Cai Shao-hang, Lv Fang-fang, Zhang Yong-hong, Jiang Ye-gui, Peng Jie
NanFang Hospital, Southern Medical University, Guangzhou, Guangdong Province, China.
BMC Infect Dis. 2014 Feb 14;14:85. doi: 10.1186/1471-2334-14-85.
Hepatitis B virus (HBV) DNA levels are crucial for managing chronic hepatitis B (CHB). It was unclear whether Daan real-time polymerase chain reaction test (Daan test) or COBAS TaqMan HBV DNA Test (Cobas TaqMan) was superior in measuring different HBV DNA levels in clinical specimens.
We enrolled 67 treatment-naïve, HBV surface antigen-positive CHB patients (high baseline viral levels) who received either lamivudine/adefovir or entecavir. Serum samples were tested at baseline and treatment week 24 using the Daan test and Cobas TaqMan.
In the 67-baseline samples, the HBV DNA levels with the Cobas TaqMan (7.90 ± 0.73 log10 IU/mL) were significantly greater than those of the Daan test (7.11 ± 0.44 log10 IU/mL; P < 0.001). Of the 67 24-week samples (low viral levels), the Cobas TaqMan detected 59 (88.1%; 8 undetected); the Daan test detected 33 (49.3%; 34 undetected; P < 0.001). The Cobas TaqMan detected HBV DNA in 26 of 34 samples undetectable by the Daan test (range, 1.4-3.7 log10 IU/mL) or 38% of samples (26/67). The reductions in viral load after 24 weeks of oral antiviral treatment in the 33 samples that were positive for both the Daan test and the Cobas TaqMan test were significantly different (3.59 ± 1.11 log10 IU/mL versus 4.87 ± 1.58 log10 IU/mL, respectively; P = 0.001). Spearman correlation analysis showed positive correlation between results from two tests (rp = 0.602,P<0.001). The HBV genotypes and the anti-viral treatment did not affect the measurements of the HBV DNA by the Daan assay and the Cobas Taqman assay.
The Cobas Taqman was more sensitive at low viral loads than the Daan test and the change from complete to partial virological response could affect clinical decisions. The Cobas Taqman may be more appropriate for detection of HBV DNA levels.
乙肝病毒(HBV)DNA水平对于慢性乙型肝炎(CHB)的管理至关重要。尚不清楚达安实时聚合酶链反应检测(达安检测)或COBAS TaqMan HBV DNA检测(Cobas TaqMan)在测量临床标本中不同的HBV DNA水平时何者更具优势。
我们纳入了67例初治的、乙肝表面抗原阳性的CHB患者(基线病毒水平高),这些患者接受了拉米夫定/阿德福韦或恩替卡韦治疗。在基线和治疗第24周时,使用达安检测和Cobas TaqMan对血清样本进行检测。
在67份基线样本中,Cobas TaqMan检测的HBV DNA水平(7.90±0.73 log10 IU/mL)显著高于达安检测(7.11±0.44 log10 IU/mL;P<0.001)。在67份第24周的样本(病毒水平低)中,Cobas TaqMan检测出59份(88.1%;8份未检测到);达安检测检测出33份(49.3%;34份未检测到;P<0.001)。Cobas TaqMan在达安检测未检测到的34份样本中的26份(范围为1.4 - 3.7 log10 IU/mL)检测到了HBV DNA,占样本的38%(26/67)。在达安检测和Cobas TaqMan检测均为阳性的33份样本中,口服抗病毒治疗24周后病毒载量的下降有显著差异(分别为3.59±1.11 log10 IU/mL和4.87±1.58 log10 IU/mL;P = 0.001)。Spearman相关性分析显示两种检测结果之间呈正相关(rp = 0.602,P<0.001)。HBV基因型和抗病毒治疗并未影响达安检测和Cobas Taqman检测对HBV DNA的测量。
在低病毒载量时,Cobas Taqman比达安检测更敏感,从完全病毒学应答到部分病毒学应答的变化可能会影响临床决策。Cobas Taqman可能更适合检测HBV DNA水平。