Quantitative serum HBV DNA levels during different stages of chronic hepatitis B infection

Abstract
The goals of this retrospective study were to determine whether there is a threshold hepatitis B virus (HBV) DNA value associated with spontaneous or antiviral therapy—related hepatitis B e antigen (HBeAg) clearance. We also investigated whether there is an HBV DNA value that can be used for differentiating inactive carriers from patients with HBeAg‐negative chronic hepatitis B. HBV DNA levels in sequential serum samples of 165 Chinese patients with different stages of chronic HBV infection were quantified by a polymerase chain reaction (PCR)—based assay. Our results showed that almost all of the patients (89%) who remained HBeAg‐positive had HBV DNA levels that were persistently above 105 copies/mL. Serum HBV DNA levels decreased by a mean of 3 log10 in patients with HBeAg loss, but 51% had levels above 105 copies/mL at the time HBeAg first became undetectable. Mean serum HBV DNA levels were significantly lower in HBeAg‐negative patients. HBV DNA value above 105 copies/mL would exclude all inactive carriers, but 45% of patients with HBeAg‐negative chronic hepatitis would also be excluded if testing were only performed at presentation and 30% would be excluded if testing were performed on 3 occasions. In conclusion, serum HBV DNA levels decreased significantly in patients with HBeAg loss, but there was no threshold HBV DNA level associated with HBeAg clearance. Given the fluctuating course of HBeAg‐negative chronic hepatitis, it is not possible to define a single cutoff HBV DNA value for differentiating inactive carriers from patients with HBeAg‐negative chronic hepatitis. (HEPATOLOGY2002;36:1408–1415).