Quantification of intrahepatic total hepatitis B virus DNA in chronic hepatitis B patients and its relationship with liver histology

Aims: This study was conducted to evaluate the relationship between total intrahepatic hepatitis B virus (HBV) DNA levels and liver histology in terms of the degree of histological activity index (HAI) that yields necroinflammation (HAI-NI) and fibrosis (HAI-F) of the liver. Methods: Prospectively, Tru-cut needle biopsy samples were obtained from the livers of 42 patients with chronic hepatitis B. Levels of serum and liver HBV DNA were determined by quantitative real-time PCR. Demographic data of patients, together with hepatitis B serology, alanine aminotransferase levels, and HAI-NI and HAI-F scores, were recorded. Results: Twenty of the patients were hepatitis B e antigen (HBeAg) positive, while 22 patients were positive for antibody to HBeAg (anti-HBe). Serum and liver total HBV DNA levels were found to correlate directly with each other in the two groups (r = 0.669, p = 0.001; and r = 0.880, p<0.001; respectively) and the correlation was more marked in anti-HBe-positive patients. Although serum HBV DNA levels correlated positively with HAI-NI and HAI-F scores in HBeAg-positive and HBeAg-negative patients, total liver HBV DNA levels correlated with HAI-NI and HAI-F scores in anti-HBe-positive patients only. Conclusions: Quantitative measurement of intrahepatic HBV DNA is a valuable marker of the histological status of the liver in anti-HBe-positive patients with chronic hepatitis B, and it may give an insight into the prognosis and the ideal time for the cessation of antiviral treatment.