Large spontaneous HBV DNA fluctuations and potential usefulness of a single point measurement of combined HBV DNA and quantitative HBsAg for the exclusion of HBeAg negative chronic hepatitis B: A prospective Tunisian cohort study

Abstract Background/Aims: We aimed to describe spontaneous short-term hepatitis B Virus (HBV) DNA level fluctuations and to assess the usefulness of quantitative HBsAg (qHBsAg) in Tunisian patients with HBeAg-negative chronic HBV infection.Patients and methods: We included 174 treatment-naïve patients with chronic HBeAg-negative HBV. A one-year prospective follow-up was carried out with serial determinations of HBV DNA, alanine aminotransferase levels and qHBsAg. Patients were classified into three groups: inactive carriers (G1), patients with HBeAg negative chronic hepatitis B (CHB) (G2) and patients with indeterminate state (G3). For this latter group, a liver biopsy was indicated.Results: Only genotype D was detected. During the follow-up, 21.6% and 19.5% of patients with low initial (<2000 IU/mL) and intermediate viral load (2000-20000 IU/mL), experienced a subsequent increase in their HBV DNA levels above 2000 and 20000 IU/mL, respectively. Significant variations of HBV DNA levels (≥0.5 log10 IU/mL) were observed in 61.1% of patients at 6 months-interval. Among the 174 patients, 89 (51.1%) belonged to G1, 33 (19%) to G2 and 52 (29.9%) to G3. Fourteen patients have undergone liver biopsy, among whom 7 (50%) showed moderate to severe liver disease. Combination of HBV DNA <2000 IU/mL and qHBsAg <832 IU/mL excluded CHB in 98.4% of cases.Conclusions: This study highlights the large short-term HBV DNA fluctuations in Tunisian patients with HBeAg negative chronic HBV of genotype D. HBV DNA < 2000 IU/mL along with qHBsAg < 832 IU/mL excluded CHB in 98.4% of cases. Significant proportion of patients with indeterminate state within genotype D would have HBeAg negative CHB.

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Large spontaneous HBV DNA fluctuations and potential usefulness of a single point measurement of combined HBV DNA and quantitative HBsAg for the exclusion of HBeAg negative chronic hepatitis B: A prospective Tunisian cohort study

10.21203/rs.3.rs-1173592/v1 ◽

2021 ◽

Author(s):

Amel Chtourou ◽

Saba Gargouri ◽

Emna Elleuch ◽

Awatef Taktak ◽

Lamia Fki-Berrajah ◽

...

Keyword(s):

Hepatitis B ◽

Liver Biopsy ◽

Single Point ◽

Significant Proportion ◽

Hbv Dna ◽

Short Term ◽

Subsequent Increase ◽

Tunisian Patients ◽

Chronic Hbv

Abstract Background/Aims: We aimed to describe spontaneous short-term hepatitis B Virus (HBV) DNA fluctuations and to assess the usefulness of quantitative HBsAg (qHBsAg) in Tunisian patients with HBeAg-negative chronic HBV infection.Methods: We included 174 treatment-naïve patients with chronic HBeAg-negative HBV. A one-year prospective follow-up was carried out with serial determinations of HBV DNA, alanine aminotransferase (ALT) levels and qHBsAg. Patients were classified into three groups: inactive carriers (G1), patients with HBeAg negative CHB (G2) and patients with “indeterminant state” (G3). For this latter group, a liver biopsy was indicated.Results: Genotype D was the only detected. During the follow-up, 21.6% and 19.5% of patients with low initial (<2000 IU/mL) and intermediate viral load (2000-20000 IU/mL), experienced a subsequent increase in their HBV DNA levels above 2000 and 20000 IU/mL, respectively. Significant variations of HBV DNA levels (≥0.5 log10 IU/mL) were observed in 61.1% of patients at 6 months-interval. Among the 174 patients, 89 (51.1%) belonged to G1, 33 (19%) to G2 and 52 (29.9%) to G3. Fourteen patients have undergone liver biopsy, among whom 7 (50%) showed moderate to severe liver disease. Combination of HBV DNA <2000 IU/mL and qHBsAg <832 IU/mL excluded CHB in 98.4% of cases.Conclusions: This study highlights the large short-term HBV DNA fluctuations in Tunisian patients with HBeAg negative chronic HBV of genotype D. HBV DNA < 2000 IU/mL along with qHBsAg < 832 IU/mL excluded CHB in 98.4% of cases. Significant proportion of patients with “indeterminant state” within genotype D would have HBeAg negative CHB.

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STUDY THE BIOCHEMICAL, VIRAL AND LIVER FIBROSIS RESPONSES IN PATIENTS WITH CHRONIC HEPATITIS B AFTER 12 MONTH-TREATMENT BY ENTECAVIR

Journal of Medicine and Pharmacy ◽

10.34071/jmp.2014.6.5 ◽

2015 ◽

pp. 36-43

Author(s):

Viet Thinh Nguyen ◽

Van Huy Tran

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Liver Biopsy ◽

Key Words ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Controlled Study ◽

Viral Responses

Introduction: Assessing the histological character liver fibrosis by transient hepatic elastography (TE) by Fibroscan has several advantages when compared with liver biopsy and can indicate repeatedly; therefore it can help us to follow up the treatment of chronic hepatitis B. This study is aimed at assessing the biochemical, viral and liver elasticity responses in patients with chronic hepatitis B after 12 months of entecavir treatment. Methods: Prospective, open, non-controlled study. 75 patients over 16 years old were diagnosed with chronic hepatitis B and treated with Entecavir 0.5 mg orally 2 hours after meal during 12 months. Using Fibroscan to assess the liver fibrosis according to the METAVIR classification. Results: ALT decreased rapidly after 3 months of treatment. There were differences in ALT at baseline, compared with ALT at 3 months, 6 months and 12 months (p < 0.05). HBV-DNA responsed below detection thredsold is 32%, 54.7% and 84% after 3, 6, 12 months of treatment, respectively (p<0.05). The change in the Fibroscan value > 1KPa at 6 months was 53.3% after treatment, and this was lower than this proportion at 12 months (61.3%) (p<0.001). Conclusion: Fibroscan may be used as a mean to monitor the responses to HBV treatment besides the biochemical and viral responses. Key words: Chronic B hepatitis, Entecavir, Elastography, Fibroscan

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[481] HBeAg-NEGATIVE CHRONIC HEPATITIS B (CHBe-) IN CHRONIC HBV PATIENTS WITH SERUM HBV-DNA LEVELS BELOW 2,000 lU/mL

Journal of Hepatology ◽

10.1016/s0168-8278(07)62079-0 ◽

2007 ◽

Vol 46 ◽

pp. S183 ◽

Cited By ~ 2

Author(s):

G.V. Papatheodoridis ◽

E.K. Manesis ◽

S. Manolakopoulos ◽

J. Goulis ◽

N. Chrysanthos ◽

...

Keyword(s):

Chronic Hepatitis ◽

Hepatitis B ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Chronic Hbv ◽

Negative Chronic Hepatitis

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Noninvasive Biomarkers in Assessment of Liver Fibrosis in Patients with HBeAg Negative Chronic Hepatitis B

Open Access Macedonian Journal of Medical Sciences ◽

10.3889/oamjms.2018.122 ◽

2018 ◽

Vol 6 (6) ◽

pp. 1052-1058

Author(s):

Marija Dimzova ◽

Irena Kondova-Topuzovska ◽

Mile Bosilkovski ◽

Ljubomir Ivanovski ◽

Zvonko Milenkovic ◽

...

Keyword(s):

Chronic Hepatitis ◽

Liver Fibrosis ◽

Hepatitis B ◽

Liver Biopsy ◽

Chronic Hepatitis B ◽

Hbv Dna ◽

Hbs Antigen ◽

Noninvasive Biomarkers ◽

Dna 2 ◽

Negative Chronic Hepatitis

BACKGROUND: Liver biopsy for evaluation of liver fibrosis has several adverse effects, for which reason noninvasive tests have been developed.AIM: To evaluate the usefulness of noninvasive biomarkers, qHBsAg and HBV DNA levels in predicting liver fibrosis in patients with hepatitis Be antigen (HBeAg) negative chronic hepatitis B (CHB).MATERIAL AND METHODS: This prospective study included 50 patients with HBeAg negative CHB. All patients underwent laboratory and serology testing, quantification of HBV DNA and HBs antigen. The liver stiffness was measured with elastography. The patients were analysed for APRI and FIB-4, quantitative hepatitis Bs antigen and HBV DNA.RESULTS: Logistic regression analysis showed that greatest significance in predicting liver fibrosis has FIB-4 (Wald = 3.24, P = 0.07), followed by HBV DNA ≥ 2 000 IU/ml ≤ 20 000 IU/ml (Wald = 2.86, P = 0.09), qHBsAg (Wald = 2.17, P = 0.14), HBV DNA > 20 000 IU/ml (Wald = 0.58, P = 0.45), APRI (Wald = 0.04, P = 0.84).CONCLUSION: the FIB-4 index has the greatest value in predicting liver fibrosis while APRI has the lowest; the more advanced liver disease is associated with lower serum level of quantitative HBs antigen. Combination of noninvasive blood biomarkers and imaging tests can provide better diagnostic accuracy and exclude the need for liver biopsy.

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