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Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
Hepatitis B surface antigen serum levels help to distinguish active from inactive hepatitis B virus genotype D
Maurizia Rossana Brunetto1, Filippo Oliveri, Piero Colombatto
1Hepatology Unit, University Hospital of Pisa, University of Pisa, Pisa, Italy. brunetto@med-club.com
Insights
Accurate identification of inactive hepatitis B virus (HBV) carriers is challenging. Measuring hepatitis B surface antigen (HBsAg) serum levels alongside HBV DNA offers a highly accurate diagnostic method.
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Accurate identification of inactive hepatitis B virus (HBV) carriers is difficult due to HBV DNA fluctuations.
- Hepatitis B e antigen-negative genotype D asymptomatic carriers present unique diagnostic challenges.
Purpose of the Study:
- To investigate the utility of hepatitis B surface antigen serum levels (HBsAgsl) in diagnosing HBV phases.
- To assess the role of HBsAgsl quantification in differentiating inactive carriers (IC) from active carriers (AC).
Main Methods:
- Prospective follow-up of 209 untreated carriers with monthly monitoring of HBV DNA and transaminases over a median of 29 months.
- Measurement of HBsAg serum levels (HBsAgsl) at baseline and end of follow-up.
- Correlation of HBsAgsl with virologic and biochemical profiles to define HBV infection phases.
Main Results:
- HBsAgsl were significantly lower in inactive carriers (IC) compared to active carriers (AC).
- A combined single-point quantification of HBsAg (<1000 IU/mL) and HBV DNA (
- HBsAgsl declined in IC during follow-up, with some achieving HBsAg clearance.
Conclusions:
- HBsAg serum levels vary during chronic hepatitis B infection and are significantly lower in inactive carriers.
- Single-point combined HBsAg and HBV DNA quantification is a highly accurate method for identifying inactive HBV carriers, comparable to long-term monitoring.
Background & Aims:
The accurate identification of inactive (serum HBV-DNA persistently
Methods:
HBsAgsl were measured at baseline and end of follow-up and correlated with virologic and biochemical profiles of 209 consecutive carriers followed-up prospectively (median, 29; range, 12-110 months). HBV phases were defined after 1-year monthly monitoring of HBV-DNA and transaminases.
Results:
HBsAgsl were significantly lower in 56 inactive carriers (IC) than 153 active carriers (AC): median, 62.12 (range, 0.1-4068) vs median, 3029 (range, 0.5-82,480) IU/mL; P<.001. Among AC, HBsAgsl were lower in 31 AC whose viremia remained persistently <20,000 IU/mL (AC1) than in 122 AC with fluctuations>or=20,000 IU/mL (AC2): 883 (0.5-7838) vs 4233 (164-82,480) IU/mL, P=.002. HBV infection was less productive in IC and AC1 than AC2 (log10 HBV-DNA/HBsAgsl ratios 0.25 and 0.49 vs 2.06, respectively, P<.001) and in chronic hepatitis than cirrhosis (1.97 vs 2.34, respectively; P=.023). The combined single point quantification of HBsAg (<1000 IU/mL) and HBV-DNA (
Conclusions:
HBsAgsl vary during chronic hepatitis B e antigen-negative genotype D infection and are significantly lower in IC. Single-point combined HBsAg and HBV-DNA quantification provides the most accurate identification of IC, comparable with that of long-term tight monitoring.
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