title: Serum hepatitis B virus DNA levels differentiating inactive carriers from patients with chronic hepatitis B.
abstract: OBJECTIVE
  We compared serum hepatitis B virus (HBV)-DNA levels in different states of hepatitis B infection, and investigated whether there is an HBV-DNA value that can be used for differentiating inactive carriers from patients with hepatitis B e antigen (HBeAg)-negative chronic hepatitis.
  
  
  METHODS
  A retrospective study using sera at a followed endpoint from 64 Japanese patients with chronic HBV infection seen in Kobe University Hospital between 1989 and 2002. Sera of patients were assayed using a polymerase chain reaction-based assay.
  
  
  RESULTS
  Genotype C was dominant (95.4%). Patients with chronic hepatitis with an elevation of the serum alanine aminotransferase (ALT) level had significantly higher HBV-DNA levels than patients with persistently normal ALT. For one time observation at a followed endpoint, the mean HBV-DNA level of HBeAg-negative inactive carriers was significantly lower than that of HBeAg-negative chronic hepatitis patients (3.6+/-1.0 versus 4.8+/-1.5 log copies/ml, P<0.005). The use of a cutoff value of 4.5 or 5.0 log copies/ml misclassified 23 and 18% of HBeAg-negative inactive carriers and 50 and 55% of patients with HBeAg-negative chronic hepatitis. If testing were performed on two occasions with approximately a 4-month interval, the cutoff values of 4.5 and 5.0 log copies/ml would misclassify 20 and 10% of HBeAg-negative inactive carriers and 28.6 and 28.6% of patients with HBeAg-negative chronic hepatitis.
  
  
  CONCLUSIONS
  The measurement of serum HBV DNA more than twice is useful for assessing chronic hepatitis B surface antigen carriers and confirms that 10 copies/ml may be an appropriate level of HBV for characterizing the inactive carrier state.
authors.affiliation: Department of Clinical Molecular Medicine, Division of Diabetes, Digestive and Kidney Diseases, International Center for Medical Research (ICMR), Kobe University Graduate School of Medicine, Kobe, Japan. yseo@med.kobe-u.ac.jp
authors.forename: Yasushi
authors.initials: Y
authors.lastname: Seo
authors.forename: Seitetsu
authors.initials: S
authors.lastname: Yoon
authors.forename: Bui Xuan
authors.initials: BX
authors.lastname: Truong
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Kato
authors.forename: Kenichi
authors.initials: K
authors.lastname: Hamano
authors.forename: Miyuki
authors.initials: M
authors.lastname: Kato
authors.forename: Yoshihiko
authors.initials: Y
authors.lastname: Yano
authors.forename: Megumi
authors.initials: M
authors.lastname: Katayama
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Ninomiya
authors.forename: Yoshitake
authors.initials: Y
authors.lastname: Hayashi
authors.forename: Masato
authors.initials: M
authors.lastname: Kasuga
mesh_terms: D000328:Adult; D002908:Chronic Disease; D004279:DNA, Viral / Q000097:blood* / Q000235:genetics; D005260:Female; D006580:Genetic Carrier Screening / Q000379:methods; D005838:Genotype; D006509:Hepatitis B / Q000097:blood* / Q000235:genetics / Q000276:immunology; D006513:Hepatitis B e Antigens / Q000276:immunology; D006515:Hepatitis B virus / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction / Q000379:methods; D012189:Retrospective Studies
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens