HBV pgRNA联合cccDNA对慢性乙型肝炎患者抗病毒疗效的预测价值  

Changes and Significance of Combined Detection of HBV pgRNA and cccDNA in Antiviral Therapy for Patients with Chronic Hepatitis B

作　　者：王学英 WANG Xue-ying(Shangqiu City Hospital,Zhengzhou 476000,Henan(Province),China)

机构地区：[1]商丘市立医院检验科,河南郑州476000

出　　处：《罕少疾病杂志》2024年第4期54-56,共3页Journal of Rare and Uncommon Diseases

摘　　要：目的探究乙型肝炎(HBV)前基因组RNA(pgRNA)联合共价闭合环状DNA(cccDNA)对慢性乙型肝炎(CHB)患者抗病毒疗效的预测价值。方法收集2019年8月至2022年8月期间于本院进行抗病毒治疗的96例CHB患者的临床资料,根据患者治疗48周后是否获得完全应答分为完全应答组(78例)及非完全应答组(15例)。检测患者不同时间HBV cccDNA和HBV pgRNA水平,Logistic回归分析影响CHB患者获得完全应答的因素,并应用受试者工作特征(ROC)曲线分析pgRNA与cccDNA联合检测在抗病毒疗效的预测价值。结果96例患者中78例抗病毒治疗后获得非完全应答;完全应答组治疗24、48周HBV pgRNA、HBV cccDNA水平均低于非完全应答组(P<0.05);Logistic回归分析显示,治疗24周HBV pgRNA、HBV cccDNA高水平及治疗前ALT低水平是影响CHB患者抗病毒治疗无效的独立危险因素(P<0.05);经ROC分析显示,HBV pgRNA预测CHB患者抗病毒疗效的AUC值为0.618,95%CI为0.513~0.716,HBV cccDNA预测的AUC值为0.667,95%CI为0.561~0.760,二者联合预测的AUC值为0.881,95%CI为0.799~0.938。结论HBV pgRNA与cccDNA在CHB患者抗病毒治疗中下调,且治疗24周HBV pgRNA联合cccDNA检测对CHB抗病毒疗效具有更高的预测价值。Objective To explore the predictive value of hepatitis B(HBV)pre-genomic RNA(pgRNA)combined with covalently closed circular DNA(cccDNA)for antiviral efficacy in patients with chronic hepatitis B(CHB).Methods Clinical data of 96 patients with CHB who received antiviral therapy in our hospital from August 2019 to August 2022 were collected.Patients were divided into complete response group(78 cases)and incomplete response group(15 cases)according to whether they received complete response after 48 weeks of treatment.The HBV cccDNA and HBV pgRNA levels were detected at different times,and the factors influencing the complete response of CHB patients were analyzed by Logistic regression.The predictive value of pgRNA and cccDNA in antiviral efficacy was analyzed by receiver operating characteristic(ROC)curve.Results Of the 96 patients,78 obtained an incomplete response after antiviral therapy.The levels of HBV pgRNA and HBV cccDNA in the complete response group were lower than those in the incomplete response group before treatment,24 weeks and 48 weeks after treatment(P<0.05).Logistic regression analysis showed that high levels of HBV pgRNA and HBV cccDNA at 24 weeks of treatment and low levels of ALT before treatment were independent risk factors for ineffective antiviral therapy in CHB patients(P<0.05).ROC analysis showed that the AUC value of HBV pgRNA in predicting the antiviral efficacy of CHB patients was 0.618,and 95%CI was 0.513-0.716.The predicted AUC value of HBV cccDNA was 0.667 and 95%CI was 0.561~0.760.The combined predicted AUC value was 0.881,and 95%CI was 0.799~0.938.Conclusion HBV pgRNA and cccDNA are down-regulated in antiviral therapy for CHB patients.HBV pgRNA combined with cccDNA detection at 24 weeks of treatment has higher predictive value for antiviral efficacy of CHB.

关 键 词：乙型肝炎 前基因组RNA 共价闭合环状DNA 抗病毒治疗 

分 类 号：R512.62[医药卫生—内科学]