Global Development and Medical Affairs, Bristol-Myers Squibb (BMS), São Paulo, Brazil.
Ann Hepatol. 2009 Oct-Dec;8(4):339-45.
Serum hepatitis B virus (HBV) DNA level is a predictor of the development of cirrhosis and hepatocellular carcinoma in chronic hepatitis B patients. Nevertheless, the distribution of viral load levels in chronic HBV patients in Brazil has yet to be described. This cross-sectional study included 564 participants selected in nine Brazilian cities located in four of the five regions of the country using the database of a medical diagnostics company. Admission criteria included hepatitis B surface antigen seropositivity, availability of HBV viral load samples and age >or=18 years. Males comprised 64.5% of the study population. Mean age was 43.7 years. Most individuals (62.1%) were seronegative for the hepatitis B e antigen (HBeAg). Median serum ALT level was 34 U/L. In 58.5% of the patients HBV-DNA levels ranged from 300 to 99,999 copies/mL; however, in 21.6% levels were undetectable. Median HBV-DNA level was 2,351 copies/mL. Over 60% of the patients who tested negative for HBeAg and in whom ALT level was less than 1.5 times the upper limit of the normal range had HBV-DNA levels > 2,000 IU/mL, which has been considered a cut-off point for indicating a liver biopsy and/or treatment. In conclusion, HBV-DNA level identified a significant proportion of Brazilian individuals with chronic hepatitis B at risk of disease progression. Furthermore, this tool enables those individuals with high HBV-DNA levels who are susceptible to disease progression to be identified among patients with normal or slightly elevated ALT.
血清乙型肝炎病毒 (HBV) DNA 水平是慢性乙型肝炎患者发生肝硬化和肝细胞癌的预测指标。然而，巴西慢性 HBV 患者的病毒载量水平分布情况尚待描述。本横断面研究纳入了 564 名参与者，这些参与者是通过一家医学诊断公司的数据库，从巴西 9 个城市中选择的，这些城市分布在该国的五个地区中的四个地区。入选标准包括乙型肝炎表面抗原血清学阳性、有 HBV 病毒载量样本以及年龄≥18 岁。研究人群中男性占 64.5%。平均年龄为 43.7 岁。大多数个体（62.1%）乙型肝炎 e 抗原（HBeAg）血清学阴性。中位血清丙氨酸氨基转移酶（ALT）水平为 34 U/L。在 58.5%的患者中，HBV-DNA 水平在 300 至 99,999 拷贝/ml 之间；然而，在 21.6%的患者中，HBV-DNA 水平不可检测。中位 HBV-DNA 水平为 2351 拷贝/ml。超过 60%的 HBeAg 阴性且 ALT 水平低于正常上限 1.5 倍的患者 HBV-DNA 水平>2000 IU/ml，这被认为是进行肝活检和/或治疗的一个临界点。总之，HBV-DNA 水平确定了巴西相当一部分慢性乙型肝炎患者存在疾病进展风险。此外，该工具可识别出具有高 HBV-DNA 水平且易发生疾病进展的患者，这些患者的 ALT 水平正常或略有升高。
