Levels of HBV RNA in chronic HBV infected patients during first-line nucleos(t)ide analogues therapy

BACKGROUND: Serum HBV RNA has been considered a potential biomarker in monitoring the prognosis of chronic hepatitis B (CHB). However, Real-life cohort studies on the profile of HBV RNA in chronic HBV infected patients during first-line nucleos(t)ide analogues (NAs) are lacking. We aimed to investigate HBV RNA dynamic pattern and clinical value chronic HBV infected patients under NA therapy. METHODS: HBV RNA and clinical assessments were measured in 82 treatment-naïve chronic HBV infected patients. These enrolled patients were categorized into HBeAg-positive chronic HBV infected (n = 53) and HBeAg-negative chronic HBV infected (n = 29). Of these, there were 59, 46, and 30 chronic HBV infected patients completed the follow-up clinical assessments at 12, 24, and 48 weeks of NAs therapy, respectively. RESULTS: In treatment-naïve patients, there was a positive correlation between HBV RNA and HBV DNA, HBsAg (r = 0.602 and 0.502. P < 0.05). The median level of HBV DNA was higher than HBV RNA by 1.64 log(10) copies/mL(.) The mean level of serum HBV RNA was 4.62 (IQR: 3.05–5.82) log(10) copies/mL at baseline, and the median level of HBV RNA was 2.88 (IQR: 0–4.67), 2.71 (IQR: 0–4.22), and 2.96 (IQR: 0–4.32) log(10) copies/mL at week 12, 24, and 48, respectively. HBV RNA showed a positive linear correlation with HBV DNA at 12, 24, and 48 weeks of NA treatment (r = 0.640, 0.715, and 0.656 respectively, P < 0.05). In patients who were treated 48 weeks NAs, 67% had quantifiable HBV RNA while only 37% had quantifiable HBV DNA. CONCLUSION: HBV RNA has signature profiles in different stages of chronic HBV infected patients receiving first-line NAs. During antiviral treatment, HBV RNA can still monitor the virus activity in patients whose serum HBV DNA cannot be detected. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s13027-022-00473-9.