Using serum HBV RNA measurement to predict HBeAg seroconversion in chronic hepatitis B patients with normal alanine aminotransferase levels

Abstract

Abstract: Objective To investigate the predictive value of serum hepatitis B virus (HBV) RNA in predicting the HBeAg seroconversion in chronic hepatitis B patients with normal alanine aminotransferase (ALT) levels. Methods A total of 28 treatment-na?ve CHB patients with normal ALT levels admitted to the Putuo District Central Hospital in Shanghai between January 2017 and June 2021 were enrolled in this study. The clinical data of all patients were collected, and serum hepatitis B virus (HBV) RNA levels were measured using PCR fluorescence probe assays. All patients received nucleos(t)ide analog (NAs) therapy for 96 weeks and were then divided into an HBeAg seroconversion group and a non-seroconversion group. Regression analysis was used to explore the predictive factors associated with HBeAg seroconversion, and the receiver operating characteristic (ROC) curve was employed to evaluate the predictive performance. Results Twenty-eight CHB patients were included and treated with entecavir or tenofovir disoproxil fumarate. After 96 weeks of follow-up, 7 patients (25%) achieved HBeAg seroconversion. The HBeAg seroconversion group had significantly lower baseline HBV DNA levels (5.91±2.30 lg IU/mL) and HBV RNA levels (5.49±2.19 lg copies/mL) compared to those of the non-seroconversion group (7.50±1.37 lg IU/mL and 7.10±1.35 lg copies/mL, respectively), with statistical significance (P<0.05). Logistic regression analysis revealed that baseline HBV RNA levels (OR=0.521, 95%CI: 0.281~0.967, P=0.039) and liver fibrosis stage (OR=3.584, 95%CI: 1.291~9.953, P=0.014) were associated with HBeAg seroconversion. The area under the ROC curve (AUC) for baseline HBV RNA was 0.782, with an optimal cutoff value of 7.14 lg IU/mL, yielding a sensitivity of 66.6% and specificity of 85.7%. Conclusion Serum HBV RNA may serve as a valuable predictor for HBeAg seroconversion in HBeAg-positive CHB patients with normal ALT levels undergoing antiviral therapy.

Key words: Chronic viral hepatitis B, HBeAg serologic conversion, HBV RNA

JIN Ye-sen, YANG Guang-yue, TAO Le, WU Liu, YE Jun , MA Wen-ting. Using serum HBV RNA measurement to predict HBeAg seroconversion in chronic hepatitis B patients with normal alanine aminotransferase levels[J]. Chinese Hepatolgy, 2026, 31(5): 631-634.

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