The World Health Organisation, in its 2019 progress report on HIV, viral hepatitis and STDs indicates that 257 million people are afflicted with chronic HBV infections, of which, 1 million patients lose their lives every year due to HBV related chronic liver diseases including serious complications such as liver cirrhosis and hepatocellular carcinoma. The course of HBV infection and associated liver injury depend on several host factors, genetic variability of the virus, and the host viral interplay. The challenge of medical science is the early diagnosis/identification of the potential for development of fatal complications like liver cirrhosis and HCC so that timely medical intervention can improve the chances of survival. Currently, neither the vaccination regime nor the diagnostic methods are completely effective as reflected in the high number of annual deaths. It is evident from numerous publications that microRNAs (miRNAs) are the critical regulators of gene expression and various cellular processes like proliferation, development, differentiation, apoptosis and tumorigenesis. Expressions of these diminutive RNAs are significantly affected in cancerous tissues as a result of numerous genomic and epigenetic modifications. Exosomes are membrane-derived vesicles (30-100 nm) secreted by normal as well as malignant cells, and are present in all body fluids. They are recognized as critical molecules in intercellular communication between cells through horizontal transfer of information via their cargo, which includes selective proteins, mRNAs and miRNAs. Exosomal miRNAs are transferred to recipient cells where they can regulate target gene expression. This provides an insight into the elementary biology of cancer progression and therefore the development of therapeutic approaches. This concise review outlines various on-going research on miRNA mediated regulation of HBV pathogenesis with special emphasis on association of exosomal miRNA in advanced stage liver disease like hepatocellular carcinoma. This review also discusses the possible use of exosomal miRNAs as biomarkers in the early detection of HCC and liver cirrhosis.

中文翻译：

---

乙型肝炎病毒相关肝病中的外泌体miRNA：生物标志物的新希望。

世界卫生组织在其关于HIV，病毒性肝炎和性病的2019年进度报告中指出，有2.57亿人患有慢性HBV感染，其中每年有100万患者因HBV相关的慢性肝病（包括严重并发症）而丧生如肝硬化和肝细胞癌。HBV感染的过程和相关的肝损伤取决于几个宿主因素，病毒的遗传变异性和宿主病毒相互作用。医学科学的挑战是对肝硬化和肝癌等致命并发症的发展进行早期诊断/识别，以便及时进行医疗干预可以提高生存机会。目前，每年的大量死亡反映了疫苗接种方案和诊断方法都没有完全有效。从众多出版物中可以明显看出，microRNA（miRNA）是基因表达和各种细胞过程（例如增殖，发育，分化，凋亡和肿瘤发生）的关键调节剂。由于许多基因组和表观遗传修饰，这些小RNA的表达在癌组织中受到显着影响。外来体是正常细胞和恶性细胞分泌的膜来源的囊泡（30-100 nm），存在于所有体液中。通过它们的货物的水平传递信息，它们被认为是细胞之间细胞间通讯的关键分子，这些信息包括选择性蛋白，mRNA和miRNA。外泌体miRNA被转移到受体细胞中，它们可以调节靶基因的表达。这为癌症进展的基本生物学以及治疗方法的发展提供了见识。这篇简明的综述概述了有关miRNA介导的HBV发病机制调控的各种正在进行的研究，特别强调了外泌体miRNA与晚期肝病（如肝细胞癌）的相关性。这篇综述还讨论了外泌体miRNA作为生物标志物在肝癌和肝硬化早期检测中的可能用途。这篇简明的综述概述了有关miRNA介导的HBV发病机制调控的各种正在进行的研究，特别强调了外泌体miRNA与晚期肝病（如肝细胞癌）的相关性。这篇综述还讨论了外泌体miRNA作为生物标志物在肝癌和肝硬化早期检测中的可能用途。这篇简明的综述概述了有关miRNA介导的HBV发病机制调控的各种正在进行的研究，特别强调了外泌体miRNA与晚期肝病（如肝细胞癌）的相关性。这篇综述还讨论了外泌体miRNA作为生物标志物在肝癌和肝硬化早期检测中的可能用途。