    2个
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    3
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    4
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    5
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    6
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    7
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    8
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    9
    北京大学第一医院感染科，北京100034电子地址：[email protected]。
    10
    北京大学第一医院感染科，北京100034电子地址：[email protected]。

    PMID：33676002 DOI：10.1016 / j.ijid.2021.02.116

抽象的

目的：探讨长期使用核苷酸类似物（NAs）进行抗病毒治疗的慢性乙型肝炎（CHB）患者血清乙型肝炎病毒（HBV）pgRNA的因素及其病毒学意义。

方法：本研究共纳入51名未接受过治疗的CHB患者。在基线，抗病毒治疗的5年和10年后收集临床数据。在第5年检测到51例患者的血清HBV前基因组RNA（pgRNA）状态。

结果：经过5年的抗病毒治疗，仍有45.10％的患者HBV pgRNA阳性。 HBV pgRNA阳性和阴性的患者在第5年时的基线乙型肝炎e抗原（HBeAg）状态，HBV DNA载量和乙肝表面抗原（HBsAg）水平存在显着差异即使经过5年的治疗（r = 0.347，p = 0.013）。经过10年的抗病毒治疗，HBV pgRNA在第5年呈阳性是持续检测不到HBV DNA的独立危险因素（OR：13.638，95％CI：1.32-140.81，p = 0.028）。此外，第5年时HBV pgRNA的状态与第10年时HBV DNA的重新出现有关（p = 0.009）。

结论：HBV pgRNA在第5年的状态可以显示HBV共价闭合环状DNA（cccDNA）的活性，长期抗病毒治疗后HBV pgRNA阳性可能表明HBV cccDNA的转录活性更高。应考虑对HBV pgRNA进行长期动态监测。

关键词：DNA，环状；乙型肝炎，慢性；转录，遗传； pgRNA。

版权所有©2021.由Elsevier Ltd.发布。

StephenW

https://www.ijidonline.com/article/S1201-9712(21)00202-2/pdf