Diagnostic Utility of Pre-Genomic Hepatitis B RNA in the Evaluation of HBV/HIV Coinfection

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Published: Jul 30, 2024
DOI: https://doi.org/10.20411/pai.v9i2.720
Keywords:
pgRNA, quantitative HBsAg, HBV DNA, HBV, HIV, treatment

Main Article Content

Kenneth E. Sherman
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
Susan D. Rouster
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
Heidi Meeds
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
Marion G. Peters
Department of Medicine, Northwestern University, Chicago, IL
Jason T. Blackard
Division of Digestive Diseases, University of Cincinnati College of Medicine, Cincinnati, OH
Paul S. Horn
Department of Pediatrics, University of Cincinnati; Neurology Division, Cincinnati Children’s Medical Center, Cincinnati, OH
Timothy Archampong
Department of Medicine and Therapeutics, University of Ghana Medical School, Accra, Ghana
Awewura Kwara
University of Florida College of Medicine, Gainesville, FL
Mark Anderson
Abbott Laboratories, Abbott Diagnostics Division, Abbott Park, IL
Michael Stec
Abbott Laboratories, Abbott Diagnostics Division, Abbott Park, IL
Gavin A. Cloherty
Abbott Laboratories, Abbott Diagnostics Division, Abbott Park, IL

Abstract

Background: Newer biomarkers of Hepatitis B virus (HBV) infection and treatment response have not been well-characterized in individuals with HBV/HIV coinfection. 


Methods: Pre-genomic RNA (pgRNA) and quantitative HBsAg (qHBsAg) were used to evaluate the associations with baseline characteristics. Participants included two separate groups – 236 with HBV/HIV coinfection enrolled in a cross-sectional cohort in Ghana and 47 from an HBV nucleoside/nucleotide treatment trial comparing tenofovir to adefovir in the United States.


Results: In both cohorts, HBe antigenemia was highly associated with pgRNA and HBV DNA levels. In the treatment cohort, pre-treatment pgRNA serum concentration was 7.0 log10 U/mL, and mean qHBsAg was 201,297 IU/mL. The observed treatment-associated decrease in pgRNA was consistent with a biphasic decline curve that reached second-phase kinetics following treatment week 12. Changes from baseline were significantly correlated with changes in serum ALT (r = - 0.518; P = 0.023) but not with changes in HBV DNA (r = 0.132, P = NS). qHBsAg also correlated with ALT change (r = - 0.488, P = 0.034).


Conclusion: pgRNA and qHBsAg represent newer biomarkers of HBV replication that may help monitor response and treatment outcomes. HBV pgRNA is highly associated with both HBeAg and ALT and may predict both active replication from the closed circular DNA (cccDNA) template as well as hepatic injury. 

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Vol. 9 No. 2 (2024): Volume 9, Number 2
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