在HBV DNA低于检测下限的乙型肝炎患者中HBV RNA的检测意义

肝脏 ›› 2024, Vol. 29 ›› Issue (10): 1243-1246.

在HBV DNA低于检测下限的乙型肝炎患者中HBV RNA的检测意义

孙梅, 谈国蕾, 徐露露, 时瑞, 倪俊明, 吴旭平

210000 江苏南京中医药大学附属南京医院/南京市第二医院精准医学中心

收稿日期:2023-12-17 出版日期:2024-10-31 发布日期:2024-12-02
通讯作者: 吴旭平,Email:xuping.wu@126.com
基金资助:
江苏省第十二批六大人才高峰项目(WSH-144)

Detection of HBV RNA and its influencing factor analysis in hepatitis B patients whose HBV DNA is lower than the limit of detection

SUN Mei, TAN Guo-lei, XU Lu-lu, SHI Rui, NI Jun-ming, WU Xu-ping

Laboratory of Molecular and Genetics Diagnosis,Nanjing Hospital Affiliated to Nanjing University of Traditional Chinese Medicine, Nanjing Second Hospital,Jiangsu 210000, China

Received:2023-12-17 Online:2024-10-31 Published:2024-12-02
Contact: WU Xu-ping,Email:xuping.wu@126.com

摘要/Abstract

摘要： 目的探讨在核苷类药物治疗后HBV DNA低于检测下限的慢性乙型肝炎(CHB)患者中检测HBV RNA的临床意义。方法纳入2020年12月至2021年10月南京市第二医院收治的226例慢乙肝和130例肝硬化患者。采用回归分析和相关性分析不同病种、HBsAg、HBeAg等因素与HBV RNA的关系。结果 HBsAg阳性肝硬化组HBV RNA检出率(97.5%)显著高于HBsAg阳性CHB组(87%)(P<0.01),检出浓度显著低于后者(2.37±1.99)比(3.86±1.46)(P<0.01);HBeAg阴性肝硬化患者的HBV RNA检出率(25.5%)高于HBeAg阴性CHB组(10.7%)(P<0.05),两组HBV RNA水平差异无统计学意义;HBeAg阳性肝硬化组HBV RNA检出率和水平与HBeAg阳性CHB组相比差异均无统计学意义。不同病种、HBsAg、HBeAg等因素对HBV RNA水平有影响。CHB组和肝硬化组中的HBV RNA与HBsAg均相关(r=0.382、0.304,P<0.05)。CHB组HBV RNA与HBeAg相关(r=0.607,P<0.01),肝硬化组中HBV RNA与HBeAg不相关。结论核苷类药物治疗后的HBV DNA低于检测下限或检测不出的情况下,病种、HBsAg、HBeAg均显著影响HBV RNA水平,HBV RNA检测可替代HBV DNA做为持续监测患者体内病毒的复制状态的生物学指标。

关键词: 核苷类药物, HBV RNA, 慢性乙型肝炎, 肝硬化

Abstract: Objective To explore the clinical application value of new serum standard HBVRNA in hepatitis B patients with HBVDNA lower limit after nucleoside treatment. Methods We detected the HBVRNA of 226 chronic hepatitis B patients and 130 liver cirrhosis cases with quantitative cobasHBVDNA value less than 20 IU/mL. By using the regression analysis, we compared the difference in detection rate and detection value between the two cases,and then we used the correlation analysis to figure out the correlation of HBVRNA with sAg and eAg in the two groups. Results 1 HBVRNA detection rate and concentration levels varied significantly in cases of CHB and cirrhosis:The HBVRNA detection rate of HBV sAg-positive cirrhosis group (97.5%) was significantly higher than that in the sAg-positive hepatitis B group (87%) (P<0.01). Similarly, the mean LOG value of HBVRNA concentration (2.37±1.98) of which was significantly lower than that in sAg-positive hepatitis B group (3.86±1.46) (P<0.01). The HBVRNA detection rate in eAg negative cirrhosis patients (25.5%) was significantly higher than that in eAg negative chronic hepatitis B patients (10.7%)(P<0.05), and there was no difference in HBVRNA concentration and the HBVRNA detection rate between two groups. There was no significant difference in the detection rate and concentration of HBVRNA between the eAg positive cirrhosis group and the eAg positive chronic hepatitis B group. 2 Different clinical status, sAg and eAg affected HBVRNA levels. 3 HBVRNA was correlated with sAg in both chronic hepatitis B group (r=0.382, P<0.01) and cirrhosis group (r=0.304, P<0.05). CHB HBVRNA was associated with eAg in the cirrhosis group (r=0.607, P<0.01), but not in cirrhosis group. Conclusion HBVRNA can replace HBVDNA as a biological indicator of continuously monitoring the replication status of the virus in chronic hepatitis B and cirrhosis patients after receiving antiviral drugs.

Key words: Nucleoside drugs for treating, HBVRNA, chronic hepatitis B, liver cirrhosis

孙梅, 谈国蕾, 徐露露, 时瑞, 倪俊明, 吴旭平. 在HBV DNA低于检测下限的乙型肝炎患者中HBV RNA的检测意义[J]. 肝脏, 2024, 29(10): 1243-1246.

SUN Mei, TAN Guo-lei, XU Lu-lu, SHI Rui, NI Jun-ming, WU Xu-ping. Detection of HBV RNA and its influencing factor analysis in hepatitis B patients whose HBV DNA is lower than the limit of detection[J]. Chinese Hepatolgy, 2024, 29(10): 1243-1246.

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