Hepatitis B virus load in serum does not reflect histologic activity in patients with decompensated cirrhosis.
OBJECTIVE
Little is known about whether histologic data can predict which patients with hepatitis B virus (HBV)-related decompensated cirrhosis will respond to antiviral therapies. We assessed the relationship between serum HBV DNA load and histologic activity by analyzing liver specimens from patients with decompensated cirrhosis.


METHODS
The study included 72 consecutive patients who underwent liver transplantation for HBV-related decompensated cirrhosis between November 2000 and March 2008. None of the patients had received nucleoside or nucleotide analogues more than 2 weeks before transplantation. Serum HBV DNA levels at the time of transplantation were compared with histologic activity in explanted liver specimens.


RESULTS
The median HBV DNA level of the 72 patients was 5.40 log(10) copies/mL (range, 1.45-8.00 log(10) copies/mL). There were no differences in HBV DNA level between patients grouped according to lobular or portoperiportal activity (P = .678, P = .291, respectively). Of 16 patients (22.2%) with HBV DNA levels less than 2000 copies/mL, 8 patients (50.0%) had moderate or severe portoperiportal activity; their median alanine aminotransferase level was 30.5 U/L (range, 12-135 U/L).


CONCLUSIONS
HBV DNA load does not reflect histologic activity in patients with HBV-related decompensated cirrhosis. Although patients with decompensated cirrhosis might have normal levels of alanine aminotransferase and a low level of viremia (<2000 copies/mL), they still can have significant portoperiportal activity.
Kim
Jin Dong
JD
Department of Internal Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea.
Choi
Jong Young
JY
Bae
Si Hyun
SH
Yoon
Seung Kew
SK
Yang
Jin Mo
JM
Han
Nam Ik
NI
Choi
Sang Wook
SW
Lee
Chang Don
CD
Lee
Young Sok
YS
Jung
Eun Sun
ES
D000328:Adult; D004279:DNA, Viral / Q000097:blood; D005260:Female; D006515:Hepatitis B virus / Q000302:isolation & purification*; D019698:Hepatitis C, Chronic / Q000473:pathology* / Q000821:virology*; D006651:Histocytochemistry; D006801:Humans; D008103:Liver Cirrhosis / Q000473:pathology*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D044967:Serum / Q000821:virology*; D012720:Severity of Illness Index; D013223:Statistics as Topic; D019562:Viral Load
D004279:DNA, Viral