不同临床结果的乙型肝炎病毒感染者血清前基因组RNA检测的诊断价值

Diagnostic value of serum pregenomic RNA in hepatitis B virus-infected patients with different clinical outcomes

目的评估血清pgRNA在HBV感染后不同临床结局患者中的诊断价值及其与血清相关指标的相关性。方法本研究纳入了210例接受核苷类似物治疗的HBV感染者,根据不同结局分为无症状携带者(ASC)、慢性乙型肝炎(CHB)患者和肝硬化(LC)患者,每组70例。比较pgRNA的差异及其与HBV DNA和HbsAg的相关性。结果HBV pgRNA水平在这3组之间有显著差异,且与血清HBV DNA和HBsAg水平显著相关(HBV pgRNA与HBV DNA:R=0.613,P<0.001;HBV pgRNA与HBsAg:R=0.503,P<0.001)。在HBV DNA水平<500 IU/mL的患者中,有72.8%的患者HBV pgRNA检测阳性,而低于20 IU/mL的患者中有17.6%可以检测到HBV pgRNA阳性。结论血清中HBV pgRNA水平是一种反映肝细胞内病毒复制的标志物,检测血清HBV pgRNA水平可为临床监测cccDNA水平提供参考。

Objective To assess the diagnostic value of serum pgRNA in patients with different clinical outcomes after HBV infection and its relevance with serum-related parameters.Methods This study recruited 210 HBV-infected patients treated with nucleoside analogues,classified as asymptomatic carriers(ASC),chronic hepatitis B(CHB),and cirrhosis(LC)according to different outcomes,each group with 70 cases.The difference of pgRNA levels among each group was compared and their correlation with HBV DNA and HbsAg was evaluated.Results HBV pgRNA levels were significantly different among these three groups.HBV pgRNA levels were significantly correlated with serum HBV DNA and HBsAg Levels(HBV pgRNA and HBV DNA:R=0.613,P<0.001;HBV pgRNA and HbsAg:R=0.503,P<0.001).Of the patients with HBV DNA levels<500 IU/mL,72.8%were HBV pgRNA positive and 17.6%of patients were still positive in patients with DNA below 20 IU/mL.Conclusion Serum HBV pgRNA level was a proper marker reflecting viral replication in hepatocytes.HBV pgRNA levels was helpful in the monitor of cccDNA levels.