血清乙肝病毒RNA在指导慢性乙肝病毒感染者临床管理中的价值  

The role of serum HBV RNA in the clinical management of chronic HBV infection

作　　者：王爱丽 李晶[1] 保紫红 范蕊璿 孙慧[1] 刘怀鄂[2] WANG Aili;LI Jing;BAO Zihong;FAN Ruixuan;SUN Hui;LIU Huaie(Department of Infectious Diseases,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650000,China;Department of Gastroenterology,the First Affiliated Hospital of Kunming Medical University,Kunming,Yunnan 650000,China)

机构地区：[1]昆明医科大学第一附属医院感染性疾病科,云南昆明650000 [2]昆明医科大学第一附属医院消化内科,云南昆明650000

出　　处：《中国热带医学》2025年第3期304-308,共5页China Tropical Medicine

基　　金：云南省科技厅科技计划项目(No.202401AY070001-245);昆明医科大学第一附属医院“535”高层次人才学科带头人培养项目(No.2023535D14)。

摘　　要：慢性乙型肝炎病毒(hepatitis B virus, HBV)感染仍然是全球范围内严重的公共卫生问题,肝内共价闭合环状DNA(covalently closed circular DNA, cccDNA)的持续存在使得彻底治愈慢性乙型肝炎面临挑战。因此,寻找可靠且有效的cccDNA血清学替代标志物,对于慢性HBV感染者的抗病毒疗效评价、预后判定及临床管理都具有重要的临床意义。近年来,血清HBV RNA已被认为是cccDNA有前景的非侵入性替代指标,可用于监测慢性HBV感染者的疾病进展并预测预后。本文综述了近年来发表的与HBV RNA相关的研究,发现HBV RNA能够对患者的免疫状态及组织学状态进行评估,探讨了其在指导抗病毒治疗时机中的重要价值;此外,还对HBV RNA在监测病毒复制情况、评估抗病毒治疗效果、预测停药后复发以及指导新型抗病毒策略等方面的重要临床意义进行综述,以期为临床医生更好地将该指标用于慢性HBV感染者的临床管理提供参考。Chronic hepatitis B virus(HBV)infection remains a major global public health concern.The persistent presence of intrahepatic covalently closed circular DNA(cccDNA)poses a major challenge to the complete cure of chronic HBV infection.Therefore,identifying reliable and effective serological surrogate markers for cccDNA holds great clinical significance in evaluating antiviral efficacy,predicting prognosis,and guiding the clinical management of chronic HBVinfected patients.In recent years,serum HBV RNA has emerged as a promising non-invasive alternative marker for cccDNA,offering the potential for monitoring disease progression and predicting prognosis in chronic HBV-infected patients.In this review,we summarize recent studies on HBV RNA,highlighting its ability to assess the immune and histological status of patients,and discussing its value in guiding the timing of antiviral therapy.Furthermore,we systematically summarize the clinical significance of HBV RNA in multiple domains:monitoring viral replication,evaluating antiviral treatment efficacy,predicting relapse after treatment cessation,and guiding new antiviral strategies.This review aims to provide clinicians with valuable insights for better utilizing this marker in the clinical management of chronic HBV infection.

关 键 词：乙型肝炎病毒 慢性乙型肝炎病毒感染者 乙型肝炎病毒RNA 肝内共价闭合环状DNA 

分 类 号：R512.6[医药卫生—内科学]