Detection and clinical significance of serum HBV pgRNA in patients with chronic hepatitis B treated with nucleoside/nucleotide analogues

ObjectiveTo observe the changes of serum hepatitis B virus (HBV) pregenomic RNA (pgRNA) levels in patients with chronic hepatitis B (CHB) after antiviral therapy with entecavir (ETV) or tenofovir disoproxil fumarate (TDF), and its relationship with HBsAg and HBV DNA, so as to explore the clinical significance of HBV pgRNA in antiviral therapy.

MethodsA total of 89 newly diagnosed CHB patients were selected, including 44 patients receiving ETV treatment (ETV group) and 45 patients receiving TDF treatment (TDF group).The patients were followed up before treatment, at 24 weeks and 48 weeks of treatment, and the serum levels of HBsAg, HBV DNA, HBV pgRNA were measured, the changes and differences in serum HBV pgRNA levels between the two groups were analyzed, as well as the correlation between HBV pgRNA and HBsAg, HBV DNA.

ResultsWith the prolongation of treatment time, the HBV pgRNA levels of patients in the two groups significantly decreased (P < 0.01).At 24 weeks of treatment, the HBV pgRNA levels of patients in the two groups were lower than those before treatment (P < 0.05), and at 48 weeks of treatment, the HBV pgRNA levels were lower than those at 24 weeks of treatment (P < 0.05).Before antiviral treatment and at 24 weeks and 48 weeks of treatment, the HBV pgRNA levels were significantly positively correlated with HBsAg levels in the ETV group (P < 0.01), and HBV pgRNA levels were also significantly positively correlated with HBV DNA (P < 0.01).Before antiviral treatment and at 24 weeks and 48 weeks of treatment, the HBV pgRNA levels were significantly positively correlated with HBsAg levels in the TDF group (P < 0.01);before antiviral treatment and at 24 weeks of treatment, the HBV pgRNA levels were significantly positively correlated with HBV DNA in the TDF group (P < 0.01), but the HBV pgRNA levels were not significantly correlated with HBV DNA in the TDF group at 48 weeks of treatment (P>0.05).The negative conversion rate of HBV DNA of patients in the TDF group was higher than that in the ETV group at the same time point, and at 48 weeks of treatment, there was a statistically significant difference between the two groups (P < 0.05).

ConclusionsThe serum HBV pgRNA levels of CHB patients show a significant downward trend during the process of antiviral treatment, and serum HBV pgRNA has certain clinical significance in evaluating and monitoring the antiviral efficacy of nucleos(t)ide analogues.