The Clinical Value Of Highly-sensitive HBV DNA Detection In Hepatitis B-related Liver Cirrhosis

Background and Objective:Studies showed that some hepatitis B patients with low viral loads progress to cirrhosis and liver cancer finally.The routine test method results in missed diagnosis or misdiagnosis due to false negatives.It plays an important role in guiding the clinical management and treatment of those patients with low virus loads by highly-sensitive and-specific testing method.Our study aims to investigate the clinical relevance between highly-sensitive HBV DNA quantitative detection and hepatitis B-related liver cirrhosis and evaluate its predictive value for end-stage liver disease.Methods:We collected serum samples from a total of 483 patients with hepatitis B-related liver cirrhosis who were treated in Qingdao Municipal Hospital and Qingdao Infectious Disease Hospital dating from Feb 1^st 2017 to Sep 1^st 2017.We selected 109cases with virul loads less than 500 IU/ml by routine testing method and detected the concrete virul load by highly-sensitive HBV DNA testing method.The under limit value of highly-sensitive HBV DNA quantitative detection is 20 IU/m L.We divided 109 cases into two groups based on the results of highly-sensitive HBV DNA quantitative detection,the positive group when HBV DNA>20 IU/m L and the negative group when HBV DNA<20 IU/m L.Then we collected the clinical data and analyzed the differences of clinical and biochemical indexes between the two groups.Detection of alanine aminotransferase（ALT）,aspartate aminotransferase（AST）,alkaline phosphatase（ALP）,glutamyl transpeptidase（GGT）and six items of hepatitis B,the biomakers for liver fibrosis,and indicators for gastrointestinal tumor.The T test was used to compare the quantitative data.The HBs Ag levels and the Child-Pugh grading of liver function were compared with Mann-Whitney Test.It was statistically significant when P<0.05.Results:1.There is significant difference between the two groups in age,sex,AST,TBIL,DBIL,IBIL,TP,ALP,ALB,GGT,TC,TG distribution between the two groups（P>0.05）.2.There is significant difference between the two groups in the distribution of ALT（p=0.018）and the Child-Pugh grading of liver function（P=0.022）.3.There was no significant difference between the two groups in HBsAg level（P=0.71）.Conclusions:There was significant difference in ALT and the Child-Pugh grading of liver function between the positive group and negative group,which can predict worse clinical outcome.We should strengthen clinical monitoring the patient’s clinical status in Qingdao.