[Dynamics of serum HBV DNA levels during the terminal phases of acute-on-chronic hepatitis B liver failure with different HBeAg status].

Objective To investigate the dynamics and clinical significance of serum hepatitis B virus (HBV) DNA levels during the terminal phase of acute-on-chronic liver failure (ACLF) with different hepatitis B e antigen (HBeAg) status.Methods One-hundred-and-seven patients with terminal ACLF were tested for HBeAg status by electrochemiluminescence immunoassay and serum HBV DNA levels by real-time PCR at three chronological time ranges,representing increasing severity of disease phases prior to death (day 0):29-56 d,15-28 d,and 0-14 d.Results In the 37 HBeAg(+) patients,HBV DNA ievels at above-mentioned phases were 6.10± 1.63,5.61 ± 1.50,and 5.29± 1.96 log10 copies/mL.In the 70 anti-HBe(+) patients,HBV DNA levels were 4.63 ± 1.82,5,81± 1.78,and 4.93 ±1.73 log10 copies/mL.Phase to phase comparisons revealed that the HBV DNA level in the HBeAg(+) group was significantly higher than that in the anti-HBe(+)group at 29-56 d (P＜0.05),and that 15-28 d and 0-14 d were not significantly different (P＞0.05).Intragroup comparisons of phases revealed no significant differences in the HBeAg(+) group (P＞0.05),but a significant difference between 15-28 d and 0-14 d (P＜0.05) for the anti-HBe(+) group.Conclusion Serum levels of HBV DNA in patients with HBeAg positivity are higher than those in patients with anti-HBe positivity as the disease phase of ACLF nears fatality.Following the deterioration to liver failure,the HBV DNA load in HBeAg(+) patients remains stable while that in anti-HBe(+) patients decreases. Key words: Hepatitis B, chronic;  Hepatitis B e antigens;  Liver failure