Correlation between Hepatitis B Viral DNA Load and Extent of Liver Pathology in Patients with Chronic Hepatitis B

Background and aims: hepatitis b virus (hbv) dna level is used as a criterion for antiviral therapy in patients withchronic hepatitis b (chb). however, the relationship between serum hbv-dna level with liver histology remainscontroversial. the objective of this study was to determine the relationship between hbv-dna load with liverhistopathology in patients with chb.methods: the study was conducted between october 2003 and may 2007 in the department of hepatology ofbangabandhu sheikh mujib medical university. 209 consecutive patients with chb were studied. the liver histologywas graded by knodell's criteria.results: 175 (83.5%) of patients were male; the patients had a mean±sd age of 26.6(plus-minus)8.4 years, had a mean(plus-minus)sd hbvdna level of 6.9(plus-minus)1.6 iog10 coplesrmt; necro-inflammatory score of 6.8(plus-minus)3.2 and fibrosis score of 1.7(plus-minus)1.2. eight-one(38.8%) patients were hbeag-negative. there was no correlation between the hbv-dna load and either of necroinflammatoryactivity or fibrosis. eight (9.9%) patients in hbeag negative group and 2 (1.6%) in hbeag positive grouphad dna level below the recommended level of treatment but had significant pathology.conclusions: hbv-dna load does not have any correlation with the histological abnormalities and fibrosis in liver andthe lowest level of hbv-dna to start the treatment requires reconsideration.