Related Experiment Video
Updated: Aug 8, 2026
Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
[How to use viral genomic analysis in clinical practice: chronic hepatitis B and C]
1Department of Gastroenterology and Hepatology, Musashino Red Cross Hospital, Musashino 180-8610.
Insights
Viral genomic analysis aids clinical practice. Monitoring Hepatitis C virus (HCV) core antigen levels predicts treatment success, with a 2-log drop indicating a 75% sustained virological response (SVR).
Area of Science:
- Virology
- Hepatology
- Clinical Diagnostics
Background:
- Hepatitis B (HB) virus genotype C is linked to poorer outcomes in Japan compared to genotype B.
- Mutations in the basic core promoter (BCP) and polymerase domains are associated with hepatic fibrosis and lamivudine resistance in HB virus.
- Chronic hepatitis C (HCV) genotype 1b treatment with peginterferon and ribavirin yields a 50% sustained virological response (SVR).
Purpose of the Study:
- To highlight the clinical significance of viral genomic analysis, particularly HB virus genotyping.
- To evaluate the utility of core antigen quantitation for predicting treatment response in chronic hepatitis C genotype 1b infection.
Main Methods:
- Analysis of viral genomic mutations, including HB virus BCP and polymerase domain mutations.
- Monitoring serum core antigen levels during peginterferon and ribavirin combination therapy for HCV genotype 1b.
Main Results:
- HBV genotype C indicates a worse prognosis than genotype B in Japan.
- BCP mutations correlate with hepatic fibrosis, and polymerase domain mutations with lamivudine resistance.
- A 2-log drop in HCV core antigen by 12 weeks predicts a 75% SVR to combination therapy.
Conclusions:
- Viral genotyping, especially for HB virus, is crucial for clinical management and prognosis.
- Sensitive core antigen quantitation is a valuable, cost-effective tool for predicting treatment outcomes in chronic hepatitis C.
- Early viral decline monitoring effectively predicts sustained virological response to combination therapy.
Abstract:
Viral genomic analysis has been developed recently, and is utilized in clinical practice. The genotype of HB virus has the most important clinical implication, and in Japan, genotype C shows worse prognosis than genotype B. Basic core promoter (BCP) mutation is associated with hepatic fibrosis, and HBe antigen seronegativity is frequently observed after lamivudine administration than wild type. Polymerase domain B mutation was shown to be associated with lamivudine resistance concomitantly with domain C mutation. In the treatment of chronic hepatitis C genotype 1b infection, peginterferon and ribavirin combination therapy was introduced, and this combination therapy has been shown to induce 50% sustained virological response (SVR). To predict the virological response to combination therapy, monitoring viral decline provides the most important information. Real-time PCR is expensive, therefore, highly sensitive core antigen quantitation is valuable in clinical practice. When patients treated by combination therapy achieve a 2 log drop in HCV antigen until twelve weeks, they are estimated to have obtained 75% SVR by monitoring the amount of serum core antigen.
Related Concept Videos
01:25Hepatitis
01:28Viral Hepatitis I: Introduction
01:27Cytomegalovirus Disease