title: On-treatment low serum HBV RNA level predicts initial virological response in chronic hepatitis B patients receiving nucleoside analogue therapy.
abstract: BACKGROUND
  Serum HBV RNA is detectable during nucleoside/nucleotide analogue therapy as a result of unaffected RNA replicative intermediates or interrupted reverse transcription. We studied the predictive value of serum HBV RNA for initial virological response during nucleoside analogue therapy.
  
  
  METHODS
  Serum HBV RNA was quantified before and at 12 and 24 weeks of lamivudine or entecavir therapy. Serum HBV DNA was measured every 4-12 weeks during treatment to define initial virological response.
  
  
  RESULTS
  Serum HBV RNA was detectable in 21 of 52 (40%) consecutive patients with a mean of 5.2 log copies/ml (male/female 35/17, mean age of 60 years with a range of 31-82, 44% HBeAg-positive, and 26 with lamivudine and 26 with entecavir) before treatment. Serum HBV RNA level at week 12 in patients with an interval from detectable to undetectable serum HBV DNA level <16 weeks was significantly lower than those with an interval ≥16 weeks (3.8 ±3.8 versus 6.6 ±3.5 log copies/ml, P=0.013). After adjustment for serum HBV DNA level at week 12, serum quantatitive HBsAg level at week 12 and pretreatment ALT level, low serum HBV RNA level at week 12 predicted a shorter interval to undetectable serum HBV DNA level (adjusted hazard ratio =0.908, 95% CI 0.829, 0.993, P=0.035).
  
  
  CONCLUSIONS
  Low serum HBV RNA level at week 12 of nucleoside analogue therapy independently predicts initial virological response in treated chronic hepatitis B patients. Serum HBV RNA levels may thus be useful for optimizing treatment of chronic hepatitis B.
authors.affiliation: Liver Center, Cathay General Hospital Medical Center, Taipei, Taiwan.
authors.forename: Yi-Wen
authors.initials: YW
authors.lastname: Huang
authors.forename: Shoichi
authors.initials: S
authors.lastname: Takahashi
authors.forename: Masataka
authors.initials: M
authors.lastname: Tsuge
authors.forename: Chi-Ling
authors.initials: CL
authors.lastname: Chen
authors.forename: Ting-Chuan
authors.initials: TC
authors.lastname: Wang
authors.forename: Hiromi
authors.initials: H
authors.lastname: Abe
authors.forename: Jui-Ting
authors.initials: JT
authors.lastname: Hu
authors.forename: Ding-Shinn
authors.initials: DS
authors.lastname: Chen
authors.forename: Sien-Sing
authors.initials: SS
authors.lastname: Yang
authors.forename: Kazuaki
authors.initials: K
authors.lastname: Chayama
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D015415:Biomarkers / Q000097:blood; D004279:DNA, Viral / Q000037:antagonists & inhibitors / Q000097:blood*; D005260:Female; D006147:Guanine / Q000031:analogs & derivatives* / Q000627:therapeutic use; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000254:growth & development / Q000378:metabolism; D019694:Hepatitis B, Chronic / Q000097:blood / Q000175:diagnosis / Q000188:drug therapy* / Q000821:virology; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012367:RNA, Viral / Q000037:antagonists & inhibitors / Q000097:blood*; D016896:Treatment Outcome; D019562:Viral Load / Q000187:drug effects
chemical_list: D000998:Antiviral Agents; D015415:Biomarkers; D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D012367:RNA, Viral; D019259:Lamivudine; C413685:entecavir; D006147:Guanine