392 SPECIFIC HBSAG GENETIC-DETERMINANTS ARE ASSOCIATED WITH OCCULT HBV-INFECTION IN VIVO AND HBSAG-DETECTION

Abstract

Background and Aim: Measuring serum HBVDNA levels after diagnosing acute hepatitis B is not a routine procedure. Its kinetics, however, could have a significant prognostic importance for the future development of the infection. The aim of our study is to detrmine whether HBVDNA levels could have prognostic value as far as the outcome of the infection is concerned: self-limited disease, fulminant or self-limited infection Material and methods: Our study included a dynamic examination of HBVDNA in 45 patients with acute HBV infection with different outcome – recovery, protrached course and fulminant hepatitis as two forms that differ from the self-limited HBV infection. HBVDNA was measured on the 1, 2, 7, 30, 60, 90, 180 day after admission to the hospital using Taq Man HBVDNA Real-time PCR. Results: HBVDNA was found in all patients. In fulminant cases relatively high levels of HBVDNA were found from the very beginning (above 10,000,000 IU/ml) and they were HBeAg(−). In patients who recovered and became HBsAg(−) replication reached maximal levels in the beginning of the symptomatic phase. With the recovery form the symptoms it fell and its disappearance marked the fall of the ALT levels and negativation of the HBsAg. The fall of HBVDNA on the 7 day from the admission to the hospital and the following disappearance in the range of the 60 day proved to be predictive for the self-limited course. In patients with protrached hepatitis HBVDNA proved to be with relatively higher levels drom the beginning (p < 0.016, F = 6.196) especially in the HBeAg(+) cases. These levels persisted at the time of 90 and 180 day with following chronification. Conclusion: The follow-up of the replication showed, that in the majority of cases the elimination of the virus becomes in the first 2 months. The persistence of the viremia on the 60 day necessitates its further examination due to the risk of chronification. High risk for protrached course is observed in the anicteric HBeAg(+) cases with relatively high replication (above 100,000,000 IU/ml).