title: [Short-term spontaneous fluctuation of viral load in patients with chronic hepatitis B].
abstract: OBJECTIVE
  To investigate the short-term spontaneous fluctuation of viral load in patients with chronic hepatitis B (CHB) and explore the related factors in treatment naive CHB patients during immune clearance phase.
  
  
  METHODS
  A total of 123 treatment naive HBeAg-positive CHB patients with ALT>2 × ULN were enrolled in this study. Paired serum samples were obtained at the first and second visits with an interval of less than 4 weeks. The levels of quantitative HBV DNA (Roche COBAS), quantitative HBsAg, ALT and AST were analyzed. Liver biopsy specimen were collected within 4 weeks and evaluated using Knodell and Ishak histological scoring system.
  
  
  RESULTS
  Of the 123 patients, 93 (75.6%) and 30 (24.4%) had HBV DNA fluctuation ≤ 0.5 Log IU/ml and >0.5 Log IU/ml, respectively. Binary logistic multivariate regression analysis identified Knodell necroinflammation score and HBV DNA level as the factors related to HBV DNA fluctuation. Patients with Knodell necorinflammation score ≥ 10 or HBV DNA<7 Log IU/ml had significantly higher rates of HBV DNA fluctuation>0.5 Log IU/ml (50.0% vs 18.3%, P=0.042; 42.9% vs 20.6%, P=0.030).
  
  
  CONCLUSIONS
  Treatment naive CHB patients in immune clearance phase show short-term spontaneous fluctuation of HBV DNA, and nearly 25% of the patients have HBV DNA fluctuation >0.5 Log IU/ml. Such fluctuation is related to liver inflammation and quantity of HBV DNA.
authors.affiliation: Hepatology Unit and Department of Infectious Diseases, Nanfang Hospital, Southern Medical University, Guangzhou 510515, China.
authors.forename: Rong
authors.initials: R
authors.lastname: Fan
authors.forename: Jun-Hua
authors.initials: JH
authors.lastname: Yin
authors.forename: Shu-Ling
authors.initials: SL
authors.lastname: Yang
authors.forename: Xiao-Xi
authors.initials: XX
authors.lastname: Li
authors.forename: Gao-Yang
authors.initials: GY
authors.lastname: Yu
authors.forename: Jian
authors.initials: J
authors.lastname: Sun
authors.forename: Jin-Lin
authors.initials: JL
authors.lastname: Hou
mesh_terms: D000328:Adult; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006515:Hepatitis B virus / Q000254:growth & development*; D019694:Hepatitis B, Chronic / Q000821:virology*; D006801:Humans; D008099:Liver / Q000503:physiopathology; D008297:Male; D019562:Viral Load / Q000706:statistics & numerical data*; D055815:Young Adult
chemical_list: D004279:DNA, Viral