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

  • Hepatitis B (J Lim, Section Editor)
  • Published:
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Abstract

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.

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Funding

Preparation of this manuscript was supported, in part, by grants from the Commonwealth of Pennsylvania, the Hepatitis B Foundation, and the US National Institutes of Health.

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Authors and Affiliations

  1. Department of Translational Medicine, Baruch S. Blumberg Institute, 3805 Old Easton Road, Doylestown, PA, 18902, USA

    Tianlun Zhou, Aejaz Sayeed & Timothy Block

  2. Department of Infectious Diseases, Taihe Hospital, Shiyan, 442000, Hubei, China

    Chuanmin Wang

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  1. Tianlun Zhou
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  2. Chuanmin Wang
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  4. Timothy Block
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Correspondence to Tianlun Zhou.

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Conflict of Interest

Timothy Block reports grants and other from Arbutus Biopharma, other from Glycotest, other from Contravir, grants from Commonwealth of PA, outside the submitted work. In addition, Timothy Block has a patent method to detect HCC licensed to Glycotest, and I am studying the role of mRNA from the host as well as the virus (HBV) in the blood of people with liver diseases, including chronic HBV. The work described in this manuscript relates to these studies. Tianlun Zhou, Chuanmin Wang, and Aejaz Sayeed each declare no potential conflicts of interest.

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This article does not contain any studies with human or animal subjects performed by any of the authors.

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This article is part of the Topical Collection on Hepatitis B

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Zhou, T., Wang, C., Sayeed, A. et al. Implications of Circulating Hepatitis B Virus RNA Levels in Assessment of Response to Antiviral Therapy. Curr Hepatology Rep 17, 451–458 (2018). https://doi.org/10.1007/s11901-018-0433-7

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