title: Quantitative DNA analysis of very low-level hepatitis B viremic patients reporting to the gastroenterology clinic.
abstract: OBJECTIVE
  To examine data on very low-level viremic hepatitis B virus (HBV) infections in patients reporting to a gastroenterology clinic, and to investigate methods to improve analysis to avoid missing follow-up data and improve the management of HBV infection, and minimize morbidity and mortality outcomes.
  
  
  METHODS
  A total of 104 patients with very low-level viremic HBV whom reported to the gastroenterology clinic at Al-Hada Armed Forces Hospital, Taif, Saudi Arabia and had a reading of <12 IU/mL on the real time (RT) polymerase chain reaction (PCR) detection system were enrolled in this study. For serological testing (for example, hepatitis B surface antigen [HBsAg]), we examined patients' results recorded in the laboratory information system since early 2007. Liver enzymes, alanine aminotransferase, and aspartate aminotransferase were assessed in some cases.
  
  
  RESULTS
  After analyzing the data collected from 1,178 patients, we found 104 (8.83%) cases that fit the criteria for our study, including a reading of <12 IU/mL. We formed 6 groups of participants based on HBsAg reactivity and very low, elevated, or no viremia, and found 4 cases of continuous occult hepatitis B infection.
  
  
  CONCLUSIONS
  The very low levels of DNA found had a diagnostic impact on the management of HBI and yielded several suggestions for clinicians regarding follow-up with patients. It is important to use a sensitive RT PCR to monitor the course of HBV infection.
authors.affiliation: Molecular Pathology Department, Al-Hada Armed Forces Hospital, PO Box 1347, Taif 21944, Kingdom of Saudi Arabia. mbamaga@hotmail.com
authors.forename: Mohammad S
authors.initials: MS
authors.lastname: Bamaga
authors.forename: Turki M
authors.initials: TM
authors.lastname: Sobahy
authors.forename: Abdul-Aziz S
authors.initials: AA
authors.lastname: Attar
mesh_terms: D004279:DNA, Viral / Q000032:analysis*; D006509:Hepatitis B / Q000821:virology*; D006515:Hepatitis B virus / Q000302:isolation & purification*; D006801:Humans; D012189:Retrospective Studies; D020133:Reverse Transcriptase Polymerase Chain Reaction; D012698:Serologic Tests; D014766:Viremia / Q000821:virology*
chemical_list: D004279:DNA, Viral