Analysis of serum hepatitis B virus RNA levels among HBsAg and HBsAb copositive patients and its correlation with HBV DNA

Hepatitis B virus particles in serum contain minus strand DNA and degraded pregenomic RNA of variable and inverse lengths

This study utilized digital PCR to quantify HBV RNA and HBV DNA within three regions of the HBV genome. Analysis of 75 serum samples from patients with chronic infection showed that HBV RNA levels were higher in core than in S and X regions (median 7.20 vs. 6.80 and 6.58 log copies/mL; p < .0001), whereas HBV DNA levels showed an inverse gradient (7.71 vs. 7.73 and 7.77 log copies/mL, p < .001). On average 80% of the nucleic acid was DNA by quantification in core. The core DNA/RNA ratio was associated with viral load and genotype. In individual patients, the relations between RNA levels in core, S and X were stable over time (n = 29; p = .006). The results suggest that pregenomic RNA is completely reverse transcribed to minus DNA in ≈75% of the virus particles, whereas the remaining 25% contain both RNA and DNA of lengths that reflect variable progress of the polymerase.

Effects of Entecavir on Serum Hepatitis B Virus-DNA, Interferon-γ, and Pregenomic RNA in Patients with Chronic Hepatitis B Virus Infection

Background: Entecavir (ETV) has been widely used in the clinical treatment of the Hepatitis B Virus (HBV). However, whether ETV is helpful in the recovery of T cell immune function remains unclear. Objectives: We aimed to assess the effects of ETV on serum HBV-DNA, interferon-γ (IFN-γ), and pregenomic RNA (pgRNA) in patients with infection. Methods: The clinical data of 300 HBV patients admitted from January 2017 to January 2019 were retrospectively analyzed, of whom 193 cases administered with ETV were assigned to an observation group, and the remaining 107 untreated cases (who refused treatment) were assigned to a blank control group. Their liver function [aspartate aminotransferase (AST) and alanine aminotransferase (ALT)], serum HBV markers [hepatitis B surface antigen (HBsAg) and hepatitis B e antigen (HBeAg)], IFN-γ, HBV-DNA, HBV pgRNA, negative conversion rates of HBeAg and HBV-DNA, and adverse reactions were compared. Results: The levels of HBsAg, IFN-γ, HBV-DNA, and HBV pgRNA were lower in the observation group than in the blank control group 12, 24, and 48 weeks after treatment (P < 0.05). The HBeAg and HBV-DNA negative conversion rates of the observation group were higher than those of the blank control group 12, 24, and 48 weeks after treatment (P < 0.05). Conclusions: Antiviral therapy with ETV can inhibit the replication of HBV-DNA, increase the HBV-DNA negative conversion rate, enhance immune function, and reduce the expression of HBV pgRNA in HBV patients.

Diversity of the nucleic acid forms of circulating HBV in chronically infected patients and its impact on viral cycle

BACKGROUND

Besides the prototypical hepatitis B virus (HBV) infectious particle, which contains a full-length double-stranded DNA (flDNA), additional circulating virus-like particles, which carry pregenomic RNA (pgRNA), spliced1RNA (sp1RNA) or spliced-derived DNA (defDNA) forms have been described. We aimed to determine the level of these four circulating forms in patients and to evaluate their impact on viral lifecycle.

METHODS

Chronic HBV untreated patients (n = 162), included in the HEPATHER cohort, were investigated. Pangenomic qPCRs were set up to quantify the four circulating forms of HBV nucleic acids (HBV_naf). In vitro infection assays were performed to address the impact of HBV_naf.

RESULTS

Hierarchical clustering individualized two clusters of HBV_naf diversity among patients: (1) cluster 1 (C1) showing a predominance of flDNA; (2) cluster 2 (C2) showing various proportions of the different forms. HBeAg-positive chronic hepatitis phase and higher viral load (7.0 ± 6.4 vs 6.6 ± 6.2 Log₁₀ copies/ml; p < 0.001) characterized C2 compared to C1 patients. Among the different HBV_naf, pgRNA was more prevalent in C1 patients with high vs low HBV viral load (22.1% ± 2.5% vs 4.1% ± 1.8% of HBV_naf, p < 0.0001) but remained highly prevalent in C2 patients, whatever the level of replication. C2 patients samples used in infection assays showed that: (1) HBV_naf secretion was independent of the viral strain; (2) the viral cycle efficiency differed according to the proportion of HBV_naf in the inoculum, independently of cccDNA formation. Inoculum enrichment before infection suggests that pgRNA-containing particles drive this impact on viral replication.

CONCLUSION

Besides the critical role of HBV replication in circulating HBV_naf diversity, our data highlight an impact of this diversity on the dynamics of viral cycle.

CLINICAL TRIAL REGISTRATION

Patients were included from a prospective multicenter French national cohort (ANRS CO22 HEPATHER, NCT01953458).