Clinical superiority of HBV RNA testing in patients with chronic hepatitis B

This study aimed to thoroughly investigate the detection levels of serum Hepatitis B Virus RNA (HBV RNA) and its clinical significance in Chronic Hepatitis B (CHB) patients before and after treatment.

Serum samples were collected from 487 chronic hepatitis B patients. First, the positivity rate and levels of serum HBV RNA were compared with other relevant indicators, and correlations were examined between untreated and treated CHB patients. Second, treated CHB patients were grouped based on their HBsAg, HBeAg, and HBV DNA status. Differences and correlations between HBV RNA and relevant indicators were further analyzed among the groups.

Among the 487 patients, the positivity rate of HBV RNA was significantly higher than that of both HBV DNA and HBeAg. In the untreated group, the positivity rates of both HBV RNA and HBV DNA were significantly higher than that of HBeAg. In patients who were treated but not cured, the positivity rate of HBV RNA was significantly higher than that of both HBV DNA and HBeAg, regardless of whether patients were grouped based on HBsAg, HBeAg, or HBV DNA levels. When analyzed at specific monitoring levels, patients in the treated group showed significantly lower levels of serum HBV RNA, HBV DNA, HBeAg, HBsAg, ALT, and AST compared to those in the untreated group. Correlation analysis revealed that in untreated patients, HBV RNA was positively correlated with ALT, AST, HBsAg, HBeAg, and HBV DNA. However, in the treated group and in those with low HBsAg, HBeAg, and HBV DNA levels, the correlation between HBV RNA and other markers was weakened.

HBV RNA exhibits greater sensitivity and accuracy in reflecting the status of viruses, particularly in patients undergoing antiviral therapy. It provides unique advantages in monitoring treatment efficacy and assessing persistent viral transcriptional activity.