Hepatitis B virus DNA is now often tested in the clinic, the cost is not expensive, its significance is also very important relative to hepatitis B patients, then the significance of the hepatitis B virus test what role does it play, here I will elaborate on the clinical significance of hepatitis B virus DNA from several aspects.
1, hepatitis B virus DNA is circulating in the blood hepatitis B virus containing ribonucleic acid, that is, the genetic material of the hepatitis B virus, so by detecting the amount of hepatitis B virus DNA can accurately determine the amount of hepatitis B virus contained in the blood in the body, so how much hepatitis B virus DNA can respond to the level of replication of the virus and the strength of the infectiousness of patients.
2, the significance of HBV-DNA: because the hepatitis B virus causes damage to the human body is through the immune system damage, so the human immune system and the hepatitis B virus there is a problem of interaction between the results of this interaction is the human liver cells received damage, accompanied by a reduction in hepatitis B virus, so the human immune system is a double-edged sword. If the human immune system does not recognize the hepatitis B virus, even if the amount of virus is high, because the hepatitis B virus itself is not very toxic to human liver cells, that is, no damage to the body, that is, healthy carriers, manifesting as a very high virus, liver function and ultrasound normal, no special treatment.
3, qualitative, that is, to determine whether it is negative or positive.
Now it has been basically eliminated, if the characterization is positive, it indicates that the hepatitis B patient has the possibility of progression, because the hepatitis B virus is the causative factor leading to disease progression (not the causative factor leading to disease progression). If the virus is positive, it indicates that patients with hepatitis B can progress through many years (20-40 years) to cirrhosis, and some will develop liver cancer. Of course not all populations undergo the hepatitis B trimesters. If hepatitis B is left untreated, the overall population has less than a 40% probability of developing and less than a 5% chance of liver cancer. In fact, in other words, the vast majority of people with hepatitis B (70%), do not need treatment for the rest of their lives. The simplest way to determine whether treatment is needed is to see if there is progress in liver function and ultrasound, and whether there is a family history, so it is important to review liver function and ultrasound regularly, and if necessary, liver biopsy or MRI or CT to determine whether the disease has progressed.
4, quantitative, that is, the detection of hepatitis B virus in the blood content. The quantitative test results are mainly to provide a reference for the detection and efficacy of antiviral treatment. Because the results are numerical, not “high/low”, “negative/positive”, “normal/abnormal”, so it seems to be more troublesome, but it is particularly applicable, especially in guiding the antiviral It is a necessary indicator, especially in guiding the process of antiviral treatment. To determine the normal value indicator, it is important to know the reference range of the experiment performed. The reference range varies depending on the testing instrument, method and reagent.
I. HBV-DNA is the “golden indicator” to determine whether the hepatitis B virus has replicated or not
HBV-DNA is called hepatitis B virus deoxyribonucleic acid. Viruses are structurally divided into two categories: RNA viruses (ribonucleic acid viruses) and DNA viruses (deoxyribonucleic acid viruses), and hepatitis B virus belongs to the latter. The nucleic acid is the core part of the virus, where the genes of the virus are located, and without it, the virus cannot replicate. Therefore, the HBV-DNA test is the “golden indicator” to determine whether the hepatitis B virus has replicated or not. Some people may ask, test hepatitis B “hepatitis B two to half” can reflect the hepatitis B virus has no replication, there is no infectious, why do you need to test HBV-DNA? This is not a repeat test, increasing the burden on the patient?
It is certain that HBV-DNA testing is necessary, not a repeat test, for the following reasons.
1, if the hepatitis B patient is “small three yang”, it is generally said that this is the hepatitis B virus into the non-replication state, the infection disappeared or very low, the disease should also tend to stabilize. But the actual situation is not the case, sometimes the patient’s transaminases still fluctuate repeatedly, and even gangrene, what is going on? After testing HBV-DNA and finding it positive, it is certain that the virus is still replicating actively and the unstable condition is related to the active hepatitis B virus. “Hepatitis B is also known as “HBeAg negative hepatitis” because it is HBeAg negative, which is caused by the “mutation” of the virus, so it is also called Hepatitis B is also called “heterohepatitis B”. This type of hepatitis B can not be taken lightly, the disease may be more serious.
2, in the detection of the patient “hepatitis B two pairs of half”, only one of them found positive, such as HBsAg positive or a single positive anti-HBc, generally considered that the body recovery. This does not indicate whether the virus in the patient’s body has replicated, because there is a very small amount of hidden hepatitis B (less than 1% of the overall hepatitis B), it is necessary to detect HBV-DNA, once positive, it is certain that there is still virus replication, but also infectious.
3, there are some hepatitis patients “hepatitis B two to half” all 5 negative, even A, C, D, forming hepatitis virus markers are also negative, but the patient’s transaminases are very high, gangrene, liver function damage is obvious, this is how? By measuring HBV-DNA, may be found to be positive, this can be concluded that this hepatitis is called “chronic occult hepatitis B”, in all unexplained hepatitis, this type of hepatitis accounted for about 30 to 60%.
4, some patients with hepatitis B are detected anti-HBs, which is a protective antibody, its positive indicates the end of the infection, but why the patient’s condition remains the same, and no signs of improvement? If HBV-DNA positive, “anti-HBs positive hepatitis B”, is also a viral variant.
Second, HBV-DNA is one of the key indicators to determine whether hepatitis B can progress
1, the qualitative and quantitative examination of hepatitis B virus DNA is very important to the doctor’s diagnosis and medication, the medical profession generally believes that antiviral treatment to reduce the content of serum hepatitis B virus DNA is the key to the treatment of hepatitis B. Hepatitis B virus DNA testing can determine which type of antiviral drugs are suitable for hepatitis B patients; detection of hepatitis B virus DNA can observe the efficacy of antiviral drug therapy and determine the prognosis; can be based on The dynamic changes in the amount of hepatitis B virus DNA can provide an important clinical reference for the dosage of drugs, the duration of drugs, the need for combination drugs and the effect of drugs, which is the most objective indicator to evaluate the efficacy of antiviral drugs.
2, hepatitis B virus DNA measurement is the best indicator to directly reflect the state of HBV replication and infectiousness, and plays a major role in the treatment of hepatitis B. The content of hepatitis B virus DNA can directly reflect the amount of virus present in the body, whether it is infectious, and how strong the infectiousness is. That is, the higher the level of hepatitis B virus DNA, the more viruses are present in the body, the more active the virus replication is, and obviously the more infectious it is. In general, the higher the amount of hepatitis B virus, the greater the chance that the patient will progress and have more complications (liver cancer, liver ascites, etc.). Therefore, it is now considered that the most critical treatment in hepatitis B treatment is antiviral therapy. Of course, when to start antiviral, how to start antiviral, what kind of antiviral drugs to choose, how long to use is a learning curve, must not be sloppy, otherwise one step wrong, step wrong. Then again, the progress of hepatitis B disease also has a lot to do with the patient’s genetic background, lifestyle and work style.
3, hepatitis B virus DNA reflects the active degree of virus replication, but also indirectly reflects the level of the body’s immune response, the higher the body’s viral content, the weaker the body’s immune response to the hepatitis B virus. The higher the level of virus in the body, the weaker the immune response of the body against hepatitis B virus. The comprehensive evaluation of hepatitis B virus DNA measurement results and serum immunological results is more scientific for the assessment of the infection status of hepatitis B virus in the body, especially the occurrence of variant strains and the prognosis of hepatitis B patients.
4. Hepatitis B virus is not the only factor that causes disease progression
Because in the human body, in addition to the hepatitis B virus can induce liver damage, there are many factors that can lead to liver cell damage (see “What are the causes of elevated transaminases”), for patients with hepatitis B, the results in patients with hepatitis B is “adding insult to injury”, you will certainly find that the hepatitis B virus DNA
You will certainly find that patients who are negative for hepatitis B virus DNA will also have repeatedly elevated ALT or T-bil, so “three parts treatment, seven parts nourishment”.
5, blood viral DNA and hepatocyte viral DNA also does not have a complete correlation
Blood viral DNA is a key indicator of viral replication, if the level of viral replication in the liver is very low, outside detection of viruses can be negative. However, “a single spark can start a huge fire”. Once antiviral drugs are discontinued, blood viral DNA will appear rapidly, along with deterioration of liver function, so antiviral treatment for hepatitis B is persistent. If after discontinuation of antiviral therapy or self-healing HBV
DNA continues to be negative and ALT rebound occurs, a liver biopsy is available to analyze the interrelationship between DNA in liver cells and liver inflammation.
Three, HBV-DNA test precautions
1, hepatitis B virus DNA test mainly refers to check the virus DNA in the serum, so if you only do HBV DNA test, you can eat before the test.
2, if you also do liver function tests, it is recommended that you avoid meals before the test, avoid staying up late, avoid alcohol, avoid medication, and avoid doing liver function tests during the female physiological period.
3.If you are a hepatitis B virus carrier or a healthy carrier, you can check the viral DNA less often (once every 6 months or once a year); check the transaminase elevation once at any time; check the liver cirrhosis, liver ascites, liver cancer once at any time; check the antiviral treatment patients once at any time according to the treatment roadmap of each drug.