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J Med Virol. 2018 Jul 16. doi: 10.1002/jmv.25271. [Epub ahead of print]
Application strategies of serum HBV DNA detection in HBV infection patients: a retrospective study of 5611 specimens.
Liu C1,2, Wu W1,2, Shang S1,2, Huang E1,2, Xun Z1,2, Lin J1,2, Chen T1,2, Yang B1,2, Chen J3, Ou Q1,2.
Author information
1
Department of Laboratory Medicine, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
2
Gene Diagnostic Laboratory, The First Affiliated Hospital of Fujian Medical University, Fuzhou, Fujian Province, China.
3
Liver Research Center, The First Affiliated Hospital of Fujian Medical University.
Abstract
The detection of HBV DNA plays a critical role in determining the level of viral replication in HBV infected patients. However, how to select appropriate HBV DNA detection method, low-sensitivity (ls) and hypersensitivity (hs), remains unclear. In this study, HBsAg, HBeAg, ALT, AST and hs HBV DNA titers in serum of 5611 cases with suspected HBV infection were reviewed. Besides, the dynamic changes of HBV DNA and HBsAg in 85 chronic hepatitis B (CHB) patients receiving PegIFNα or entecavir (ETV) were observed. The results showed the positive rate of HBV DNA was 32.8%, of which low viral load (20~500 IU/ml) accounted for 51.8%. In the 5611 cases, when the HBsAg<1000 IU/ml, the proportion of low viral load was 76.3%. Moreover, in patients receiving antiviral treatment, when HBsAg<2000 IU/ml (PegIFNα) or HBsAg<3500 IU/ml (ETV), the proportion of patients with low viral load was 79.5% or 78.0%, respectively. We developed a strategy of serum HBV DNA detection in HBV infection patients. When HBsAg was negative, HBV DNA detection should be unnecessary. When HBsAg was 0.05~1000 IU/ml, hs HBV DNA should be detected in patients with abnormal level of ALT, AST or HBeAg. While HBsAg was ≥1000 IU/ml, ls HBV DNA was recommended. Moreover, the cut-off value of HBsAg increased during antiviral therapy of CHB patients. In conclusion, hs HBV DNA is of great value in HBV infected patients with low viral load. HBV DNA detection methods should be selected reasonably according to the levels of HBsAg, HBeAg, ALT and AST. This article is protected by copyright. All rights reserved.
KEYWORDS:
HBV DNA; clinical detection pathway; hepatitis B virus; quantitative HBsAg
PMID:
30011350
DOI:
10.1002/jmv.25271
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