A comparative study of HBV DNA with serological and biochemical markers in chronic hepatitis B carriers

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A comparative study of HBV DNA with serological and biochemical markers in chronic hepatitis B carriers


Author: Chui, Pui-chi Kathryn
Title: A comparative study of HBV DNA with serological and biochemical markers in chronic hepatitis B carriers
Degree: M.Sc.
Year: 2009
Subject: Hong Kong Polytechnic University -- Dissertations
Hepatitis B virus -- Genetic aspects
Carrier state (Communicable diseases)
Polymerase chain reaction
Department: Dept. of Health Technology and Informatics
Pages: xii, 75 leaves : ill. (some col.) ; 31 cm.
InnoPac Record: http://library.polyu.edu.hk/record=b2355947
URI: http://theses.lib.polyu.edu.hk/handle/200/5812
Abstract: Background: Hepatitis B is one of the most conunon types of viral hepatitis in the world and is caused by a virus named hepatitis B virus (HBV). Those who are infected may develop acute or chronic infection depends on the infection age. In some cases. progression from acute to chronic hepatitis B may occur. The sequels of chronic infection may include fibrosis. compensated cirrhosis, hepatitis decompensation, and hepatocellular carcinoma. For the last thirty years, only serological markers and liver function test have been utilized to monitor the disease progression and treatment response until the emergence of molecular detection, which is the serum hepatitis B virus deoxyribonucleic acid (HBV DNA) quantification. First generation molecular detection is not that sensitive due to its narrow dynamic range. The latest generation using real time polymerase chain reaction (PCR) has improved analytical performance characteristics, including low limits of detection, broad linear ranges, and excellent precision. Objectives: The aim of this study is using a sensitive quantitative real time polymerase chain reaction (PCR) assay to investigate a correlation between serum HBV DNA levels with serological and biochemical markers in chronic hepatitis B carriers.
Methods: A total of four hundred sixty-nine chronic B carriers were studied, serum HBV DNA were detected by the COBAS TaqMan real time PCR. They were divided into two groups according to their hepatitis e antigen (HBeAg) status. Group I patients were HBeAg positive with no hepatitis e antibody (anti-HBe) detected; while Group II were HBeAg negative but hepatic e antibody (anti-HBe) positive. Biochemical markers were also performed on both groups. Results: Group I had a significant higher median serum HBV DNA level than Group II (141,500 copies/ml vs.13,500 copies/ml; p<0.0001). However, there was about 28% of subjects in Group II with serum HBV DNA > 10⁵ copies/ml. Only ALT and AST shown significant difference between these groups (p value= 0.001, 0.002 respectively). A weak correlation of serum HBV DNA and ALT was observed in Group I only (r=0.384, p=0.004), no correlation at all between HBV DNA and ALT in Group II. Also there was no correlation of serum HBV DNA with other biochemical markers that included aspartate aminotransferase (AST), total bilirubin (TB), alkaline phosphatase (ALP), total protein (TP), and albumin (ALB) in both groups. Conclusion: Serum HBV DNA is a more sensitive and specific tool for viral activity; also it is not that invasive as compare to the liver biopsy. Management on chronic hepatitis B carriers is no longer depended on the hepatitis e status and liver function tests. They can be used in conjunction with the serum HBV DNA level but just for supplementary data. When choosing method to detect the serum HBV DNA. we should consider an assay to be very sensitive with the lower limit of detection less than the 10⁵ copies/ml, board dynamic range, and specific to all HBV genotypes for better drug management and prediction of any drug resistance. Real time PCR is one ofthe choices.

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