ABSTRACT
OBJECTIVE: To discuss the significance of Entecavir(ETV) in the treatment of chronic serious hepatitis B(HBV).METHODS: 54 patients with chronic serious hepatitis B were assigned to receive combined therapy in which antiviral drugs such as interferon and(or) nucleoside(acid) analogues antiviral drugs were excluded(control group,n=26) or combined therapy in combination with entecavir(0.5 mg?d-1) qd(treatment group,n=28).The course of treatment in both groups were 6 weeks.The hepatic function,HBV markers and HBV-DNA quantitation were deteted every two weeks.The improvement rate of patients after the completion of treatment were recorded.RESULTS: In the follow-up of six weeks,serum HBV-DNA and total bilirubin levels decreased markedly,and significant difference was noted between compared with the control group;ALT,AST,ALB and PT decreased in both groups,but the differnces between the two groups were not significant;there was no signficnant differnce in improvement rate between the treatment group and the control group(89.3% versus 84.6%).CONCLUSION: Entecavir can rapidly lower serum HBV-DNA level,downregulate bilirubin level,improve liver function,improve patients prognosis in patients with hepatitis B,thus it can be used to treat serious hepatitis B.However,used in short term,the survival rate of patients with severe hepatitis B can hardly be improved.
ABSTRACT
BACKGROUND: Accurate measurement of the concentration of hepatitis B virus (HBV) DNA in clinical samples is important for the appropriate treatment of patients and evaluation of their therapeutic responses. In addition, the concentration of HBV DNA in the serum of patients with chronic HBV infection has a very broad range. Real-time PCR is very sensitive and useful to detect HBV DNA in a wide range of concentrations. We designed new primers and probes for real-time PCR to detect HBV DNA. METHODS: Primers and probes specific for HBV were designed. EUROHEP HBV DNA standards (NIBSC, Hertfordshire, UK) with the HBV DNA concentration of 7.0 x 10(4) copies/mL was used to determine the calibration curve and efficacy for the real-time PCR assay. Sensitivity, dynamic range, and precision were evaluated. The correlation between the real-time PCR and Cobas Amplicor HBV Monitor(TM) assay in the measurement of serum HBV DNA concentrations in 52 patients with chronic HBV infection was evaluated. RESULTS: The sensitivity of the assay was approximately 6.08 x 10(2) copies/mL for HBV, and the quantitation was accurate and reproducible over a wide dynamic range from 6.1 x 0(2) to 6.5 x 10(9) copies/mL without any dilution of specimens. The assay showed low coefficients of variation of repeatability (3.7-24.9%) and reproducibility (7.8-24.7%). The results were found to correlate well with those obtained by Cobas Amplicor HBV Monitor(TM) kit. CONCLUSIONS: We provide a new in-house method for the measurement of serum HBV DNA using real-time PCR, which enables us to detect HBV DNA rapidly, sensitively, and accurately.
Subject(s)
Humans , Calibration , DNA , Hepatitis B virus , Real-Time Polymerase Chain ReactionABSTRACT
BACKGROUNDS/AIMS: Serum levels of hepatitis B virus (HBV) DNA are direct measures of viral replication in hepatocytes. We compared branched-DNA assay (QuantiplexTM, bDNA) and Hybridization Capture II (HCII), and evaluated the clinical significance of HBV DNA quantitation in the natural course of HBV infection. METHODS: We analyzed results of bDNA in 324 serum samples from 83 untreated male patients with chronic hepatitis B. Mean follow up period was 11.8 years. HCII was also performed in 157 arbitrarily selected samples. RESULTS: HBV DNA levels measured with two assays were very similar (r2=0.893, p<0.0001). HBV DNA detection rate of HCII was 6.4% higher than that of bDNA in HBeAg positive samples. HBV DNA detection rate was higher in cases with higher ALT. Among 73 patients with initial diagnosis of chronic hepatitis, 38 patients (52.1%) experienced progression to cirrhosis, and hepatocellular carcinoma (HCC) was developed in 9 (12.3%). HCC was developed in 5 (50.0%) of 10 patients with initial diagnosis of cirrhosis. While HBeAg positive rates during chronic hepatitis, cirrhosis and HCC were 57.8%, 55.0% and 14.3%, respectively (p=0.006), HBV DNA detection rates were 70.6%, 64.0% and 42.9%, respectively (p=0.08). Especially in HCC, the discrepancy between HBeAg positive rate and HBV DNA detection rate may suggest the appearance of variants which cannot produce HBeAg. CONCLUSION: Both HCII and bDNA were similar HBV DNA quantitation assays for clinical use. HBV DNA level correlated with the severity of liver disease. Screening tests for HCC should be recommended in patients whose HBeAg is negative and have detectable HBV DNA.