Factors and virological significance of hepatitis B virus pregenomic RNA status after 5 years of antiviral therapy. (April 2021)

• Record Type: Journal Article
• Authors: Pan, Jiali; Xu, Jinghang; Luo, Hao; Tan, Ning; Kang, Qian; Chen, Hongyu; Cheng, Ran; Han, Yifan; Yang, Yuqing; Xu, Xiaoyuan
• Is Part Of: International journal of infectious diseases. Volume 105(2021)
• Page Start: 418
• Page End: 423
• Publication Date: 2021-04
• Subjects: Circular DNA -- Chronic hepatitis B -- pgRNA -- Transcription -- Genetic; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2021.02.116
• Languages: English
• ISSNs: 1201-9712

Abstract

Highlights: After 5 years of antiviral treatment, 45.10% of patients remained positive for hepatitis B virus pregenomic RNA (HBV pgRNA). Serum HBV pgRNA was correlated with serum HBV DNA after 5 years of antiviral treatment. HBV pgRNA can reveal HBV covalently closed circular DNA (cccDNA) activity after 5 years of antiviral treatment. Positive HBV pgRNA after 5 years of treatment may indicate higher cccDNA activity. Abstract: Objectives: To investigate the factors and virological significance of serum hepatitis B virus (HBV) pregenomic RNA (pgRNA) status after long-term antiviral therapy with nucleos(t)ide analogues (NAs) in patients with chronic hepatitis B (CHB). Methods: In total, 51 treatment-naïve patients with CHB were included in the study. Clinical data were collected at baseline, during 5 years and at year 10 of NA treatment. Serum HBV pgRNA status of 51 patients was determined at year 5. Results: At year 5, 45% of the patients remained positive for HBV pgRNA. There were significant differences in baseline hepatitis B e antigen (HBeAg) status, HBV DNA load and hepatitis B surface antigen (HBsAg) levels between patients testing positive and negative for HBV pgRNA at year 5. Serum HBV pgRNA status and serum HBV DNA load were correlated after 5 years of NA treatment ( r = 0.347, P = 0.013). Being HBV pgRNA positive at year 5 was an independent risk factor for sustainedly undetectable HBV DNA after 10 years of NA treatment (odds ratio 13.638, 95% confidence interval 1.32–140.81; P = 0.028). Furthermore, HBV pgRNA status at year 5 was associated with HBV DNA re-appearance at year 10 ( P = 0.009). Conclusions: HBV pgRNA status at year 5 can reveal HBV covalently closed circular DNA (cccDNA) activity, and HBV pgRNA positivity after long-term antiviral therapy may indicate higher transcriptional activity of HBV cccDNA. Long-term dynamic monitoring of HBV pgRNA should be considered.