title: The role of serial measurement of serum HBV DNA levels in patients with chronic HBeAg(-) hepatitis B infection: association with liver disease progression. A prospective cohort study.
abstract: OBJECTIVE
  To evaluate the fluctuating course of serum HBV-DNA levels during the natural history of chronic HBV infection in the general population of North-Eastern Greece, in association with liver disease progression.
  
  
  METHODS
  Two hundred and sixty-three adults with chronic HBV, median 34 years of age, were randomly selected and prospectively followed-up for a maximum period of 12 years. Viral markers, liver biochemistry and physical examination were performed every 6 months, and liver biopsy/abdominal ultrasound every 2-4 years.
  
  
  RESULTS
  At entry, 195/263 (76%) were HBeAg (-)/anti-HBe (+) inactive carriers: (a) almost all 195 individuals with undetectable or HBV-DNA levels <2000IU/ml had no liver disease at entry and at follow-up period by imaging or liver histology evaluation (b) only 4/195 (2%) showed HBV reactivation with HBV-DNA >2000IU/ml. At entry, 48/263 (18%) patients were chronic HBeAg(-); (a) 1/3 patients had intermittently HBV-DNA <2000IU/ml for at least one occasion and were misclassified as inactive carriers (b) 22/48 (46%) had moderate/severe histology at entry and 5/48 (10%) showed liver disease progression during follow-up. Logistic regression analysis was used to derive OR (95%CI) for factors associated with liver disease progression.
  
  
  CONCLUSIONS
  Close monitoring of serum HBV-DNA levels is useful in the management of chronic HBeAg(-) patients, as associated with liver disease progression.
authors.affiliation: Unit of Preventive Medicine, Social Security Institute, Alexandroupolis, Greece. GZacharakis@yahoo.gr
authors.forename: George
authors.initials: G
authors.lastname: Zacharakis
authors.forename: John
authors.initials: J
authors.lastname: Koskinas
authors.forename: Stamatia
authors.initials: S
authors.lastname: Kotsiou
authors.forename: Fevronia
authors.initials: F
authors.lastname: Tzara
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Vafeiadis
authors.forename: Menelaos
authors.initials: M
authors.lastname: Papoutselis
authors.forename: Eustratios
authors.initials: E
authors.lastname: Maltezos
authors.forename: Eleftherios
authors.initials: E
authors.lastname: Sivridis
authors.forename: Kostantinos
authors.initials: K
authors.lastname: Papoutselis
mesh_terms: D000328:Adult; D000368:Aged; D000410:Alanine Transaminase / Q000097:blood; D002353:Carrier State; D004279:DNA, Viral / Q000097:blood*; D018450:Disease Progression; D005260:Female; D005500:Follow-Up Studies; D006115:Greece / Q000453:epidemiology; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics* / Q000302:isolation & purification; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000473:pathology* / Q000635:transmission / Q000821:virology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000453:epidemiology / Q000473:pathology / Q000821:virology; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012307:Risk Factors; D055815:Young Adult
chemical_list: D004279:DNA, Viral; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase