Correlation between HBV pgRNA level and the risk of recurrence in patients with chronic hepatitis B after withdrawal of antiviral drug

Abstract

Abstract: Objective To investigate the corrrelation between the level of hepatitis B virus (HBV) pregenomic ribonucleic acid (pgRNA) and the risk of recurrence in patients with chronic hepatitis B (CHB) after withdrawal of antiviral drug.Methods A total of 224 patients with CHB treated in our hospital and meeting the discontinuation criteria from May 2017 to May 2019 were enrolled. They were followed up for 2 years. The Kaplan-Meier method was used to draw the cumulative recurrence curve of patients after drug withdrawal. Patients were divided into recurrence group and non-recurrence group according to whether relapse. Their general data, laboratory examination data, and serum HBV pgRNA level (detected by fluorescence quantitative polymerase chain reaction) were collected. COX regression analysis was used to analyze the related risk factors of the recurrence, and the restricted cubic spline was used to fit the nonlinear relationship between HBV pgRNA level and the risk of recurrence in patients with CHB after drug withdrawal.Results All the patients were followed up for 2 years, 6 cases were lost due to various reasons, and 218 cases were finally enrolled (70 cases in the recurrence group and 148 cases in non-recurrence group), and the cumulative recurrence rate was 32.11% (70/218). The alanine transaminase (ALT) level and the HBeAb negative rate when stopping medication between the 2 groups were significantly different. The HBV DNA load [(4.23 ± 1.09) lg copies/mL], the HBsAg level at the time of drug withdrawal [(2.36 ± 0.71) lgIU/mL], and the HBV pgRNA level [(4.55 ± 1.32) lg copies/mL] of recurrence group were significantly higher than those of non- recurrence group [HBV DNA load: (3.71 ± 1.02) lg copies/mL, HBsAg level: (1.82 ± 0.21) lgIU/mL, HBV pgRNA level: (4.06 ± 1.23) lg copies/mL] (all P<0.05). Cox regression analysis showed that HBV pgRNA level (HR=1.235, 95%CI 1.064 ~ 1.432), ALT level (HR=1.011, 95%CI 1.006 ~ 1.016), HBsAg level at the time of drug withdrawal (HR=3.623, 95%CI 2. 791 ~ 6.557) and HBV DNA load (HR=1.384, 95%CI 1.099 ~ 1.743) were risk factors for relapse in patients with CHB after drug withdrawal (all P<0.05). Restricted cubic spline showed that there was a significant non-linear relationship between HBV pgRNA level and the risk of relapse in patients with CHB (χ²=24.710, P<0.001).Conclusion The HBVpgRNA level is related to the relapse in patients with CHB after drug withdrawal.

Key words: Pregenomic ribonucleic acid, Chronic hepatitis B, Hepatitis B virus, Risk of recurrence

CHEN Jing-yu, QI Wei, HU Ming-le, LI Hua-dong, WANG Jing. Correlation between HBV pgRNA level and the risk of recurrence in patients with chronic hepatitis B after withdrawal of antiviral drug[J]. Chinese Hepatolgy, 2022, 27(4): 413-417.

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