Premium
Serial HBV DNA levels in patients with persistently normal transaminase over 10 years following spontaneous HBeAg seroconversion
Author(s) -
Chen Y.C.,
Huang S.F.,
Chu C.M.,
Liaw Y.F.
Publication year - 2012
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/j.1365-2893.2011.01450.x
Subject(s) - seroconversion , hbeag , medicine , hepatitis b virus , gastroenterology , virology , liver biopsy , alanine transaminase , hepatitis b , genotype , immunology , hbsag , biopsy , virus , biology , gene , biochemistry
Summary. Earlier studies addressing the hepatitis B virus (HBV) DNA cut‐off level for inactive chronic HBV infection largely involved patients with normal alanine aminotransferase (ALT) for only 1–2 years and based on a single time HBV DNA assay. This study was conducted to address this issue using serial HBV DNA assays in patients with persistently normal ALT (PNALT) over 10 years following spontaneous hepatitis B e antigen (HBeAg) seroconversion. Serial serum specimens (mean 9 samples per patient) of 62 patients with PNALT and no disease progression over 10 years (median 18.1 years) after spontaneous HBeAg seroconversion were assayed for HBV DNA. Excluding assays within 1 year after HBeAg seroconversion, 21% and 82.3% of the patients with PNALT had HBV DNA levels persistently lower than 4 log 10 and 5 log 10 copies/mL, respectively, and only 8% had a level ≥5 log 10 copies/mL in at least two assays. Of the 27 patients with PNALT defined by ALT <30 U/L for male and <19 U/L for female, only 33% had serum HBV DNA level persistently <4 log 10 copies/mL. There was no significant difference in the serial HBV DNA changes among patients with different gender, HBV genotype or age at HBeAg seroconversion. Liver biopsy in nine patients invariably showed minimal necroinflammation and one showed Ishak fibrosis score 4. These results suggest that 5 log 10 copies/mL (20 000 IU/mL) is a more appropriate cut‐off HBV DNA level for inactive chronic HBV infection in the setting of PNALT.