Changes And Clinical Significance Of HBV RNA Quantification In Chronic Hepatitis B Patients Treated With NAs

Objective Serum HBV RNA comes from the transcription of HBV ccc DNA released into the blood and is more closely related to ccc DNA,and it is more sensitive in reflecting the condition of chronic hepatitis B disease,guiding clinical treatment and determining the prognosis.We investigated changes in serum HBV RNA levels and detection rates in chronic hepatitis B(CHB)patients treated with active nucleotide analogues(NAs)over different years of antiviral therapy and their relationship with other virological markers.Methods395 patients with chronic hepatitis B were included.All enrolled patients received regular NAs therapy for more than 12 months,and serum HBV DNA was under the lower limit of detection at least 2 times with an interval of 3 months.According to the serum HBe Ag status,the patients were divided into HBe Ag negative group(n=282)and HBe Ag positive group(n=113).The two groups were divided into 1 year group,2 years group,3 years group,4 years group,5 years group and >5 years group according to the time of receiving NAs therapy.93 patients with chronic HBV infection without antiviral treatment were enrolled.Serum samples were collected for HBV RNA detection,and serum HBV markers such as HBs Ag,HBe Ag and liver function detection results were collected.ResultsIn the HBe Ag-positive group,the detection rate of HBV RNA at different treatment time was 100%.The quantitative results of HBV RNA(log10Copies/m L)in the 1-year group to the > 5-year group was 4.675(3.3225-6.23),4.37(3.71-5.2475),4.17(3.205-5.42),4.045(3.4175-4.7625),3.98(3.25-5.35),3.865(3.155-5.88),respectively.I n HBe Ag negative group,the detection rates of HBV RNA from 1-year group to >5-years group were 72.0%,61.7%,61.29%,57.89%,43.64% and 42.62%,respectively.The quantitative results of HBV RNA(log10Copies/m L)were 2.385(2.00-2.9775),2.22(2.00-2.76),2.38(2.00-2.93),2.19(2.00-2.7025),2.00(UD-2.46)and 2.00(UD-2.29),respectively.The influencing factors of HBV RNA detection were analyzed in the HBe Ag negative group.Binary logistics regression showed that serum HBs Ag levels and duration of medication were independent influencing factors of HBV RNA detection(OR=1.809,0.867,P<0.05).In the correlation analysis of HBV RNA and other serological indicators,HBV RNA in HBe Ag positive group was positively correlated with HBe Ag and HBs Ag,but not significantly correlated with ALT,AST and bilirubin,and HBV RNA in HBe Ag negative group was not significantly correlated with any serological indicators.Regardless of HBe Ag status,serum HBV RNA levels in untreated chronic HBV infected patients were higher than CHB patients treated with oral NAs drugs.ConclusionAfter long-term NAs treatment,serum HBV RNA can be detected,while HBV DNA levels is below the lower limit of detection.Patients with HBe Ag-positive have a higher positive detection rate and quantitative level of HBV RNA than which with HBe Ag-negative.When HBe Ag is negative,patients with detectable HBV RNA receive shorter treatment time and have higher HBs Ag levels.HBs Ag and HBe Ag levels may be correlated with HBV RNA levels in HBe Ag-positive patients.