[Relationship between HBV DNA serum level and acute exacerbation of the disease in chronic hepatitis B patients].
OBJECTIVE
In this study, we evaluated the relationship between HBV DNA serum level and acute hepatic exacerbation of the disease in chronic hepatitis B patients.


METHODS
A series of serum samples from 14 patients of acute exacerbation of chronic hepatitis B were analyzed for alteratieus in serum HBV DNA and alanine transaminase (ALT) level before, during, and after episode of an acute exacerbation. The serum HBV DNA concentrations were tested by the quantitative polymerase chain reaction (PCR) using the AmpliSensor assay.


RESULTS
1. Serum HBV DNA average level in 11 patients significantly increased from 7.148 +/- 2.008(logarithm) at 2-8 weeks before maximum injury of liver to 8.416 +/- 2.160 (logarithm), the time that ALT reached its peak, and then, following the declining of ALT level, decreased to 6.093 +/- 1.428 (logarithm). In 9 of 11 cases, the HBV DNA peak value occurred before the ALT peak level or at the same time; 2. Two patients who experienced several episodes of acute exacerbation showed that the appearance of acute hepatic injury and the relatively normal liver function occurred alternatively. Whereas, one patient with liver cirrhosis showed persistence of high level viremia in three episodes of acute exacerbation in one year.


CONCLUSIONS
1. This investigation revealed a clear correlation between increasing level of serum HBV DNA and acute exacerbation of patients with chronic hepatitis B. The findings suggest that host's immune response which causes acute exacerbation of liver injury in patients with chronic hepatitis B is triggered by the change of viremia and HBV replication; 2. Patients with severe chronic active hepatitis and persistent hepatitis B virus replication are at very high risk of rapid progression to cirrhosis.
Zhou
X
X
Department of Infectious Diseases, Second Affiliated Hospital of Medical College of Shantou University, Shantou 515031.
Gao
Z
Z
Yao
J
J
D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006515:Hepatitis B virus / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000201:enzymology / Q000473:pathology; D006801:Humans; D008297:Male; D008875:Middle Aged
D004279:DNA, Viral; D000410:Alanine Transaminase