P0643 : Serum HBV RNA is an early predictor of HBeAg seroconversion in patients with chronic hepatitis B (CHB) treated with Peg-Interferon alpha-2A (40kD)

EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection

“…Because of its strong correlation with intrahepatic cccDNA, serum HBV RNA is an interesting marker to study cccDNA transcriptional activity. [236][237][238] A strong correlation between quantitative serum HBV RNA dynamics and HBeAg loss in both NA and PegIFNa treated patients 239 was recently demonstrated by using a new rapid amplification of cDNA-ends with polymerase chain reaction (RACE-PCR). 240 HBV RNA quantification might be also helpful in predicting viral rebound after discontinuation of NAs.…”

Host and viral factors associated with serum hepatitis B virus RNA levels among patients in need for treatment

“…HBV RNA in serum could fulfill criteria of such a biomarker, as the 4 major types of HBV RNAs are direct transcriptional products of the cccDNA. HBV RNA can be detected in serum and can be quantified by using PCR techniques . The nature of HBV RNA in serum has not fully been researched, but it most likely includes the 3.5‐kilobase pregenomic RNA, which is the template for reverse transcription to HBV DNA and for translation of core protein and polymerase.…”

“…Thus, before and during treatment with nucleos(t)ide analogue (NA) or pegylated interferon alfa (PEG‐IFN), a correlation between serum HBV RNA and the transcriptional activity of cccDNA was demonstrated . In addition, serum HBV RNA levels were found to be associated with the probability of response to treatment with either NAs or PEG‐IFN . However, before the further development of serum HBV RNA as a response‐predicting marker, it is mandatory to evaluate which factors which may influence HBV RNA levels in individuals who are eligible for treatment.…”

Clinical Trial Watch: Reports from the Liver Meeting®, AASLD, San Francisco, November 2015

“…Dynamics of HBV RNA in serum have been recently associated with the probability of HBeAg seroconversion in NUC treated patients. Van Bömmel et al now evaluated whether changes in serum HBV RNA levels from baseline to week 12 and week 24 may be used as a marker to predict HBsAg seroconversion following treatment with PegIFN alone or in combination with lamivudine [30]. HBV RNA (similar to HBV DNA/HBeAg) fairly well predicted HBeAg seroconversion until week 72 as early as at weeks 12 and 24 of treatment (AUROC scores 0.60-0.75), while ALT and HBsAg levels were poor predictors at these time points (AUROC scores 0.55-0.61).…”

“…An open and non-controlled trial showed that a very low calorie diet (900 kCal) based on the meal replacement Optifast Ò for 6-8 weeks was able to improve steatosis in 47 liver transplant donors. The donors had a baseline BMI >30 or confirmed steatosis (only in 6 patients: 10-30%) and after the intervention there was a significant decrease in BMI (35, [33-37] to 31 [28][29][30][31][32][33]), and all 25 patients having a post-intervention biopsy showed absent (in 17-68%) or <10% steatosis. Compared with 400 liver donors with a significantly lower BMI (26 [23][24][25][26][27][28][29]) and no dietary intervention, there were no differences in outcomes for either donor or recipient.…”