The role of serial measurement of serum HBV DNA levels in patients with chronic HBeAg(−) hepatitis B infection: Association with liver disease progression. A prospective cohort study☆
Received 30 March 2008; accepted 10 June 2008. published online 02 July 2008.
Background/Aims
To evaluate the fluctuating course of serum HBV-DNA levels during the natural history of chronic HBV infection in the general population of North-Eastern Greece, in association with liver disease progression.
Methods
Two hundred and sixty-three adults with chronic HBV, median 34 years of age, were randomly selected and prospectively followed-up for a maximum period of 12 years. Viral markers, liver biochemistry and physical examination were performed every 6 months, and liver biopsy/abdominal ultrasound every 2–4 years.
Results
At entry, 195/263 (76%) were HBeAg (−)/anti-HBe (+) inactive carriers: (a) almost all 195 individuals with undetectable or HBV-DNA levels <2000IU/ml had no liver disease at entry and at follow-up period by imaging or liver histology evaluation (b) only 4/195 (2%) showed HBV reactivation with HBV-DNA >2000IU/ml.
At entry, 48/263 (18%) patients were chronic HBeAg(−); (a) 1/3 patients had intermittently HBV-DNA <2000IU/ml for at least one occasion and were misclassified as inactive carriers (b) 22/48 (46%) had moderate/severe histology at entry and 5/48 (10%) showed liver disease progression during follow-up. Logistic regression analysis was used to derive OR (95%CI) for factors associated with liver disease progression.
Conclusions
Close monitoring of serum HBV-DNA levels is useful in the management of chronic HBeAg(−) patients, as associated with liver disease progression.
☆ Preliminary results of this study were presented at the Liver Meeting 2007 of the American Association for the Study of Liver Diseases. This study is supported by a grant from the Subprogram 5, “Quality of Life and Environment” of the European Community Project Interreg I and II .
ABSTRACT