Lower Serum HBV RNA Level is Associated with Liver Cirrhosis in Patients Treated with Nucleos(t)ide Analogs: A Population-Based Cross-Sectional Study.

Background/Aims: There is evidence suggesting an association between hepatitis B virus (HBV) RNA and hepatic fibrosis in treatmentnaïve chronic hepatitis B (CHB) patients. However, few studies have delved into the relevance between HBV RNA and HBV-related cirrhosis. The purpose of this article is to elucidate the connection between HBV RNA and cirrhosis in patients undergoing nucleos(t)ide analogs (NAs). Materials and Methods: This study included 381 patients. Logistic regression was employed to investigate the variables linked to the development of cirrhosis. Propensity score matching was used to correct for confounders. Results: In this cross-sectional study, multivariable logistic regression showed HBV RNA detectability was associated with cirrhosis. Multivariate regression suggests that the variables associated with cirrhosis were: older age, HBV RNA above the lower limit of quantification, shorter duration of treatment, higher level of serum bilirubin, and treatment strategy. Among patients with quantifiable HBV RNA (n = 242), cirrhotic patients exhibit lower median serum HBV RNA titers compared to those with CHB patients. Furthermore, qHBsAg ≤ 3.3 lg IU/mL and qHBV RNA ≤ 3.7 lg copies/mL may be linked to cirrhosis. Conclusion: Nucleos(t)ide analogs treatment may result in varying degrees of decrease in HBV RNA levels. Lower levels of HBV RNA may be linked to the development of cirrhosis.