Longitudinal observation of viral load changes in untreated HBeAg negative chronic hepatitis B
Journal | Volume 76 - 2013 |
Issue | Fasc.3 - Original articles |
Author(s) | Catherine M.N. Croagh, Sally J. Bell, Robert Y. Chen, Stephen Locarnini, Paul V. Desmond |
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(1) Department of Gastroenterology. St Vincent's Hospital, Fitzroy, Victoria, Australia ; (2) Victorian Infectious Diseases Reference Laboratory, North Melbourne, Australia. |
Introduction : An HBV DNA level of 2000 IU/ml has been used to differentiate HBeAg negative chronic hepatitis B from the inactive carrier state. We sought to examine the nature and frequency of fluctuations in viral load and ALT around this threshold. Methods : A retrospective review of St Vincent's Hospital data- base was performed to identify patients who had been observed, untreated, with HBV DNA and ALT levels over a period of at least 18 months. Results : 27 HBeAg negative patients with HBV DNA < 2000 IU/ ml at baseline (Group 1) and 20 HBeAg negative patients with HBV DNA = 2000 IU/ml (Group 2) were identified. Of group 1 patients, only 8/27 had persistently normal ALT and HBV DNA persistently < 2000 IU/ml over a median followup of 24 months. 11/27 (41%) Group 1 patients showed fluctuations above 2000 IU/ml over a median of 24 months followup, most of which were transient and in the range < 20,000 IU/ml. They were accompanied by persistently normal ALT in 5/11 (45%). 8 of 20 (40%) Group 2 patients had a drop of HBV DNA to < 2000 IU/ml over followup. These had a significantly lower baseline HBV DNA (8610 v/s 208763, p = 0.03) than those that remained persistently > 2000 IU/ml. Conclusions : Minor fluctuations in HBV DNA up to 20,000 IU/ ml, accompanied by persistently normal ALT occur frequently in HBeAg negative chronic hepatitis B. (Acta gastroenterol. belg., 2013, 76, 275-281). |
© Acta Gastro-Enterologica Belgica. PMID 24261020 |