Serum HBV RNA Levels Predict Significant Liver Fibrosis in Patients with Chronic HBV Infection

Background and Aim. Recently, several studies demonstrated that serum HBV RNA levels were associated with liver disease progression in patients with chronic hepatitis B virus (HBV) infection. This study aimed to determine whether serum HBV RNA levels were correlated with liver fibrosis. Methods. 319 treatment-naive patients with chronic HBV infection were included. The correlation between serum HBV RNA levels and liver histological fibrosis stages was analyzed, and calculations of the area under the receiver operating curve (AUROC) were performed for serum HBV RNA. Results. Serum HBV RNA levels were an independent predictor for significant liver fibrosis both in HBeAg-positive patients (OR=0.514, p<0.001) and HBeAg-negative patients (OR=3.574, p<0.001). In 153 HBeAg-positive patients, HBV RNA had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.77, 0.66, and 0.66 for HBV RNA, APRI, and FIB-4, respectively; p=0.045 for HBV RNA vs. APRI; p=0.043 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis. In 166 HBeAg-negative patients, HBV RNA also had a better diagnostic performance than APRI and FIB-4 (AUROC of 0.78, 0.68, and 0.62 for HBV RNA, APRI, and FIB-4, respectively; p = 0.036 for HBV RNA vs. APRI; p=0.003 for HBV RNA vs. FIB-4) for the diagnosis of significant liver fibrosis. Conclusion. Serum HBV RNA levels were a more accurate noninvasive test than APRI and FIB-4 for the diagnosis of significant liver fibrosis in treatment-naive patients with chronic HBV infection.