Serum HBV DNA plus RNA shows superiority in reflecting the activity of intrahepatic cccDNA in treatment-naive HBV-infected individuals
Serum HBV DNA plus RNA shows superiority in reflecting the activity of intrahepatic cccDNA in treatment-naive HBV-infected individuals
复制标题
血清 HBV DNA 加 RNA 在反映初治 HBV 感染者肝内 cccDNA 活性方面表现出优越性
DOI：
10.1016/j.jcv.2017.12.016
复制
发表时间：
2018-02-01
影响因子：
8.8
通讯作者：
Lu, Fengmin
中科院分区：
文献类型：
--
作者：
Huang, Hongxin;Wang, Jie;Lu, Fengmin
背景：血清B型肝炎病毒（HBV）DNA和RNA均能反映肝内共价闭合环状DNA（cccDNA）活性。然而，病毒标志物之间的相关性还没有得到充分explored.Objectives：在这里，我们调查了血清HBV RNA和其他病毒标志物之间的相关性在急性肝炎B患者和治疗初治的慢性HBV感染individuals.Study design：19例急性肝炎B患者和84例治疗初治的慢性HBV感染者在不同感染阶段的血清病毒标志物进行了定量。Pearson或斯皮尔曼相关性analysis.Results：急性B肝炎患者血清病毒标志物和肝内cccDNA水平低于未经治疗的慢性HBV感染者。在HBeAg阳性的慢性HBV感染者中，血清HBV RNA水平与血清HBV DNA、HBsAg和肝内cccDNA水平呈正相关。总血清HBV核酸（HBV DNA加RNA）在反映肝内cccDNA活性方面显示出优越性。分层分析显示，这种相关性仅见于HBeAg阳性的慢性B型肝炎阶段。结论：急性B型肝炎患者HBV复制能力低于慢性HBV感染者，慢性HBV感染期患者HBV复制能力低于慢性HBV感染者。在初治HBeAg阳性的慢性HBV感染者中，血清HBV DNA + RNA在反映肝内cccDNA活性方面优于单独使用。此外，HBV聚合酶RT区突变可能导致HBeAg阴性慢性HBV感染期HBV聚合酶逆转录活性减弱。
Background: Both serum hepatitis B virus (HBV) DNA and RNA can reflect intrahepatic covalently closed circular DNA (cccDNA) activity. However, correlations among viral markers haven't been fully explored.Objectives: Here we investigated the correlations between serum HBV RNA and other viral markers in acute hepatitis B patients and treatment-naive chronic HBV-infected individuals.Study design: The serum viral markers of 19 acute hepatitis B patients and 84 treatment-naive chronic HBV-infected individuals at different infection stages were quantified. Correlations among viral markers were analyzed by Pearson's or Spearman's correlation analysis.Results: Serum viral markers and intrahepatic cccDNA levels were lower in acute hepatitis B patients than in treatment-naive chronic HBV-infected individuals. Serum HBV RNA levels were positively correlated with serum HBV DNA, HBsAg and intrahepatic cccDNA levels in HBeAg-positive chronic HBV-infected individuals. Total serum HBV nucleic acids (HBV DNA plus RNA) showed superiority in reflecting intrahepatic cccDNA activity. Stratified analysis revealed that such correlations were only found in HBeAg-positive chronic hepatitis B phase. Moreover, high-frequency R193M and P196A mutations were found in the RT region of HBV polymerase leading to lower serum HBV DNA and higher serum HBV RNA levels in HBeAg-negative chronic HBV infection phase.Conclusions: HBV replication capability was lower in acute hepatitis B patients than in chronic HBV-infected individuals. In treatment-naive HBeAg-positive chronic HBV-infected individuals, serum HBV DNA plus RNA showed superiority in reflecting intrahepatic cccDNA activity than each alone. Moreover, mutated RT region of HBV polymerase might lead to the attenuated reverse transcriptional activity of HBV polymerase in HBeAg-negative chronic HBV infection phase.