Hayashi, Sanae Nagoya City University|Kumamoto University
Isogawa, Masanori Nagoya City University
Kawashima, Keigo Nagoya City University
Ito, Kyoko Nagoya City University
Chuaypen, Natthaya Chulalongkorn University
Higashi‑Kuwata, Nobuyo National Center for Global Health and Medicine Research Institute
Watanabe, Takehisa Kumamoto University
Tangkijvanich, Pisit Chulalongkorn University
Mitsuya, Hiroaki National Center for Global Health and Medicine Research Institute|National Institutes of Health|Kumamoto University
Tanaka, Yasuhito Nagoya City University|Kumamoto University
The persistence of covalently closed circular DNA (cccDNA) poses a major obstacle to curing chronic hepatitis B (CHB). Here, we used droplet digital PCR (ddPCR) for cccDNA quantitation. The cccDNA-specific ddPCR showed high accuracy with the dynamic range of cccDNA detection from 101 to 105 copies/assay. The ddPCR had higher sensitivity, specificity and precisely than qPCR. The results of ddPCR correlated closely with serum HB core-related antigen and HB surface antigen (HBsAg) in 24 HBV-infected human-liver-chimeric mice (PXB-mice). We demonstrated that in 2 PXB-mice after entecavir treatment, the total cccDNA content did not change during liver repopulation, although the cccDNA content per hepatocyte was reduced after the treatment. In the 6 patients with HBV-related hepatocellular carcinoma, ddPCR detected cccDNA in both tumor and non-tumor tissues. In 13 HBeAg-negative CHB patients with pegylated interferon alpha-2a, cccDNA contents from paired biopsies were more significantly reduced in virological response (VR) than in non-VR at week 48 (p = 0.0051). Interestingly, cccDNA levels were the lowest in VR with HBsAg clearance but remained detectable after the treatment. Collectively, ddPCR revealed that cccDNA content is stable during hepatocyte proliferation and persists at quantifiable levels, even after serum HBsAg clearance.
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