Objective To explore the value of hepatitis Bsurface antigen（HBsAg）

covalent closed-circular DNA（cccDNA）

and pregenomic RNA（pgRNA） level detection in the diagnosis and management of chronic hepatitis B（CHB）.Methods Eighty-three patients with CHB treated in a hospital in Zhengzhou from January 2019 to April 2021 were selected for the study.Quantitative polymerase chain reaction was used to detect pgRNA levels;serum HBsAg was detected by chemiluminescence;and cccDNA was detected after DNA extraction from liver biopsy tissues.pgRNA

HBsAg

and cccDNA levels were compared among patients with different stages before treatment.The relationship between serum pgRNA and HBsAg and cccDNA in patients before treatment was compared.The pgRNA

HBsAg

and cccDNA levels in patients before treatment

at 6 months

and at 12 months of treatment were compared.The value of pgRNA

HBsAg

and cccDNA levels in determining disease progression in patients with CHB was compared regarding sensitivity

specificity

and accuracy.Results The differences in pgRNA levels were statistically significant（P<0.05） when comparing patients with different stages of CHB.All stage Ⅰ CHB patients had higher pgRNA levels than stage Ⅱ

Ⅲ

and Ⅳ patients

and stage ⅡCHB patients had higher pgRNA levels than stage Ⅲ and Ⅳ patients

and the differences were statistically significant（P <0.05）.For all CHB patients

pgRNA levels were positively correlated with HBsAg and cccDNA levels（P<0.05）;for stage Ⅰ and Ⅱ CHB patients

pgRNA levels were positively correlated with HBsAg and cccDNA levels（P<0.05）.At 6 and 12 months of treatment

the pgRNA levels of patients were lower than those before treatment

and the differences were statistically significant（P<0.05）.At 6 and 12 months of treatment

patients’ HBsAg levels were lower than those before treatment;also

at 12 months of treatment

patients’ HBsAg levels were lower than those at 6 months of treatment

and the differences were statistically significant（P<0.05）.At 6 and 12 months of treatment

patients’ cccDNA levels were lower than those before treatment;at 12 months of treatment

patients’ cccDNA levels were lower than those at 6 months of treatment

and the differences were statistically significant（P<0.05）.cccDNA and pgRNA both had higher AUCs and could be used as indicators of disease progression in CHB patients

and the predictive

sensitivity

specificity

and accuracy of pgRNA were higher.Conclusion The detection of HBsAg

pgRNA and cccDNA in patients with CHB can help physicians accurately determine the progression of patients disease and provide a reliable basis for the assessment of efficacy and the selection of clinical protocols.