Serum HBV DNA And Hepatitis B Surface Antigen Levels Help Predict Diseases Progression In Patients With Low Hepatitis B Virus Loads

Background:Quantitative measurements of HBV DNA and HBsAg are indispensable tools in the clinical assessment and management of chronic hepatitis B viral infection.Objectives:To explore the clinical implications of HBV DNA and HBsAg quantification for chronic hepatitis B (CHB) patients with HBV DNA levels<2000IU/mL.Methods:Total4087chronic hepatitis B cases dating from January,2011to December,2013were investigated. HBV DNA was quantified by Cobas AmpliPrep/Cobas TaqMan (Roche). HBsAg was quantified by the Architect HBsAg assay (Abbott Diagnostics). Final1873cases of them were screened into different groups according to their HBV DNA, HBsAg, and ALT levels, age and gender.Results:1.86.93%of the4087cases had less then2,000IU/mL CHB HBV DNA levels, while51.72%had less than20IU/mL.74.96%of the1873cases which HBV DNA levels less then2,000IU/mL were HBeAg(-).2. In CHB patients with HBV DNA<2000IU/mL, HBV DNA load in HBeAg (+) group was relatively higher, both HBV DNA and HBsAg levels had positive correlation with HBeAg levels.3. In HBeAg (-) groups, incidence of cirrhosis was18.62%of cases with HBV DNA200-1999IU/mL,17.28%of cases with HBV DNA20-199IU/mL, and17.87%of cases with HBV DNA<20IU/mL, respectively, which was significantly higher than HBeAg (+) group with HBV DNA200-1999IU/mL (7.77%)4. In HBeAg (-) groups, incidence of HCC was4.04%of cases with HBV DNA200-1999IU/mL,3.99%of cases with HBV DNA20-199IU/mL, and3.15%of cases with HBV DNA<20IU/mL, respectively, which was significantly higher than HBeAg (+) group with HBV DNA200-1999IU/mL (1.94%)5. In HBV DNA<20IU/mL group,35.40%had HBsAg>1,000IU/mL, indicating HBsAg level whold be a bettet monitor and prediction index than HBV DNA level for CHB progress, especially for cases with quite lower HBV DNA level (<20IU/mL).Conclusions:More sensitive HBV DNA quantitative determination contributed not only to a better understand significance of viral replication and clearance for CHB cases with lower viral loads, but also to find occult HBV infection. HBsAg levels, combined with HBV DNA loads help to better predicting the course of CHB for cases with HBV DNA<2000IU/mL,while for cases with lower HBV loads (<20IU/mL), HBsAg level is a much better index for monitoring and predicting progress of CHB.