Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection

Authors

  • Chi-Jen Chu,

    1. Department of Medicine, Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI
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  • Munira Hussain,

    1. Department of Medicine, Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI
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  • Anna S. F. Lok M.D.

    Corresponding author
    1. Department of Medicine, Division of Gastroenterology, University of Michigan Medical Center, Ann Arbor, MI
    • Division of Gastroenterology, University of Michigan Medical Center, 3912 Taubman Center, Box 0362, Ann Arbor, MI 48109. fax: 734–936–7392
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Abstract

The goals of this retrospective study were to determine whether there is a threshold hepatitis B virus (HBV) DNA value associated with spontaneous or antiviral therapy—related hepatitis B e antigen (HBeAg) clearance. We also investigated whether there is an HBV DNA value that can be used for differentiating inactive carriers from patients with HBeAg-negative chronic hepatitis B. HBV DNA levels in sequential serum samples of 165 Chinese patients with different stages of chronic HBV infection were quantified by a polymerase chain reaction (PCR)—based assay. Our results showed that almost all of the patients (89%) who remained HBeAg-positive had HBV DNA levels that were persistently above 105 copies/mL. Serum HBV DNA levels decreased by a mean of 3 log10 in patients with HBeAg loss, but 51% had levels above 105 copies/mL at the time HBeAg first became undetectable. Mean serum HBV DNA levels were significantly lower in HBeAg-negative patients. HBV DNA value above 105 copies/mL would exclude all inactive carriers, but 45% of patients with HBeAg-negative chronic hepatitis would also be excluded if testing were only performed at presentation and 30% would be excluded if testing were performed on 3 occasions. In conclusion, serum HBV DNA levels decreased significantly in patients with HBeAg loss, but there was no threshold HBV DNA level associated with HBeAg clearance. Given the fluctuating course of HBeAg-negative chronic hepatitis, it is not possible to define a single cutoff HBV DNA value for differentiating inactive carriers from patients with HBeAg-negative chronic hepatitis. (HEPATOLOGY2002;36:1408–1415).

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