Background and Aims: Hepatitis B virus (HBV) DNA level is used as a criterion for antiviral therapy in patients with chronic hepatitis B (CHB). However, the relationship between serum HBV-DNA level with liver histology remains controversial. The objective of this study was to determine the relationship between HBV-DNA load with liver histopathology in patients with CHB.
Methods: The study was conducted between October 2003 and May 2007 in the Department of Hepatology of Bangabandhu Sheikh Mujib Medical University. 209 consecutive patients with CHB were studied. The liver histology was graded by Knodell's criteria.
Results: 175 (83.5%) of patients were male; the patients had a mean±SD age of 26.6±8.4 years, had a mean±SD HBV DNA level of 6.9±1.6 log10 copies/mL, necro-inflammatory score of 6.8±3.2 and fibrosis score of 1.7±1.2 . Eight-one (38.8%) patients were HBeAg-negative. There was no correlation between the HBV-DNA load and either of necro-inflammatory activity or fibrosis. Eight (9.9%) patients in HBeAg negative group and 2 (1.6%) in HBeAg positive group had 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 and the lowest level of HBV-DNA to start the treatment requires reconsideration.
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