ABSTRACT
To evaluate the strength of association and to determine the best prediction of response in terms of sensitivity and specificity among quantitative baseline HBV-DNA levels in blood serum in patients with chronic hepatitis B [CHB] infection who treated with interferon-alpha-2b. Totally, 78 CHB patients with serum HBV-DNA>10[5] copies/mL were treated with interferon-alpha-2b [Pdferon: Pooyesh Darou, Tehran, Iran] for 52 weeks as 5 MU Sc. For 24 weeks in HbeAg[+] and 48 weeks for HbeAg[-] at baseline of study in Tehran, Iran. Serum HBV-DNA level using Cobas Amplicor HBV Monitor test and HbeAg status were assessed at baseline and end of 6-months follow-up. Sustained response [SR] [n=42, 56%] was defined by HbeAg seroconversion [n=12], or with a decrease in HBV-DNA >10[5] copies/mL to undetectable value [n=33], or chemical response [n=20]. Higher pretreatment HBV-DNA levels have a significant relationship with better response to treatment in HbeAg [+] [R=0.7, p=0.04]. Positivity of HbeAg in SR was a better predictor of chemical response in our patients, when compared to HbeAg negative [SR: 85% vs. 15%, respectively]. At end of follow up, HbeAg [-] patients revealed more decrease in HBV-DNA levels than HbeAg [+] [412 vs. 290 _10[5] copies/ml, p<0.05]. Sensitivity of HBV-DNA in HbeAg [+] was more than HbeAg[-] [75% vs. 62%], but specificity was less in HbeAg[+] [58% vs. 45%]. Area under ROC was 0.63 in HbeAg [-]. Higher pretreatment HBV-DNA levels have a significant relationship with better response to treatment in HbeAg positive patients of CHB. Although HBV-DNA in HbeAg negative was decreased significantly from baseline to end of follow-up, monitoring with sensitive quantitative baseline HBV-DNA measurement in these patients was not a better predictor of SR than HbeAg positive