title: Paired, quantitative measurements of hepatitis B virus DNA in saliva, urine and serum of chronic hepatitis B patients.
abstract: OBJECTIVE
  Despite an abundance of epidemiological evidence for horizontal transmission of hepatitis B virus (HBV), the transmission route remains to be fully elucidated. In a new approach, we evaluated quantitative HBV DNA content in serum, saliva and urine as a first step in exploring possible modes of horizontal transmission.
  
  
  METHODS
  In an outpatient setting of an academic hospital, paired serum, saliva and urine samples were collected from 150 chronically infected HBV patients. A validated HBV DNA TaqMan assay was used to quantitatively measure HBV DNA.
  
  
  RESULTS
  Mean log HBV DNA in serum was 5.8 (range, undetectable to 10.0 log HBV DNA) copies/ml, 50% of the patients had an HBV DNA above 10 copies/ml in serum. Mean log HBV DNA level in saliva was 3.2 (range, undetectable to 7.5) copies/ml, 15% had an HBV DNA above 10 copies/ml in saliva. Mean log HBV DNA level in urine was 2.6 (range, undetectable to 5.4) copies/ml and 1% had an HBV DNA above 10 copies/ml in urine. A high, non-linear correlation was shown between HBV DNA in serum and saliva (Spearman's rho 0.82) and between serum and urine (Spearman's rho 0.74).
  
  
  CONCLUSIONS
  The significant amounts of HBV DNA found in saliva and urine in chronic HBV patients with high viraemia in serum may have implications for the understanding of hepatitis B epidemiology. The potential infectivity of these body fluids may provide an explanation for the 20% of cases of infection obtained through horizontal transmission for which the origin of infection is yet unknown.
authors.affiliation: Department of Gastroenterology & Hepatology, Erasmus MC, University Medical Centre Rotterdam, The Netherlands.
authors.forename: Annemiek A
authors.initials: AA
authors.lastname: van der Eijk
authors.forename: Hubert G M
authors.initials: HG
authors.lastname: Niesters
authors.forename: Bettina E
authors.initials: BE
authors.lastname: Hansen
authors.forename: Suzan D
authors.initials: SD
authors.lastname: Pas
authors.forename: Jan H
authors.initials: JH
authors.lastname: Richardus
authors.forename: Marijke
authors.initials: M
authors.lastname: Mostert
authors.forename: Harry L A
authors.initials: HL
authors.lastname: Janssen
authors.forename: Solko W
authors.initials: SW
authors.lastname: Schalm
authors.forename: Robert A
authors.initials: RA
authors.lastname: de Man
mesh_terms: D000328:Adult; D000368:Aged; D002353:Carrier State / Q000821:virology; D004279:DNA, Viral / Q000032:analysis* / Q000097:blood / Q000652:urine; D018562:Disease Transmission, Infectious; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000635:transmission / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015233:Models, Statistical; D012463:Saliva / Q000821:virology*; D014766:Viremia / Q000821:virology
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens