Abstract:

Objective To investigate the expression of HBV RNA in hepatitis B virus?associated hepatocellular carcinoma （HBV?HCC）. Methods A total of 259 patients with chronic hepatitis B （CHB） and 41 HBV?HCC patients treated in the outpatient or inpatient department of the Affiliated Hospital of Zunyi Medical University from December 2023 to January 2025 were enrolled as subjects. The differences in age， sex， and levels of HBV RNA， HBV DNA， ALT， AST， and TBIL between the two groups were compared. Differences in viral load between HBV RNA and HBV DNA within each group were compared. Correlations between HBV RNA and HBV DNA， ALT， AST， and TBIL within each group were analyzed. Diagnostic efficacy of HBV RNA for HBV?HCC was determined using receiver operating characteristic （ROC） curve analysis. Results The HBV?HCC group had significantly higher HBV RNA load， HBV RNA positivity rate， ALT， AST and TBIL levels and proportion of male patients and older age compared to the CHB group （P < 0.05）. Scatter plot analysis revealed a higher HBV DNA load compared to the HBV RNA load in the CHB group （P < 0.000 1）. Correlation analysis showed that HBV RNA was positively correlated with HBV DNA in both groups （P < 0.05）. In the CHB group， HBV RNA was positively correlated with ALT， AST and TBIL （P < 0.001）. The ROC curve showed that the area under the curve （AUC） for HBV RNA was 0.6923 （P < 0.000 1）， with an optimal cut?off value of ≥ 2.5 log₁₀ copies/mL for diagnosing HBV?HCC. Conclusion Serum HBV RNA levels demonstrate high sensitivity and specificity for identifying HBV?HCC and can serve as a reliable indicator for predicting the occurrence of HBV?HCC.

Key words: HBV RNA, chronic hepatitis B, hepatitis B virus associated hepatocellular carcinoma