Correlation Between Serum HBV PgRNA And Antigen Status In Patients With Chronic Hepatitis B After Long-term Nucleotide Analogues Treatment

Objective:To study the relationship between serum HBV pgRNA and antigen status in patients with chronic hepatitis B treated with long-term nucleotide analogues,and to elucidate the reason and possible mechanism of high relapse rate in antiviral therapy of nucleotide analogues in chronic hepatitis B.Methods:94 patients with chronic hepatitis B who had been treated with long-term antiviral therapy with nucleotide analogues(more than 2 years)were divided into 2groups according to their HBeAg status,the serum HBV pgRNA levels of the two groups were compared.Then,the HBeAg negative group was further divided into three groups according to the HBsAg level of the patients: e antigen negative and HBsAg≥1500IU/m L group,antigen negative and 100≤HBsAg <1500IU/m L group,e antigen negative and HBsAg < 100IU/m L group.To detect the difference of HBV pgRNA level under different e-antigen status and different HBsAg levels.Results:There was a significant correlation between the level of HBV pgRNA and the level of HBsAg(R=0.746,P=0.000).According to the status of e antigen,the level of serum HBV pgRNA in patients with positive e antigen was significantly higher than that in patients with negative e antigen(Z=5.98 P<0.001).Further analysis of whether HBeAg status is related to HBV pgRNA status: the results showed that HBV pgRNA negative but e antigen positive accounted for only 2.6%(1/38),HBV pgRNA negative,e antigen negative accounted for 97.40%(37/38),HBV pgRNA positive,e antigen positive accounted for 33.9%(19/56),HBV pgRNA positive,e antigen negative accounted for 66.1%(37/56),P<0.001,the difference was statistically significant.In addition,CHB patients with seroconversion of e antigen were further divided into groups according to the level of HBsAg.The results showed that there was no significant difference in serum pgRNA levels between the HBsAg>1500IU/ml group and the 100IU/ml<HBsAg≤1500IU/ml group.The level of HBVpgRNA in the HBsAg>1500IU/ml group and 100 < HBsAg≤1500IU/ml group were significantly higher than that in the 0 < HBsAg ≤ 100 HBsAg group,the difference was statistically significant(P < 0.05).Conclusion:There is a significant correlation between the serological antigen status and the presence of HBV pgRNA in chronic hepatitis B after long-term treatment of nucleotide analogues.The persistence of HBV pgRNA is closely related to the low seroconversion rate of e antigen and the high level of HBsAg.HBV pgRNA can be used as one of the biomarkers to judge the transcription activity and replication status of HBV ccc DNA in liver.