title: Short-term spontaneous fluctuations of HBV DNA levels in a Senegalese population with chronic hepatitis B.
abstract: BACKGROUND
  We evaluated the short-term spontaneous fluctuations of HBV DNA and HBsAg levels in Senegalese patients with chronic infection with hepatitis B virus and normal ALT and determined factors related to these fluctuations.
  
  
  METHODS
  A total of 87 patients with persistent normal ALT values were enrolled in the study. Serum samples were obtained at three different visits, with an interval of 2 months (M0, M2, and M4), and without initiating anti HBV treatment. Levels of HBV DNA, quantitative HBsAg, ALT and AST, genotyping and viral DNA mutations were analyzed.
  
  
  RESULTS
  Among the 87 patients, genotype E was predominant (75%). The median HBV DNA level was 2.9 log10 IU/mL [2.2-3.4], 2.7 log10 IU/mL [2.1-3.6] and 2.7 log10 IU/mL [2.1-3.4] at M0, M2 and M4, respectively. The values ranged from <1.1 to 7 log10 IU/mL and 55 (63%) had HBV DNA fluctuations≥0.5 log10 IU/mL between two visits. Patients in whom HBV DNA fluctuated ≥0.5 log10 IU/mL between M0 and M2 also had significant fluctuations between M2 and M4, while patients with stable HBV DNA between M0 and M2 showed a stable viral load between M2 and M4. The only factor found to be associated with HBV DNA fluctuations≥0.5 log10 IU/mL was a low BMI (<21 kg/ m2). HBsAg levels were not correlated with HBV DNA levels.
  
  
  CONCLUSIONS
  Sixty-three percent of the enrolled Senegalese population showed a large, short-term fluctuation of HBV DNA levels. Such fluctuations may have an impact on therapeutic management, requiring closer monitoring.
authors.affiliation: Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, 1 avenue Claude Vellefaux, Paris, France. sarah.maylin@sls.aphp.fr.|Université Paris-Diderot, Paris, France. sarah.maylin@sls.aphp.fr.
authors.forename: Sarah
authors.initials: S
authors.lastname: Maylin
authors.affiliation: Laboratoire de Microbiologie, Centre hospitalier intercommunal de Poissy-Saint-Germain-en-Laye, Poissy, France. jmsire@chi-poissy-st-germain.fr.
authors.forename: Jean-Marie
authors.initials: JM
authors.lastname: Sire
authors.affiliation: Department of Hepatology and Gastroenterology, Principal Hospital, Dakar, Senegal. psaliou@yahoo.fr.
authors.forename: Papa Saliou
authors.initials: PS
authors.lastname: Mbaye
authors.affiliation: Laboratoire de Virologie, Hôpital Saint-Louis, AP-HP, 1 avenue Claude Vellefaux, Paris, France. francois.simon@sls.aphp.fr.|Université Paris-Diderot, Paris, France. francois.simon@sls.aphp.fr.|Inserm U941, Paris, France. francois.simon@sls.aphp.fr.
authors.forename: François
authors.initials: F
authors.lastname: Simon
authors.affiliation: Department of Hepatology and Gastroenterology, Abass Ndao Hospital, Dakar, Senegal. annasarr@sentoo.sn.
authors.forename: Anna
authors.initials: A
authors.lastname: Sarr
authors.affiliation: Department of Hepatology and Gastroenterology, Abass Ndao Hospital, Dakar, Senegal. mlevra2@yahoo.fr.
authors.forename: Marie-Louise
authors.initials: ML
authors.lastname: Evra
authors.affiliation: Department of Hepatology and Gastroenterology, Principal Hospital, Dakar, Senegal. f.fatou@hotmail.com.
authors.forename: Fatou
authors.initials: F
authors.lastname: Fall
authors.affiliation: Department of Hepatology and Gastroenterology, Saint-Jean de Dieu Hospital, Thies, Senegal. punho21@hotmail.com.
authors.forename: Jean
authors.initials: J
authors.lastname: Daveiga
authors.affiliation: Department of Hepatology and Gastroenterology, Grand-Yoff Hospital, Dakar, Senegal. aboumodydiallo@yahoo.fr.
authors.forename: Aboubakry
authors.initials: A
authors.lastname: Diallo
authors.affiliation: Direction des Services de Santé des Armées, Paris, France. jm.debonne@hotmail.com.
authors.forename: Jean-Marc
authors.initials: JM
authors.lastname: Debonne
authors.affiliation: Epidemiology Unit of Infectious Diseases, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France. chartierloic2000@yahoo.fr.
authors.forename: Loic
authors.initials: L
authors.lastname: Chartier
authors.affiliation: Epidemiology Unit of Infectious Diseases, Institut Pasteur, 25 rue du Dr Roux, Paris, 75015, France. muriel.vray@pasteur.fr.|INSERM, Paris, France. muriel.vray@pasteur.fr.
authors.forename: Muriel
authors.initials: M
authors.lastname: Vray
mesh_terms: D000328:Adult; D000410:Alanine Transaminase / Q000097:blood; D004279:DNA, Viral / Q000097:blood*; D005260:Female; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics* / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000821:virology*; D006801:Humans; D008297:Male; D012675:Senegal; D012698:Serologic Tests; D019562:Viral Load / Q000706:statistics & numerical data
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D000410:Alanine Transaminase