血清HBV RNA的方法學依賴性預測慢性乙型肝炎患者的治療效果

StephenW

Methodology-dependent performance of serum HBV RNA in predicting treatment outcomes in chronic hepatitis B patients
Shi Liu  1 , Yaobo Wu  1 , Rui Deng  1 , Sheng Shen  1 , Rong Fan  1 , Jie Peng  1 , Wanying Li  1 , Xieer Liang  1 , Jinlin Hou  1 , Jian Sun  2 , Bin Zhou  3
Affiliations
Affiliations

    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, China.
    2
    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, China. Electronic address: [email protected].
    3
    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, China. Electronic address: [email protected].

    PMID: 33711337 DOI: 10.1016/j.antiviral.2021.105037

Abstract

Background: Whether different serum HBV RNA detection assays can consistently predict treatment outcomes in patients with chronic hepatitis B remains controversial.

Methods: We enrolled 188 patients who had stopped nucleos(t)ide analogues (NAs) (STOP cohort-1, -2) and 78 receiving entecavir (ETV) therapy (ETV cohort) and used double-target (targeting both 5' and 3' ends of the HBV pregenome RNA [DT-RNA]) and three single-target (targeting the S-region [S-RNA], X-region [X-RNA], and poly-A tail of HBV RNA [PolyA-RNA]) assays to predict treatment outcomes.

Results: In STOP cohorts, DT-RNA, S-RNA and X-RNA at NAs cessation showed higher predictive powers for clinical relapse (time-dependent areas under the curve [AUCs] for years 1, 2, 3, and 4 ranged between 0.724 and 0.772 in cohort-1, and between 0.741 and 0.824 in cohort-2) than the PolyA-RNA (AUCs between 0.604 and 0.611 in cohort-1; and between 0.530 and 0.584 in cohort-2). The predictive power for 2-year HBeAg loss of the four targeted RNAs in the ETV cohort at 6 months were similar (AUCs, 0.848, 0.838, 0.825, and 0.801), and superior to that of the HBV DNA level at 6 months (AUC, 0.721).

Conclusion: The outcome prediction performance of serum HBV RNAs is methodology-dependent. PolyA-RNA detection was not recommended to predict off-treatment relapses.

Keywords: HBV RNA; HBeAg loss; Methodology-dependent; Off-treatment relapse.

Copyright © 2021. Published by Elsevier B.V.

StephenW

血清HBV RNA的方法學依賴性預測慢性乙型肝炎患者的治療效果
劉士1，吳耀波1，鄧銳1，申深1，榮帆1，傑鵬1，李萬應1，謝爾梁1，侯金林1，孫建2，周斌3
隸屬關係
隸屬關係

    1個
    南方醫科大學南方醫院傳染病科，器官衰竭研究國家重點實驗室，廣東省病毒性肝炎研究重點實驗室，廣州。
    2個
    南方醫科大學南方醫院傳染病科，器官衰竭研究國家重點實驗室，廣東省病毒性肝炎研究重點實驗室，廣州。電子地址：[email protected]。
    3
    南方醫科大學南方醫院傳染病科，器官衰竭研究國家重點實驗室，廣東省病毒性肝炎研究重點實驗室，廣州。電子地址：[email protected]。

    PMID：33711337 DOI：10.1016 / j.antiviral.2021.105037

抽象的

背景：不同的血清HBV RNA檢測方法能否始終如一地預測慢性乙型肝炎患者的治療結果仍存在爭議。

方法：我們招募了188例停止使用核苷酸（t）核苷酸類似物（NAs）（STOP隊列1，-2）的患者，其中78例接受了恩替卡韋（ETV）治療（ETV隊列）的患者，並且使用了雙重靶點（同時靶向5'和HBV前基因組RNA [DT-RNA]的3'端和三個單靶標（靶向HBV RNA的S區域[S-RNA]，X區域[X-RNA]和poly-A尾巴[PolyA -RNA]），以預測治療效果。

結果：在STOP隊列中，NA終止時的DT-RNA，S-RNA和X-RNA對臨床復發顯示出更高的預測能力（曲線[AUCs]下的時間依賴性區域[1,2,3,4年介於隊列1中的0.724和0.772，以及隊列2中的0.741和0.824）比PolyA-RNA（隊列1中的AUC在0.604和0.611之間，隊列2中的0.530和0.584之間）。 ETV隊列中四個靶向RNA在6個月時對2年HBeAg丟失的預測能力相似（AUC，0.848、0.838、0.825和0.801），並且優於6個月時HBV DNA水平（AUC） ，0.721）。

結論：血清HBV RNA的結局預測性能取決於方法學。不建議使用PolyA-RNA檢測來預測非治療復發。

關鍵字：HBV RNA； HBeAg丟失；與方法有關；非治療復發。

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