Application strategies of serum HBV DNA detection in HBV infection patients: A retrospective study of 5611 specimens
Application strategies of serum HBV DNA detection in HBV infection patients: A retrospective study of 5611 specimens
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血清HBV DNA检测在HBV感染者中的应用策略：5611例标本的回顾性研究
DOI：
10.1002/jmv.25271
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发表时间：
2019-02-01
影响因子：
12.7
通讯作者：
Ou, Qishui
中科院分区：
文献类型：
--
作者：
Liu, Can;Wu, Wennan;Ou, Qishui
B型肝炎病毒（HBV）DNA的检测在确定HBV感染患者的病毒复制水平中起着关键作用。然而，如何选择合适的HBV DNA检测方法，低敏感性（ls）和超敏感性（hs）仍不清楚。本文对5611例疑似HBV感染者血清中HBsAg、HBeAg、ALT、AST及hsHBVDNA进行了检测。同时观察了85例慢性B型肝炎（CH B）患者用聚乙二醇干扰素α（PegIFN α）或恩替卡韦（ETV）治疗后HBV DNA和HBsAg的动态变化。结果显示，HBV DNA阳性率为32.8%，其中低病毒载量（20 ~ 500 IU/mL）者占51.8%。5611例HBsAg <1000 IU/mL者中，低载率占76.3%。此外，在接受抗病毒治疗的患者中，当HBsAg小于2000 IU/mL（PegIFN α）或HBsAg小于3500 IU/mL（ETV）时，低病毒载量的患者比例分别为79.5%或78.0%。我们建立了一种检测HBV感染者血清HBV DNA的方法。HBsAg阴性者可不做HBVDNA检测。当HBsAg为0.05 ~ 1000 IU/mL时，ALT、AST或HBeAg异常者应检测hsHBVDNA。当HBsAg大于或等于1000 IU/mL时，建议使用ls HBV DNA。此外，乙肝病毒表面抗原的临界值在抗病毒治疗过程中增加。结论：hsHBVDNA在低病毒载量HBV感染者中具有重要价值。应根据HBsAg、HBeAg、ALT、AST水平合理选择HBV DNA检测方法。
The detection of hepatitis B virus (HBV) DNA plays a critical role in determining the level of viral replication in HBV-infected patients. However, how to select appropriate HBV DNA detection method, low-sensitivity (ls) and hypersensitivity (hs) remains unclear. In this study, hepatitis B surface antigen (HBsAg), hepatitis B e-antigen (HBeAg), alanine transaminase (ALT), aspartate transaminase (AST), and hs HBV DNA titers in serum of 5611 cases with suspected HBV infection were reviewed. Besides, the dynamic changes of HBV DNA and HBsAg in 85 chronic hepatitis B (CHB) patients receiving peginterferon alpha (PegIFN alpha) or entecavir (ETV) were observed. The results showed the positive rate of HBV DNA was 32.8%, of which low viral load (20 to 500 IU/mL) accounted for 51.8%. In the 5611 cases, when the HBsAg was less than 1000 IU/mL, the proportion of low viral load was 76.3%. Moreover, in patients receiving antiviral treatment, when HBsAg was less than 2000 IU/mL (PegIFN alpha) or HBsAg was less than 3500 IU/mL (ETV), the proportion of patients with low viral load was 79.5% or 78.0%, respectively. We developed a strategy of serum HBV DNA detection in HBV-infected patients. When HBsAg was negative, HBV DNA detection should be unnecessary. When HBsAg was 0.05 to 1000 IU/mL, hs HBV DNA should be detected in patients with abnormal level of ALT, AST, or HBeAg. While HBsAg was greater than or equal to 1000 IU/mL, ls HBV DNA was recommended. Moreover, the cutoff value of HBsAg increased during antiviral therapy of CHB patients. In conclusion, hs HBV DNA is of great value in HBV-infected patients with low viral load. HBV DNA detection methods should be selected reasonably according to the levels of HBsAg, HBeAg, ALT, and AST.