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Author: Cai Hao East chief physician Beijing Ditan Hospital, the medical article is the author's permission Naomaitong release, please do not reprint without authorization.
Introduction Research in recent years has found that HBV RNA is related to the transcriptional activity of cccDNA, which can reflect the replication activity in the liver and become a biomarker for predicting treatment response and prognosis of drug withdrawal.
A recent study by Dutch scholar Brakenhoff et al.
[1] found that a decrease in HBV RNA without a decrease in viral antigens is related to the low probability of sustained viral response (HBV DNA <2000 IU/mL) and hepatitis B surface antigen (HBsAg) loss.
Study introduction Brakenhoff et al.
on a PEG-IFN (PEG-IFN) treatment of two randomized controlled trials (PEG-IFN single agent, PEG-IFN+lamivudine or PEG-IFN+ribavirin) chronic Hepatitis B patients undergo quantitative analysis of HBV RNA, HBsAg and hepatitis B core related antigen (HBcrAg).
The results showed that 52.
3% (135/258) of the patients had undetectable HBV RNA at 24 weeks of treatment (the lower detectable limit of HBV RNA was <800 copies/ml).
Among the 135 HBV RNA responders, the response continued after the drug was stopped 37 Among patients (27.
4%), 14 cases (10.
4%) had HBsAg loss, and the sustained response rate and HBsAg loss rate of patients who responded to HBV RNA after drug withdrawal were significantly higher (Figure 1).Figure 1 The relationship between HBV RNA response rate and sustained virological response and HBsAg loss at 24 weeks of treatment.
In the analysis of 135 patients who obtained HBV RNA response at 24 weeks of treatment, it was found that 56.
4% of patients had a decrease in HBsAg at 24 weeks of treatment.
0.
5 log10 IU/ml; the sustained response rate of those with HBsAg drop >1 log10 IU/ml was 47.
6% (n=20/42), and the sustained response rate of those with a drop of <0.
5 log10 IU/ml was 16.
0% ( n=12/75), the difference was statistically significant (P=0.
001).
The response of HBcrAg also obtained similar results.
Figure 2 The relationship between the decline of HBsAg and sustained virological response and HBsAg loss in HBV RNA responders at 24 weeks of treatment.
The conclusion of the study The results of Brakenhoff et al.
showed that after HBV RNA response during peginterferon treatment, if there is no HBsAg and/ Or HBcrAg decreased, the sustained response of the virus and the loss rate of HBsAg were lower after stopping the drug.
References: [1]Brakenhoff SM, de Man RA, Boonstra A, et al.
Hepatitis B virus RNA decline without concomitant viral antigen decrease is associated with a low probability of sustained response and hepatitis B surface antigen loss[J].
Aliment Pharmacol Ther.
2021.
53(2): 314-320.
Introduction Research in recent years has found that HBV RNA is related to the transcriptional activity of cccDNA, which can reflect the replication activity in the liver and become a biomarker for predicting treatment response and prognosis of drug withdrawal.
A recent study by Dutch scholar Brakenhoff et al.
[1] found that a decrease in HBV RNA without a decrease in viral antigens is related to the low probability of sustained viral response (HBV DNA <2000 IU/mL) and hepatitis B surface antigen (HBsAg) loss.
Study introduction Brakenhoff et al.
on a PEG-IFN (PEG-IFN) treatment of two randomized controlled trials (PEG-IFN single agent, PEG-IFN+lamivudine or PEG-IFN+ribavirin) chronic Hepatitis B patients undergo quantitative analysis of HBV RNA, HBsAg and hepatitis B core related antigen (HBcrAg).
The results showed that 52.
3% (135/258) of the patients had undetectable HBV RNA at 24 weeks of treatment (the lower detectable limit of HBV RNA was <800 copies/ml).
Among the 135 HBV RNA responders, the response continued after the drug was stopped 37 Among patients (27.
4%), 14 cases (10.
4%) had HBsAg loss, and the sustained response rate and HBsAg loss rate of patients who responded to HBV RNA after drug withdrawal were significantly higher (Figure 1).Figure 1 The relationship between HBV RNA response rate and sustained virological response and HBsAg loss at 24 weeks of treatment.
In the analysis of 135 patients who obtained HBV RNA response at 24 weeks of treatment, it was found that 56.
4% of patients had a decrease in HBsAg at 24 weeks of treatment.
0.
5 log10 IU/ml; the sustained response rate of those with HBsAg drop >1 log10 IU/ml was 47.
6% (n=20/42), and the sustained response rate of those with a drop of <0.
5 log10 IU/ml was 16.
0% ( n=12/75), the difference was statistically significant (P=0.
001).
The response of HBcrAg also obtained similar results.
Figure 2 The relationship between the decline of HBsAg and sustained virological response and HBsAg loss in HBV RNA responders at 24 weeks of treatment.
The conclusion of the study The results of Brakenhoff et al.
showed that after HBV RNA response during peginterferon treatment, if there is no HBsAg and/ Or HBcrAg decreased, the sustained response of the virus and the loss rate of HBsAg were lower after stopping the drug.
References: [1]Brakenhoff SM, de Man RA, Boonstra A, et al.
Hepatitis B virus RNA decline without concomitant viral antigen decrease is associated with a low probability of sustained response and hepatitis B surface antigen loss[J].
Aliment Pharmacol Ther.
2021.
53(2): 314-320.
