Related Experiment Video
Updated: May 27, 2026
Real-Time Polymerase Chain Reaction-Based Detection and Quantification of Hepatitis B Virus DNA
Published on: December 15, 2023
The HBV DNA cutoff value for discriminating patients with HBeAgnegative chronic hepatitis B from inactive carriers
Eun Sun Kim1, Yeon Seok Seo, Bora Keum
1Departments of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
Insights
Distinguishing between HBeAg-negative chronic hepatitis B (CHB) and inactive carriers is crucial. HBV DNA levels effectively differentiate these groups, guiding tailored follow-up strategies for better patient management.
Area of Science:
- Hepatology
- Virology
- Internal Medicine
Background:
- Hepatitis B virus (HBV) infection management requires differentiating chronic hepatitis B (CHB) from inactive carriers.
- HBeAg-negative CHB and inactive carriers have distinct prognoses but are difficult to distinguish.
- Current strategies lack reliability in differentiating these patient groups.
Purpose of the Study:
- To establish a reliable strategy for discriminating HBeAg-negative CHB patients from inactive carriers.
- To identify key biomarkers for differentiating disease states in HBV infection.
Main Methods:
- Enrolled 208 inactive carriers (HBeAg-negative, anti-HBe-positive, normal ALT, HBV DNA < 2000 IU/mL).
- Defined HBV reactivation as HBV DNA elevation to ≥ 2000 IU/mL.
- Classified patients as true inactive carriers (HBV DNA < 2000 IU/mL) or false inactive carriers (HBV DNA ≥ 2000 IU/mL) within one year.
Main Results:
- HBV reactivation occurred in 19.7% of patients within the first year.
- Significant differences in baseline HBV DNA and ALT levels were observed between true and false inactive carriers.
- Baseline HBV DNA (AUROC 0.831) was a strong predictor of false inactive carriers, with higher reactivation rates in those with baseline HBV DNA ≥ 200 IU/mL.
Conclusions:
- HBV DNA levels are effective in discriminating HBeAg-negative CHB from true inactive carriers.
- Follow-up strategies for inactive carriers should be individualized based on their baseline HBV DNA levels.
Background:
Patients with HBeAg-negative chronic hepatitis B (CHB) has a significantly different prognosis than inactive carriers; there is however, no reliable strategy for accurately differentiating these two disease conditions.
Objectives:
To determine a strategy for discriminating patients with HBeAg-negative CHB from inactive carriers.
Materials And Methods:
Consecutive inactive carriers (i.e. HBeAg-negativity, anti-HBe-positivity, normal ALT levels, and HBV DNA < 2000 IU/mL) were enrolled. HBV reactivation was defined as the elevation of the HBV DNA level to ≥ 2000 IU/mL. Patients were classified into true inactive carriers when their HBV DNA levels remained at < 2000 IU/mL or false inactive carriers when their HBV DNA levels increased to ≥ 2000 IU/mL during the first year.
Results:
The Mean ± SD age of 208 inactive carriers (140 males) was 47.7 ± 12.6 years. The Mean ± SD serum ALT and HBV DNA levels were 22.8 ± 8.6 IU/L and 360 ± 482 IU/mL, respectively. HBV reactivation developed in 41 (19.7%) patients during the first year. Baseline HBV DNA and ALT levels differed significantly between true inactive and false inactive carriers. The AUROCs of the baseline ALT and HBV DNA levels for predicting a false inactive carrier were 0.609 and 0.831, respectively. HBV reactivation developed more often in patients with a baseline HBV DNA level of ≥ 200 IU/mL than in those with a baseline HBV DNA level of < 200 IU/mL during a Mean ± SD follow-up of 622 ± 199 days.
Conclusions:
The HBV DNA level was useful for discriminating patients with HBeAg-negative CHB from true inactive carriers. The follow-up strategies applied to inactive carriers need to vary with their HBV DNA levels.
