Dynamic changes of serum HBV pgRNA and HBcrAg in patients with chronic hepatitis B after discontinuation of NAs therapy: assessment of clinical and virology relapse

Abstract

Abstract: Objective To observe the value of dynamic changes of serum markers such as hepatitis B virus pregene RNA (HBV pgRNA) and hepatitis B core associated antigen (HBcrAg) in the evaluation of the clinical and virological recurrence in chronic hepatitis B (CHB) patients after discontinuing nucleoside (acid) analogues (NAs) treatment. Methods Between July 2020 and July 2021, sixty-five patients with CHB were admitted to our hospital. All patients met the criteria for discontinuation of NAs therapy, and were followed up for at least half a year after discontinuation. Serum levels of HBV pgRNA, HBcrAg, aspartate aminotransferase (AST), alanine aminotransferase (ALT) and total bilirubin (TBil) were detected. Results Patients with a family history of HBV infection (70.4%) had a higher recurrence rate than those without (30.8%). Patients with serum HBV pgRNA levels ≥ 4.06 log₁₀copies/mL (79.2%) had a higher recurrence rate than patients with<4.06 log₁₀copies/mL (41.5%). Patients with serum HBcrAg levels ≥ 3.4 log₁₀ U/L (76.9%) had a higher recurrence rate than patients with<3.4 log₁₀ U/L (41.0%), The recurrence rate (46.0%) of patients with hepatitis B E antigen (HBeAg) disappearance within 12 months was lower than that of patients with HBeAg disappearance within 12 to 24 months (88.9%, 83.3%), and the recurrence rate (46.0%) of patients with serological HBeAg conversion within 12 months was lower than that of patients with HBeAg disappearance within 12 to 24 months (88.9%, 83.3%), The recurrence rate of patients with hepatitis B B surface antigen (HBsAg)<150 ng/mL (26.3%) was lower than that of patients with HBsAg≥ 150 ng/mL (67.4%) (P<0.05). HBeAg serological conversion time, family history of HBV infection, HBeAg disappearance time, HBsAg level, serum HBV pgRNA level and serum HBcrAg level at the time of drug withdrawal were all influential factors for clinical and virologic recurrence in CHB patients who stopped NAs treatment (P<0.05). HBeAg serological conversion time, family history of HBV infection, HBsAg level at drug withdrawal, serum HBV pgRNA level, and serum HBcrAg level were all risk factors for clinical and virologic recurrence in CHB patients who stopped NAs treatment (P<0.05). Conclusion The risk factors for clinical and virological recurrence in CHB patients who have stopped NAs therapy are HBeAg serological conversion time, family history of HBV infection, HBsAg level, serum HBV pgRNA level and serum HBcrAg level at the time of drug withdrawal. Clinical measures should be taken accordingly. The HBsAg level, serum HBV pgRNA level and serum HBcrAg level should be monitored regularly to reduce the recurrence rate of CHB patients.

Key words: Chronic hepatitis B, Hepatitis B virus pregene RNA, Hepatitis B core-associated antigen, Clinical recurrence, Virological relapse

LU Shi, ZHANG Zhi-hong, OUYANG Hui, HE Yu. Dynamic changes of serum HBV pgRNA and HBcrAg in patients with chronic hepatitis B after discontinuation of NAs therapy: assessment of clinical and virology relapse[J]. Chinese Hepatolgy, 2025, 30(2): 175-179.

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