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| Predictive value study of HBVpgRNA for viral relapse in chronic hepatitis B patients after drug withdrawal |
| MO Jinying YU Xi ZHOU Jing XIAO Pujun QU Zhijun |
| Department of Infectious Diseases, Longgang District Central Hospital of Shenzhen City, Guangdong Province, Shenzhen 518116, China |
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Abstract Objective To explore the predictive value of hepatitis B virus pregenomic RNA (HBVpgRNA) for viral relapse in patients with chronic hepatitis B (CHB) after drug withdrawal. Methods From January 2019 to January 2020, 42 CHB patients after drug withdrawal from the Liver Disease Clinic of Longgang District Central Hospital of Shenzhen City were selected as the research objects, and then the enrolled patients were followed up for 24 months. The situation of HBVpgRNA, hepatitis B virus deoxyribonucleic acid (HBV DNA), hepatitis B five quantitative and liver function were tested regularly. According to the follow-up results, they were divided into the virological relapse group and the non relapse group, and the differences of the above detection indicators between the two groups were compared. Re-sults The titers levels of HBVpgRNA and HBsAg of the viral relapse group at the time of drug withdrawal and the viral relapse occurred were significantly higher than those of the non-relapsed group, and the differences were statistically significant (P＜0.05). Serum HBVpgRNA positive after drug withdrawal was an independent risk factor for viral relapse (HR=3.99, 95%CI:1.03-15.38, P=0.045). HBsAg＞1000 U/ml after drug withdrawal was another independent risk factor for viral relapse (HR=20.81, 95%CI: 4.66-92.99, P=0.000). The receiver operating characteristic (ROC) curve showed that the area under the curve (AUC) of HBVpgRNA and HBsAg independently predicting viral relapse in patients with CHB after drug withdrawal was 0.857 (sensitivity was 65.00%, specificitywas 100.00%) and 0.886 (sensitivity was 90.00%, specificity was 77.27) respectively. The AUC of the combined detection of HBsAg and HBVpgRNA was 0.936, compared with the the two alone, there were no statistically significant the difference (P＞0.05), the sensitivity was 90.00% and the specificity was 86.36%. Conclusion The expression levels of HBVpgRNA and HBsAg in patients with viral relapse are significantly higher than those in the non-relapsed patients when the drug was discontinued. HbvpgRNA positive and HBsAg＞1000 U/ml are independent risk factors for viral relapse in patients with CHB after drug withdrawal, which has certain clinical value in predicting safe drug withdrawal in patients with CHB.
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