Serum HBV RNA,HBcrAg Levels In Chronic Hepatitis B Patients With HBV DNA Undetectable

Objective: Our study was aimed at evaluation the expression levels of serum HBV RNA and HBcrAg in chronic hepatitis B patients when serum high sensitivity HBV DNA amplification negative after NAs treament,to provide more clinical evidences for antiviral treatment discontinuation safely?Methods :Fourty-three chronic hepatitis B patients treated with oral NAs were enrolled in Sichuan Mianyang 404 Hospital from 2017 to 2018?All patients were treated with at least two years antiviral therapy,and were negative for three consecutive high sensitivity HBV DNA tests evrry half year and normal liver function?Antiviral treatment was discontinuation in 10 HBeAg negative patients when antiviral therapy for at least 3.5 years and three consecutive high sensitivity HBV DNA test amplification negative ?HBcrAg was detected by chemiluminescent enzyme immunoassay,the serum HBV RNA levels was detected by quantitative polymerase chain reaction,and serum All statistical analyses were performed in the IBM SPSS software,version 17?Data with two-tailed P value < 0.05 were considered statistically significant?Results: 1.Seven had a level of serum HBcrAg <LOD(lower limit of detection),twenty-five had a level of serum HBV RNA <LOD in fourty-three chronic hepatitis B patients,Thirty-six patients with serum HBcrAg and eighteen patients with serum HBV RNA can detectable ?2.Serum HBcrAg was positively correlated with HBsAg and HBV RNA? HBcrAg was negatively correlated with age(r=-0.390,p<0.05)and antiviral treatment time(r=-0.316,p<0.05)?HBV RNA was positively correlated with HBsAg(r=0.620,p<0.01)?3.HBsAg and HBV RNA in HBcrAg?3log10 U/ml group were lower than HBcrAg>3log10 U/ml group,the difference was statistically significant(p<0.05)?4.HBV replication in HBeAg-positive group was more active than the HBeAg-negative group.The HBeAg-positive group had high levels of HBcrAg and HBV RNA than the HBeAg-negative group.There was no significant difference in HBsAg levels between the two groups.In the HBeAg-negative group,HBV RNA was positively correlated with HBsAg(r=0.584,p < 0.01)and HBcrAg(r=0.424,p < 0.05),HBcrAg was negatively correlated with age(r=-0.361,p < 0.05)?5.There were no significant differences in gender,age,antiviral treament time,HBsAg,HBV RNA,and HBcrAg between the anti-HBe positive and anti-HBe negative groups? 6.HBV RNA in the HBsAg-positive group was significantly higher than that in the HBsAg-negative group,with an average value of 2.74±0.99 log10 copies /ml and 2.00 log10 copies /ml(p < 0.01)? There was no significant difference in HBcrAg between the two groups,with an average value of 4.31±0.83 log10 U/ml and 3.75±1.11 log10 U/ml,respectively(p > 0.05)?In the HBsAg-positive group,HBV RNA was positively correlated with HBcrAg(r=0.584,p < 0.01)and HBsAg(r=0.474,p < 0.05),HBcrAg was negatively correlated with age(r=-0.389,p < 0.05)?7.Four patients had viral rebound in the ten patients with NAs discontinuation?HBV RNA in the viral rebound group was significantly higher than that in the non-viral rebound group,with an average value of 2.72±0.66 log10 copies /ml and 1.17±0.75 log10 copies /ml(p < 0.05);HBcrAg in the viral rebound group was significantly higher than that in the non-viral rebound group,with an average value of 4.23±1.03 log10 U/ml and 2.98±0.30 log10 U/ml(p < 0.05)?In the viral rebound group,HBcrAg was positively correlated with HBV RNA(r=0.995,p < 0.01),HBcrAg and HBV RNA were negatively correlated with age(r=-0.971 and r=-0.984,respectively,both p < 0.05)?HBcrAg,HBV RNA and HBsAg have no correlation? Conclusion:1.When chronic Hepatitis B patients with high sensitivity HBV DNA amplification negative after NAs treament,HBV replication may be still persistent ?HBcrAg and HBV RNA are better than HBV DNA in montoring HBV replication?2.When HBV DNA was undetectable after NAs treament,HBsAg clearance and HBeAg clearance can reflect HBV replication decreases,the presence or absence of anti-HBe cannot be used to determine the strength of viral replication?3.HBcrAg and HBV RNA can be used to predict viral rebound after discontinuation,the rate of viral rebound possiblely lower when HBcrAg<3log 10 U/ml and HBV RNA<2log10copies/ml.