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最近的工作证实了慢性乙型肝炎患者血清中存在的HBV RNA为3.5 kb大小的前基因组RNA(pgRNA),这些pgRNA存在于形态结构类似于丹颗粒的病毒样颗粒中。由于pgRNA直接以肝细胞核内的病毒共价闭合环状DNA(ccc DNA)为模板转录,其产生过程不受核苷和核苷酸类药物的抑制。据此推测,血清中病毒RNA的存在应能够反映接受治疗的患者肝细胞内ccc DNA的存在及转录活性,故可作为一个潜在的指导患者核苷和核苷酸类药物安全停药的指标。基于小样本停药队列的结果显示停药点血清中HBV RNA的存在的确与停药后的病毒学反弹相关。
Recent work has demonstrated the presence of HBV RNA in the serum of patients with chronic hepatitis B as 3.5 kb pregenomic RNAs (pgRNAs) that are found in virus-like particles that morphologically resemble Dan particles. Since pgRNA is directly transcribed by the covalently-closed circular DNA (ccc DNA) in the nucleus of a hepatocyte, the process of its production is not inhibited by nucleosides and nucleotides. It is speculated that the presence of viral RNA in serum should be able to reflect the presence and transcriptional activity of ccc DNA in the hepatocytes of patients undergoing therapy and therefore may be used as a potential indicator of the safe discontinuation of nucleosides and nucleotide drugs in patients. The results of a small sample-based discontinuation cohort showed that the presence of HBV RNA in the serum of the stopping point was indeed associated with a virological rebound after withdrawal.