血清HBV RNA定量在指导慢性乙型肝炎抗病毒治疗过程中的作用

Role of serum hepatitis B virus RNA quantification in guiding antiviral therapy for chronic hepatitis B

慢性HBV感染及其所致终末期肝病严重威胁着我国公民健康。HBV cccDNA的存在是慢性乙型肝炎难以治愈和停药后容易复发的主要原因。HBV RNA作为一种新的血清标志物,由cccDNA转录产生,理论上其能够反映肝细胞内cccDNA的水平及转录活性。主要介绍了血清HBV RNA的形成过程,并分析了其在评估肝组织内cccDNA活性或状态,以及在预测抗病毒治疗过程中和停药后患者应答情况等方面的意义。指出血清HBV RNA检测的临床意义需要大规模的临床研究予以验证和完善,进一步优化抗病毒治疗方案,指导患者的精准化治疗。

Chronic hepatitis B virus(HBV)infection and end-stage liver disease caused by such infection pose a serious threat to the health of Chinese citizens.The presence of HBV cccDNA is the main reason for the difficulties in the treatment of chronic hepatitis B and recurrence after drug withdrawal.HBV RNA,as a new serum marker,is produced by cccDNA transcription,and theoretically,it can reflect the level and transcriptional activity of cccDNA in hepatocytes.This article mainly introduces the formation of serum HBV RNA and analyzes its significance in evaluating the activity or status of cccDNA in liver tissue and predicting patients’response during antiviral therapy and after drug withdrawal.Moreover,it is pointed out that further large-scale clinical studies are needed to verify and improve the clinical significance of serum HBV RNA measurement,so as to further optimize the regimens of antiviral therapy and guide the precision treatment of patients.