Journal of Clinical Hepatology
This article investigates the characteristics of serum HBV RNA levels in patients with chronic HBV infection at different stages of natural history and analyzes their correlation with HBV DNA and HBsAg. A total of 306 chronic HBV carriers who had not received antiviral treatment were included in the study and divided into six clinical staging groups. The results showed that the HBV RNA level in the HBeAg-positive chronic HBV infection group was the highest, significantly higher than that in other groups (except for the HBeAg-positive CHB group), and there was a significant difference between the six groups (H=830.770, P<0.001). HBV RNA was strongly correlated with HBV DNA (r=0.92, P<0.001) and moderately correlated with HBsAg (r=0.67), and the correlation was stronger in HBeAg-positive individuals. The innovation lies in the systematic depiction of the distribution characteristics of HBV RNA at different stages of chronic HBV infection, clarifying its clinical value as a marker of cccDNA transcriptional activity, and finding that the HBV RNA level in HBeAg-positive individuals with elevated ALT but not yet meeting the CHB diagnostic criteria has significantly decreased, suggesting that they may be in the transition stage from immune tolerance to clearance, providing new evidence for early identification of disease progression.
This study systematically analyzed the characteristics of serum HBV RNA levels in chronic HBV carriers who had not received antiviral treatment at different stages of natural history and their correlation with HBV DNA and HBsAg, which has important clinical significance. Firstly, the study fills the gap in domestic research on the dynamic changes of HBV RNA based on the domestic guidelines "Prevention and Treatment Guidelines for Chronic Hepatitis B (2022 Edition)". Secondly, the results show that there are significant differences in serum HBV RNA levels at different clinical stages, especially the highest in the HBeAg-positive chronic infection stage, indicating that it can effectively reflect the transcriptional activity of cccDNA. In addition, HBV RNA is strongly correlated with HBV DNA (r=0.92), while the correlation with HBsAg is weak, showing that HBV RNA can better reflect the viral replication status than HBsAg. Especially in HBeAg-positive individuals, the HBV RNA level in those with elevated ALT but not yet meeting the CHB diagnostic criteria has significantly decreased, suggesting that they may be in the transition stage from immune tolerance to immune clearance, which helps identify potential patients with disease activity. Therefore, this study provides strong evidence for the application of HBV RNA as a new serological marker in disease evaluation and individualized management.
Objective: To investigate the features of serum HBV RNA in different stages of the natural history of chronic hepatitis B virus (HBV）…
