慢性乙型肝炎患者长期核苷酸类似物抗病毒治疗后血清HBV pgRNA检出率及与血清学抗原状态的相关性

Detection rate of serum HBV pgRNA and its relationship with serological status of HBV antigens in patients receiving long-term antiviral treatment with nucleotides analogues for chronic hepatitis B

摘要:

目的 分析慢性乙型肝炎患者长期核苷酸类似物抗病毒治疗后血清乙型肝炎病毒前基因组RNA（HBV pgRNA）的检出率及与血清学抗原状态的相关性。方法 选取2020年7月—2022年7月在海南西部中心医院接受长期核苷酸类似物抗病毒治疗的150例慢性乙型肝炎患者，根据乙型肝炎e抗原（HBeAg）状态将其分为HBeAg阳性组（32例）、HBeAg阴性组（118例），再根据乙型肝炎表面抗原（HBsAg）水平高低将HBeAg阴性组患者分为4组，其中HBsAg> 1 500 IU/mL患者32例（A组），HBsAg >100～1 500 IU/mL患者32例（B组），HBsAg≤ 100 IU/mL患者32例（C组），HBsAg阴性患者22例（D组）。比较不同抗原状态下HBV pgRNA的检出率，分析HBV pgRNA与血清学抗原状态的相关性。结果 HBeAg阳性组血清HBV pgRNA检出率（93.8%）高于HBeAg阴性组（43.2%）（P <0.05）。A、B组血清HBV pgRNA检出率（78.1%和65.6%）均高于C、D组（15.6%和0.00%）（P <0.05）。结论 慢性乙型肝炎患者长期核苷酸类似物抗病毒治疗后血清HBV pgRNA检出率与血清学抗原（HBsAg、HBeAg）状态有相关性，HBV pgRNA可作为判断慢性乙型肝炎患者长期核苷酸类似物抗病毒治疗后肝内HBV cccDNA转录活性及复制状态的生物标志物。

Abstract:

Objective To analyze the detection rate of serum hepatitis B virus (HBV) pregenomic RNA (HBV pgRNA) and its relationship with serological status of HBV antigens in patients receiving long-term antiviral treatment with nucleotides analogues for chronic hepatitis B.Methods A total of 150 patients with chronic hepatitis B who received long-term antiviral treatment with nucleotide analogues in our hospital from July 2020 to July 2022 were selected and divided into HBeAg positive group (n = 32) and HBeAg negative group (n = 118) based on the serological status of hepatitis B e antigen (HBeAg). According to the level of hepatitis B surface antigen (HBsAg), the patients were divided into four groups, including 32 patients with HBsAg > 1 500 IU/mL in group A, 32 patients with 100 IU/mL< HBsAg ≤ 1 500 IU/mL in group B, 32 patients with HBsAg≤ 100 IU/mL in group C, and 22 patients with negative HbsAg in group D. The detection rate of HBV pgRNA was compared among patients with different serological status of HBV antigens, and the relationship between the presence of HBV pgRNA and serological status of HBV antigens was analyzed.Results The detection rate of serum HBV pgRNA in HBeAg positive group (93.8%) was higher than that in HBeAg negative group (43.2%) (P < 0.05). The detection rates of serum HBV pgRNA in groups A and B (78.1% and 65.6%) were higher than those in groups C and D (15.6% and 0.00%) (P < 0.05).Conclusions The detection rate of serum HBV pgRNA after long-term antiviral treatment with nucleotides analogues for chronic hepatitis B is correlated with the serological status of HBV antigens (such as HbsAg and HBeAg). HBV pgRNA can be established as a biomarker to determine the transcription activity and replication status of intrahepatic HBV cccDNA after long-term antiviral treatment with nucleotides analogues for chronic hepatitis B.