不同临床结果的乙型肝炎病毒感染者血清前基因组RNA检测的诊断价值

肝脏 ›› 2021, Vol. 26 ›› Issue (10): 1150-1153.

不同临床结果的乙型肝炎病毒感染者血清前基因组RNA检测的诊断价值

马海霞, 赵丽萍, 陈文洁, 胡伟宏, 张世坤

454000 河南焦作煤业(集团)中央医院检验科

收稿日期:2020-11-23 出版日期:2021-10-31 发布日期:2021-12-07
通讯作者: 张世坤,Email:2779003459@qq.com

Diagnostic value of serum pregenomic RNA in hepatitis B virus-infected patients with different clinical outcomes

MA Hai-xia, ZHAO Li-ping, CHEN Wen-jie, HU Wei-hong, ZHANG Shi-kun

Coal industry (Group) Central Hospital of Henan Jiaozuo, Department of laboratory, Henan 454000, China

Received:2020-11-23 Online:2021-10-31 Published:2021-12-07
Contact: ZHANG Shi-kun,Email:2779003459@qq.com

摘要/Abstract

摘要： 目的评估血清pgRNA在HBV感染后不同临床结局患者中的诊断价值及其与血清相关指标的相关性。方法本研究纳入了210例接受核苷类似物治疗的HBV感染者,根据不同结局分为无症状携带者(ASC)、慢性乙型肝炎(CHB)患者和肝硬化(LC)患者,每组70例。比较pgRNA的差异及其与HBV DNA和HbsAg的相关性。结果 HBV pgRNA水平在这3组之间有显著差异,且与血清HBV DNA和HBsAg水平显著相关(HBV pgRNA与HBV DNA:R=0.613,P<0.001;HBV pgRNA与HBsAg:R=0.503,P<0.001)。在HBV DNA水平<500 IU/mL的患者中,有72.8%的患者HBV pgRNA检测阳性,而低于20 IU/mL的患者中有17.6%可以检测到HBV pgRNA阳性。结论血清中HBV pgRNA水平是一种反映肝细胞内病毒复制的标志物,检测血清 HBV pgRNA水平可为临床监测cccDNA水平提供参考。

关键词: 乙型肝炎病毒, pgRNA, cccDNA, 表面抗原

Abstract: Objective To assess the diagnostic value of serum pgRNA in patients with different clinical outcomes after HBV infection and its relevance with serum-related parameters. Methods This study recruited 210 HBV-infected patients treated with nucleoside analogues, classified as asymptomatic carriers (ASC), chronic hepatitis B (CHB), and cirrhosis (LC) according to different outcomes, each group with 70 cases. The difference of pgRNA levels among each group was compared and their correlation with HBV DNA and HbsAg was evaluated. Results HBV pgRNA levels were significantly different among these three groups. HBV pgRNA levels were significantly correlated with serum HBV DNA and HBsAg Levels (HBV pgRNA and HBV DNA: R=0.613, P<0.001; HBV pgRNA and HbsAg: R=0.503, P<0.001). Of the patients with HBV DNA levels <500 IU/mL, 72.8% were HBV pgRNA positive and 17.6% of patients were still positive in patients with DNA below 20 IU/mL. Conclusion Serum HBV pgRNA level was a proper marker reflecting viral replication in hepatocytes. HBV pgRNA levels was helpful in the monitor of cccDNA levels.

Key words: Hepatitis B virus, Pregenomic RNA, Covalently closed circular DNA, HBsAg

马海霞, 赵丽萍, 陈文洁, 胡伟宏, 张世坤. 不同临床结果的乙型肝炎病毒感染者血清前基因组RNA检测的诊断价值[J]. 肝脏, 2021, 26(10): 1150-1153.

MA Hai-xia, ZHAO Li-ping, CHEN Wen-jie, HU Wei-hong, ZHANG Shi-kun. Diagnostic value of serum pregenomic RNA in hepatitis B virus-infected patients with different clinical outcomes[J]. Chinese Hepatolgy, 2021, 26(10): 1150-1153.

参考文献

[1] 王贵强, 王福生, 庄辉,等. 慢性乙型肝炎防治指南(2019年版). 肝脏, 2019, 12: 2648-2669.
[2] Lai C, Wong D, Ip P, et al. Reduction of covalently closed circular DNA with long-term nucleos(t)ide analogue treatment in chronic hepatitis B. J Hepatol, 2017, 66:275-281.
[3] 田原, 任锋. 乙型肝炎病毒共价闭合环状DNA(cccDNA)检测和清除的研究进展. 中华微生物学和免疫学杂志, 2019, 39:875-879.
[4] Nassal, M. HBV cccDNA: viral persistence reservoir and key obstacle for a cure of chronic hepatitis B. Gut, 2015, 64:1972–1984
[5] Dong J, Ying J, Qiu X, et al. Advanced Strategies for Eliminating the cccDNA of HBV. Dig Dis Sci, 2018, 63:7-15.
[6] 张宇, 赵景民. HBV cccDNA检测技术与临床应用. 临床肝胆病杂志, 2019:2140-2144.
[7] Tan Z, Pionek K, Unchwaniwala N, et al. The Interface between Hepatitis B Virus Capsid Proteins Affects Self-Assembly, Pregenomic RNA Packaging, and Reverse Transcription. J Virol, 2015, 89:3275-3284.
[8] Wu Y, Wen J, Xiao W, et al. Pregenomic RNA: How to assist the management of chronic hepatitis B. Rev Med Virol, 2019, 29:e2051.
[9] 潘美晨, 时景仁, 王爽,等. HBV pgRNA在HBV相关疾病中的表达及其临床意义. 标记免疫分析与临床, 2019, 026:1269-1272,1289.
[10] Levrero M, Testoni B, Zoulim F. HBV cure: why, how, when. Curr Opin Virol, 2016, 18:135-143
[11] Huang, Hongxin, Wang, et al. Serum HBV DNA plus RNA shows superiority in reflecting the activity of intrahepatic cccDNA in treatment-naive HBV-infected individuals. J Clin Virol, 2018, 99-100:71-78
[12] 王贵强, 王福生, 成军,等. 慢性乙型肝炎防治指南(2015年版). 中华实验和临床感染病杂志:电子版, 2015, 9:6-25.
[13] Rapti I . Risk for hepatocellular carcinoma in the course of chronic hepatitis B virus infection and the protective effect of therapy with nucleos(t)ide analogues. World J Hepatol, 2015, 7 :1064-1073.
[14] Thompson A J V, Nguyen T, Iser D, et al. Serum hepatitis B surface antigen and hepatitis B e antigen titers: Disease phase influences correlation with viral load and intrahepatic hepatitis B virus markers. Hepatology, 2010, 51:1933-1944.
[15] Petersen J, Thompson A J, Levrero M. Aiming for cure in HBV and HDV infection. J Hepatol, 2016, 65:835-848.
[16] Tu T, Budzinska M A, Shackel N A, et al. HBV DNA Integration: Molecular Mechanisms and Clinical Implications. Viruses, 2017, 9:E75.
[17] 黄晨璐, 陈良. 血清乙型肝炎病毒RNA临床研究进展. 中华传染病杂志, 2018:382-384.
[18] Asian-Pacific clinical practice guidelines on the management of hepatitis B: a 2015 update. Hepatol Int, 2015, 10:1-98.