title: Real Time-PCR HBV-DNA Analysis: Significance and First Experience in Armed Forces.
abstract: BACKGROUND
  HBV DNA quantitation is used extensively world wide for the diagnosis and monitoring of treatment of Hepatitis B virus (HBV) infection. However, it has still to be popular in India. The aim of this study was to quantitate HBV - DNA by Real time - PCR method in Hepatitis B and in immuno-compromised patients, to compare the results with HBeAg detection and to monitor the response to therapy of chronic Hepatitis B patients to antivirals.
  
  
  METHODS
  Ninety one serum samples of Hepatitis group of patients (all HBsAg positive), 41 samples from immuno-compromised patients (all HBsAg negative) and 49 patients of Chronic Hepatitis B group (all HBsAg positive) were the subjects of this first ever study in Armed Forces. Twenty serum samples from healthy volunteers and non-hepatitis B patients served as negative controls. The amplification detection was carried out in a Rotor-Gene 2000-sequence detector.
  
  
  RESULTS
  Amongst Hepatitis B group, 33% (30/91) of the samples were positive for HBV-DNA and 26% (24/91) of samples were positive for HBeAg. In the immuno-compromised group of patients 14.6% (6/11) of samples were positive for HIV-DNA and 9.7% (4/41) were positive for HBeAg. Of the Chronic Hepatitis B patients on treatment, all (100%) were positive by HBV-DNA, whereas 29/49 (59.2%) were positive by HBeAg before treatment. After treatment with antivirals, 06/49 (12.2%) were positive by both tests and 11/49 (22.5%) were positive only by HBV-DNA. 32/49 (65.3%) patients became negative serologically after therapy.
  
  
  CONCLUSIONS
  HBeAg status did not necessarily reflect HBV-DNA level in the serum, as 10/91 (11%) in the Hepatitis B group, 2/41 (4.9%) in the immuno compromised group and 20/49 (40.8%) patients in the Chronic Hepatitis B group were positive for HBV-DNA but negative for HBeAg. HBV-DNA was not found to be positive amongst any of the negative controls. Real time - PCR is a sensitive and reproducible assay for HBV-DNA quantitation and may be started in Armed Forces referral centers in the near future.
authors.affiliation: Senior Advisor (Pathology and Immunology), Army Hospital (R and R), Delhi Cantt.
authors.forename: G S
authors.initials: GS
authors.lastname: Chopra
authors.affiliation: Reader, Department of Blood Transfusion, Armed Forces Medical College, Pune.
authors.forename: P K
authors.initials: PK
authors.lastname: Gupta
authors.affiliation: Professor and Head, Department of Medicine, Armed Forces Medical College, Pune.
authors.forename: A C
authors.initials: AC
authors.lastname: Anand
authors.affiliation: Senior Advisor (Medicine and Nephrology), Army Hospital (R and R), Delhi Cantt.
authors.forename: P P
authors.initials: PP
authors.lastname: Varma
authors.affiliation: Senior Advisor, (Medicine and Haematology), Army Hospital (R and R), Delhi Cantt.
authors.forename: V
authors.initials: V
authors.lastname: Nair
authors.affiliation: Director General Medical Services (Army), Army Head Quarters, New Delhi.
authors.forename: Ramji
authors.initials: R
authors.lastname: Rai
keywords: Antivirals; Chronic Hepatitis B; HBV – DNA; Real time – PCR