HBV-DNA levels in HBsAg-positive blood donors and its relationship with liver histology.
OBJECTIVE
The clinical meaning of viremia, especially at low levels, in chronic hepatitis B virus (HBV)-infected patients remains unknown. The objective of the present study was to determine serum HBV-DNA levels and its relationship with liver histology in HBsAg-positive blood donors.


METHODS
A cross-sectional study was conducted on 78 blood donors, with alanine aminotransferase (ALT) and HBeAg evaluation and quantitative determination of HBV-DNA by polymerase chain reaction (Amplicor, HBV Monitor, Roche; lower limit of sensitivity 1,000 copies/mL). Liver biopsy was obtained from all patients with detectable viremia irrespective of ALT and HBV-DNA levels.


RESULTS
Among 78 blood donors, serum HBV-DNA was detected in 47 (60%) patients; 39 (83%) were males; mean age 37.6+/-10.4 years; 31 (66%) were HBeAg-negative, and ALT was elevated in 26 (55%). The median of HBV-DNA levels was 24,000 copies/mL and 31 (40%) subjects had no detectable serum HBV-DNA. Although the histologic lesions were mild in the majority of patients, HBV-DNA levels were significantly higher in patients with chronic hepatitis or cirrhosis when compared with patients without histologic liver disease (25,260,000 vs. 9480 copies/mL; P<0.001). There was a significant correlation between HBV-DNA levels and necroinflammatory score (r=0.59) and fibrosis (r=0.50); however, in the subset of HBeAg-negative patients with HBV-DNA levels below 30,000 copies/mL, 25% presented histologic disease related to HBV.


CONCLUSIONS
Most HBsAg-positive blood donors show low viral load. There is a significant association between viral replication and liver damage; however, low HBV-DNA levels do not exclude the presence of histologic disease.
Nabuco
Leticia Cancella
LC
Division of Hepatology, Clementino Fraga Filho University Hospital, Federal University of Rio de Janeiro, Brazil. leticia.nabuco@terra.com.br
Villela-Nogueira
Cristiane Alves
CA
Perez
Renata Mello
RM
Ceci
Loredana
L
Pannain
Vera Lucia
VL
Nogueira
Carmem Martins
CM
Segadas-Soares
Jorge André
JA
Coelho
Henrique Sergio Moraes
HS
D000328:Adult; D001782:Blood Donors; D004279:DNA, Viral / Q000097:blood* / Q000235:genetics*; D003710:Demography; D005260:Female; D005355:Fibrosis; D006509:Hepatitis B / Q000821:virology; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification*; D006801:Humans; D008099:Liver / Q000166:cytology* / Q000473:pathology / Q000821:virology; D008297:Male; D019562:Viral Load
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens