Disappearance of serum hepatitis B virus DNA by polymerase chain reaction after adenine arabinoside 5'-monophosphate therapy in chronic hepatitis B.
The aim of antiviral therapy in chronic hepatitis B is the cessation of viral replication, which may be demonstrated by the loss of hepatitis B "e" antigen (HBeAg) and serum hepatitis B virus DNA (HBV-DNA) detected by dot-blot hybridization. With the development of the sensitive polymerase chain reaction (PCR) technique for detecting HBV-DNA, it has become apparent that many HBeAg negative patients may still have small amounts of circulating viral DNA. We assessed 19 of 25 patients with chronic hepatitis B who seroconverted from HBeAg to anti-HBe after adenine arabinoside 5'-monophosphate therapy (5 mg.kg-1.day-1 for 7 weeks) to determine whether serum HBV-DNA became undetectable. Sixteen of the 19 HBeAg negative patients remained hepatitis B surface antigen (HBsAg) positive, and the other three lost HBsAg during follow-up. All of them were HBV-DNA negative by dot-blot hybridization. Using the PCR technique, HBV-DNA became negative in 13 (81.2%) of the 16 patients who seroconverted to anti-HBe without losing HBsAg, and in all the patients who lost HBsAg. These data suggest that the majority of patients who respond to adenine arabinoside 5'-monophosphate show a complete inhibition of hepatitis B virus replication, as demonstrated by the absence of viral DNA by PCR. This inhibition was present in all patients who, at the same time, lost HBsAg.
Buti
M
M
Liver Section, Hospital General Universitario Valle Hebrón, Barcelona, Spain.
Rodriguez-Frias
F
F
Genesca
J
J
Arranz
A
A
Jardi
R
R
Esteban
R
R
Guardia
J
J
D000328:Adult; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006509:Hepatitis B / Q000188:drug therapy* / Q000382:microbiology; D006513:Hepatitis B e Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000187:drug effects / Q000502:physiology*; D006521:Hepatitis, Chronic / Q000188:drug therapy* / Q000382:microbiology; D006801:Humans; D015151:Immunoblotting; D008297:Male; D016133:Polymerase Chain Reaction; D001084:Vidarabine Phosphate / Q000627:therapeutic use*; D014779:Virus Replication / Q000187:drug effects*
D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D001084:Vidarabine Phosphate