Implications of Circulating Hepatitis B Virus RNA Levels in Assessment of Response to Antiviral Therapy

• Published in: Current hepatology reports 2018-12, Vol.17 (4), p.451-458
• Main Authors: Zhou, Tianlun, Wang, Chuanmin, Sayeed, Aejaz, Block, Timothy
• Format: Article
• Language: English
• Subjects: Hepatitis B (J Lim; Hepatology; Medicine; Medicine & Public Health; Section Editor; Topical Collection on Hepatitis B
• ISSN: 2195-9595; 2195-9595
• DOI: 10.1007/s11901-018-0433-7

Purpose of Review Treatment of chronic hepatitis B infection with nucleos(t)ide analogues induces a significant inhibition of HBV DNA titer. However, reduction of viral DNA load is not an ideal marker to predict sustainable antiviral effect. Circulating HBV RNA has been, recently, explored as a novel biomarker for monitoring viral persistence and the progression of liver disease. This review aims to discuss the characteristics of circulating HBV RNA and to evaluate its applications in hepatitis B infection management. Recent Findings HBV RNA is readily detectable in the blood of infected patients. Circulating viral RNA is originated from polyadenylated pgRNA that is packaged in, and secreted with, either naked core particles or virion-like particles. Serum pgRNA could be presented in full length or multiple-spliced forms. The amount and composition of pgRNA in blood can be used to gauge intrahepatic cccDNA transcriptional activity, predict drug response, and reflect liver histologic changes. Summary Circulating HBV pgRNA is exclusively transcribed from cccDNA in the liver. As an alternative to liver biopsy, non-invasive measurement of serum HBV RNA in patients receiving antiviral treatment might provide clinicians a safe and effective tool to oversee therapeutic efficacy.