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[Quantitative detection of intrahepatic hepatitis B virus DNA in patients with chronic hepatitis B]
Hui Lu1, Li-xian Ma, Wan-su Xu
1Jinan Infectious Diseases Hospital, Jinan 250021, China.
Insights
Intrahepatic HBV DNA is a better indicator of hepatitis B virus (HBV) replication and treatment efficacy than serum HBV DNA or HBeAg. Higher pretreatment intrahepatic HBV DNA levels correlate with better treatment outcomes in chronic hepatitis B patients.
Area of Science:
- Hepatology and Virology
- Viral Load Quantification
- Immunodiagnostics
Context:
- Chronic hepatitis B (CHB) infection affects millions globally.
- Accurate assessment of hepatitis B virus (HBV) replication is crucial for effective treatment.
- Current markers like serum HBV DNA and HBeAg have limitations in reflecting viral activity.
Purpose:
- To investigate the correlation between intrahepatic HBV DNA and serum HBV DNA levels.
- To examine the relationship between intrahepatic HBV DNA and hepatitis B e antigen (HBeAg) levels in CHB patients.
- To evaluate the predictive value of pretreatment intrahepatic HBV DNA levels for antiviral therapy outcomes.
Summary:
- Liver HBV DNA levels were significantly higher than serum HBV DNA and positively correlated with serum HBV DNA and HBeAg levels.
- Intrahepatic HBV DNA levels showed a negative correlation with liver damage severity.
- Patients with lower pretreatment intrahepatic HBV DNA (< or = 10(4)fg/cm(3)) exhibited higher HBeAg and anti-HBe seroconversion rates after combination therapy.
Impact:
- Intrahepatic HBV DNA serves as a more sensitive marker for assessing HBV replication compared to serum markers.
- Pretreatment intrahepatic HBV DNA levels can predict the efficacy of antiviral treatment in CHB patients.
- This finding may guide personalized treatment strategies and improve patient management in chronic hepatitis B.
Objective:
To study the relationships between intrahepatic HBV DNA level and serum HBV DNA level, between intrahepatic HBV DNA level and hepatitis B e antigen (HBeAg) level in patients with chronic hepatitis B (CHB), and assess the valuation of pretreatment liver HBV DNA level in antivirus therapy.
Methods:
Liver specimens taken from 41 HBeAg-positive CHB patients before antivirus treatment were divided into two parts, one for histological examination, and the other for intrahepatic HBV DNA quantified detection by PCR-fluorescence. At the same time, serum levels of HBV DNA and HBeAg were detected. The patients were classified into two groups according to the pretreatment intrahepatic HBV DNA level (< or = 10(4)fg/cm(3) in group A, >10(4)fg/cm(3) in group B) and accepted interferon alpha-1b (3MU every day for 26 weeks) in combination with lamivudine (100mg per day for 52 weeks). During the treatment, the serum levels of alanine aminotransferase (ALT), HBV DNA and HBeAg seroconversion rate were monitored.
Results:
(1) The level of liver HBV DNA was much higher than that of serum HBV DNA (4.081 +/-1.127 vs 3.163 +/-1.010, t = 2.218, P < 0.05). Liver HBV DNA level had positive correlation to serum HBV DNA level (r = 0.840, t = 4.322, P < 0.001) and serum HBeAg level (r = 0.459, t = 3.056, P < 0.005). (2) Intrahepatic HBV DNA level was negative correlation to the severity of liver damage (chi(2) = 3.874, P < 0.05). (3) Serum HBV DNA level in all the patients reduced remarkedly after therapy, especially in group A. At the end of 52 weeks, the rates of HBeAg and anti-HBe seroconversion in group A were higher than those in group B (68.4% vs 36.4%, chi(2) = 4.194, P < 0.05; 73.7% vs 40.9%, chi(2) = 4.447, P<0.05).
Conclusions:
Intrahepatic HBV DNA is a more valuable marker than serum HBV DNA or HBeAg to assess HBV replication, and can reflect the status of body immunity indirectly. It may be a useful indicator for the efficacy of antivirus treatment.