Clinical characteristics analysis of hepatitis B virus infected individuals with high hepatitis B virus pregenomic RNA_West China Medical Journal

Authors：

XU Tian , ZHANG Yunzhe ,  LEI Xuezhong

Center of Infectious Diseases, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

LEI Xuezhong, Email: 18980601317@163.com

Keywords：

Hepatitis B virus pregenomic RNA; chronic hepatitis B; serological marker

DOI：

10.7507/1002-0179.202305083

Video：

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Objective To analyze the clinical characteristics of individuals with high hepatitis B virus (HBV) pregenomic RNA (pgRNA), and further explore the value of pgRNA in the management of patients with chronic hepatitis B. Methods From December 1st, 2020 to April 1st, 2022, chronic hepatitis B patients who had been treated with nucleotide analogues for a long time and followed up in the Hepatitis Clinic of the Center of Infectious Diseases, West China Hospital, Sichuan University were included, and the clinical characteristics of chronic hepatitis B patients with high pgRNA were analyzed and summarized. Results A total of 107 patients were included. Male patients accounted for 66.4%, with an average age of 44.02 years. There were no statistically significant differences in gender, age, aspartate transaminase, alanine transaminase, γ-glutamyl transferase, HBV surface antigen, proportion of patients with HBV e antigen ≥0.1 U/mL, HBV DNA, and alpha fetoprotein between the high and low pgRNA groups (P>0.05). The proportion of patients with HBV surface antigen<100 U/mL in the high pgRNA group was lower than that in the low pgRNA group (4.4% vs. 22.6%, P<0.05). Conclusion The proportion of chronic hepatitis B patients with high pgRNA whose HBV surface antigen≥100 U/mL is higher.

Citation： XU Tian, ZHANG Yunzhe, LEI Xuezhong. Clinical characteristics analysis of hepatitis B virus infected individuals with high hepatitis B virus pregenomic RNA. West China Medical Journal, 2024, 39(8): 1184-1187. doi: 10.7507/1002-0179.202305083 Copy

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6.	Wang J, Shen T, Huang X, et al. Serum hepatitis B virus RNA is encapsidated pregenome RNA that may be associated with persistence of viral infection and rebound. J Hepatol, 2016, 65(4): 700-710.
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8.	Yuen MF, Chen DS, Dusheiko GM, et al. Hepatitis B virus infection. Nat Rev Dis Primers, 2018, 4: 18035.
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14.	Xia Y, Guo H. Hepatitis B virus cccDNA: formation, regulation and therapeutic potential. Antiviral Res, 2020, 180: 104824.
15.	Kramvis A, Chang KM, Dandri M, et al. A roadmap for serum biomarkers for hepatitis B virus: current status and future outlook. Nat Rev Gastroenterol Hepatol, 2022, 19(11): 727-745.
16.	Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet, 2014, 384(9959): 2053-2063.
17.	Lin J, Jiang S, Chen X, et al. The significance of detecting HBV pgRNA and HBcrAg in HBV patients treated with NAs. Medicine (Baltimore), 2024, 103(14): e37752.
18.	Mak LY, Huang Q, Wong DK, et al. Residual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy. J Gastroenterol, 2021, 56(5): 479-488.
19.	Meier MA, Calabrese D, Suslov A, et al. Ubiquitous expression of HBsAg from integrated HBV DNA in patients with low viral load. J Hepatol, 2021, 75(4): 840-847.
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21.	Hu P, Dou XG, Xie Q, et al. HBsAg loss with peg-interferon alfa-2a in hepatitis B patients with partial response to nucleos(t)ide analog: New Switch study. Hepatol Int, 2017, 11(Suppl 1): S1-1093.
22.	Abdelwahed AH, Heineman BD, Wu GY. Novel approaches to inhibition of HBsAg expression from cccDNA and chromosomal integrants: a review. J Clin Transl Hepatol, 2023, 11(7): 1485-1497.
23.	Zheng JR, Wang ZL, Feng B. Hepatitis B functional cure and immune response. Front Immunol, 2022, 13: 1075916.

1. Martinez MG, Boyd A, Combe E, et al. Covalently closed circular DNA: the ultimate therapeutic target for curing HBV infections. J Hepatol, 2021, 75(3): 706-717.
2. Global cancer burden growing, amidst mounting need for services. Saudi Med J, 2024, 45(3): 326-327.
3. Yang JD, Kim WR, Coelho R, et al. Cirrhosis is present in most patients with hepatitis B and hepatocellular carcinoma. Clin Gastroenterol Hepatol, 2011, 9(1): 64-70.
4. European Association for the Study of the Liver. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol, 2017, 67(2): 370-398.
5. Chen EQ, Feng S, Wang ML, et al. Serum hepatitis B core-related antigen is a satisfactory surrogate marker of intrahepatic covalently closed circular DNA in chronic hepatitis B. Sci Rep, 2017, 7(1): 173.
6. Wang J, Shen T, Huang X, et al. Serum hepatitis B virus RNA is encapsidated pregenome RNA that may be associated with persistence of viral infection and rebound. J Hepatol, 2016, 65(4): 700-710.
7. Wang Y, Liu Y, Liao H, et al. Serum HBV DNA plus RNA reflecting cccDNA level before and during NAs treatment in HBeAg positive CHB patients. Int J Med Sci, 2022, 19(5): 858-866.
8. Yuen MF, Chen DS, Dusheiko GM, et al. Hepatitis B virus infection. Nat Rev Dis Primers, 2018, 4: 18035.
9. 王贵强, 王福生, 庄辉, 等. 慢性乙型肝炎防治指南(2019 年版). 中国病毒病杂志, 2020, 10(1): 1-25.
10. Liu J, Li T, Zhang L, et al. The role of hepatitis B surface antigen in nucleos(t)ide analogues cessation among asian patients with chronic hepatitis B: a systematic review. Hepatology, 2019, 70(3): 1045-1055.
11. Fung S, Choi HSJ, Gehring A, et al. Getting to HBV cure: the promising paths forward. Hepatology, 2022, 76(1): 233-250.
12. Nassal M. HBV cccDNA: viral persistence reservoir and key obstacle for a cure of chronic hepatitis B. Gut, 2015, 64(12): 1972-1984.
13. Bhat SA, Kazim SN. HBV cccDNA-A culprit and stumbling block for the hepatitis B virus infection: its presence in hepatocytes perplexed the possible mission for a functional cure. ACS Omega, 2022, 7(28): 24066-24081.
14. Xia Y, Guo H. Hepatitis B virus cccDNA: formation, regulation and therapeutic potential. Antiviral Res, 2020, 180: 104824.
15. Kramvis A, Chang KM, Dandri M, et al. A roadmap for serum biomarkers for hepatitis B virus: current status and future outlook. Nat Rev Gastroenterol Hepatol, 2022, 19(11): 727-745.
16. Trépo C, Chan HL, Lok A. Hepatitis B virus infection. Lancet, 2014, 384(9959): 2053-2063.
17. Lin J, Jiang S, Chen X, et al. The significance of detecting HBV pgRNA and HBcrAg in HBV patients treated with NAs. Medicine (Baltimore), 2024, 103(14): e37752.
18. Mak LY, Huang Q, Wong DK, et al. Residual HBV DNA and pgRNA viraemia is associated with hepatocellular carcinoma in chronic hepatitis B patients on antiviral therapy. J Gastroenterol, 2021, 56(5): 479-488.
19. Meier MA, Calabrese D, Suslov A, et al. Ubiquitous expression of HBsAg from integrated HBV DNA in patients with low viral load. J Hepatol, 2021, 75(4): 840-847.
20. Emery JS, Feld JJ. Treatment of hepatitis B virus with combination therapy now and in the future. Best Pract Res Clin Gastroenterol, 2017, 31(3): 347-355.
21. Hu P, Dou XG, Xie Q, et al. HBsAg loss with peg-interferon alfa-2a in hepatitis B patients with partial response to nucleos(t)ide analog: New Switch study. Hepatol Int, 2017, 11(Suppl 1): S1-1093.
22. Abdelwahed AH, Heineman BD, Wu GY. Novel approaches to inhibition of HBsAg expression from cccDNA and chromosomal integrants: a review. J Clin Transl Hepatol, 2023, 11(7): 1485-1497.
23. Zheng JR, Wang ZL, Feng B. Hepatitis B functional cure and immune response. Front Immunol, 2022, 13: 1075916.

West China Medical Journal

Clinical characteristics analysis of hepatitis B virus infected individuals with high hepatitis B virus pregenomic RNA

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