Specific Association and Independent Predictive Value of HBV RNA in the Disease Progression of Hepatitis B with Low-Level Viremia - 13/07/25

Doi : 10.1016/j.clinre.2025.102648

Liang Xu ^a, Bin Yin ^a, Dandan Chen ^a, Xia Xiong ^a, Yongfeng Yang ^b,^c,^⁎ , Xuping Wu ^a,^⁎
^a The Precision Medical Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, No. 1-1 Zhongfu Road, Gulou District, Nanjing, Jiangsu Province, 210003, China.
^b Department of Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing, China
^c The Clinical Infectious Disease Center of Nanjing, No. 1-1 Zhongfu Road, Gulou District, Nanjing, Jiangsu Province, 210003, China

^⁎Corresponding author: Xuping Wu, The Precision Medical Center, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, ChinaThe Precision Medical CenterThe Second Hospital of NanjingNanjing University of Chinese MedicineNanjing210003China^⁎⁎Corresponding author: Yongfeng Yang, Department of Liver Disease, The Second Hospital of Nanjing, Nanjing University of Chinese Medicine, Nanjing 210003, ChinaDepartment of Liver DiseaseThe Second Hospital of NanjingNanjing University of Chinese MedicineNanjing210003China

Sous presse. Manuscrit accepté. Disponible en ligne depuis le Sunday 13 July 2025
Cet article a été publié dans un numéro de la revue, cliquez ici pour y accéder

Highlights

•	HBV RNA and HBsAg correlation surpasses HBV DNA in HBV low-level viremia (LLV)
•	HBV RNA rises with HBV LLV disease progression versus HBV DNA and HBsAg decline
•	In HBV LLV HBV RNA correlates with HBsAg across all HBeAg states.
•	HBV RNA serves as independent predictor across early-mid HBV LLV progression stages
•	In the HBV RNA reduction group, HBsAg and HBeAg primarily showed level reductions

Le texte complet de cet article est disponible en PDF.

ABSTRACT

Background and objective(s)

HBV RNA serve as a downstream transcriptional product of cccDNA within the liver. This study is the first to investigate the diagnostic significance of serum HBV RNA in HBV low-level viremia (LLV) patients, elucidating the interrelationships among serum HBV RNA, HBV DNA, and HBsAg.

Methods

A cohort of 514 HBV LLV patients was collected from The Second Hospital of Nanjing and divided into four groups: asymptomatic HBV carriers (ASC), chronic hepatitis B (CHB), liver cirrhosis (LC), and hepatocellular carcinoma (HCC). All were tested and analyzed for HBV RNA, HBV DNA, HBsAg, HBeAg, and liver function.

Results

serum pathological indicators showed statistically significant differences included RNA, DNA, HBsAg, HBeAg-positive, TBIL, DBIL, IBIL, TP, ALB, ALT, AST, ALP, GGT (P < 0.001), and HBeAg-negative (P = 0.019). Both HBV RNA and HBV DNA were positively correlated with HBsAg (r = 0.405, P < 0.001; r = 0.198, P < 0.001). The correlation between HBV RNA and HBsAg was stronger than that between HBV DNA and HBsAg, and this difference became more pronounced after stratifying patients based on disease progression stages. This was also the case in different HBeAg states. We further conducted multivariate logistic regression analysis, and the results showed that RNA had strong statistical significance in the ASC and CHB groups (P < 0.001).

Conclusions

Monitoring HBV RNA levels holds certain value in assessing antiviral therapy efficacy and predicting disease progression stages and clinical outcomes in HBV LLV patients.

Le texte complet de cet article est disponible en PDF.

KEYWORDS : hepatitis B virus, Hepatitis B, Low Level Viremia, LLV, HBV RNA