Circulating HBV RNA and conventional HBV markers in treatment-naïve persons with HBV in Senegal.

Background HBV infection affects approximately 10% of the general population in West Africa. Circulating HBV RNA may help improve the characterization of HBV disease and prognosis. We aimed to evaluate the associations between HBV RNA and conventional biomarkers of HBV replication in the Senegalese Hepatitis B Cohort study (SEN-B).Methods We included all treatment-naïve, HIV-negative participants of SEN-B with chronic HBV infection confirmed by a quantitative HBsAg >0.05 IU/ml. We quantified HBV RNA, HBV DNA and HBsAg levels and evaluated associations between those markers stratified by HBV infection phase, alanine aminotransferase (ALT) level and liver fibrosis stage.Results Of 719 participants, 17 (2.4%) were HBeAg-positive (EP), 620 (86.2%) were classified as HBeAg-negative chronic infection (ENCI) and 82 (11.4%) as HBeAg-negative chronic hepatitis (ENCH). HBV RNA was undetectable in 361 (49.8%) participants, and detectable but unquantifiable in 188 (26.1%). HBV RNA levels correlated moderately with HBV DNA levels in EP (ρ=0.58, p=0.01) and ENCH (ρ=0.54, p<0.001) and weakly in ENCI (ρ=0.39, p<0.001). HBsAg levels were only significantly correlated with HBV RNA levels in the ENCH (ρ=-0.22, p=0.05). Using multivariable logistic regression, HBV RNA levels and HBV RNA to HBV DNA ratio were independently associated with significant liver fibrosis.Conclusions In our cohort of treatment-naïve persons with HBV from Senegal, approximately 50% had undetectable HBV RNA levels. HBV RNA levels correlated with HBV DNA but not HBsAg levels in all phases of HBV infection and may provide an additional tool to assess HBV disease phase and activity.