Changes of HBV DNA titers and serum alanine aminotransferase level in chronic hepatitis B patients during adefovir dipivoxil treatment

Objective To study the changes of HBV viral DNA titers and serum alanine aminotransferase(ALT) levels during adefovir dipivoxil(ADV) treatment on chronic hepatitis B (CHB) patient in order to guide the clinical practice. Methods Sixteen CHB patients were treated with ADV for 92 weeks. Blood samples were collected at week 12, 16, 28,40, 52, 68, 80 and 92. ALT and HBV DNA titer were determined by automatic biochemistry analyzer and real-time PCR respectively. Results Mean HBV DNA titers decreased significantly from the start of the treatment to week 48. At week 52, HBV DNA level rebounded instead of decreasing continuously. From week 52 to week 92, HBV DNA decreased again. The change of ALT level was consistent to that of HBV DNA. At week 12, mean reduction of HBV DNA reached to 2.34 lg copies/ml, compared to before trestment baseline (BL), with no patient showing HBV DNA negative and HBeAg seroconversion. At week 28, mean reduction of HBV viral DNA titer was 2.91 lg copies/ml, compared to BL, with two patient showing HBV DNA negative and HBeAg seroconversion. At week 40 and week 48, mean reduction of HBV viral DNA got to 3.83 lg copies/hal and 3. 95 lg copies/ml respectively. Four patients showed HBV DNA negative, ALT normalization and HBeAg seroconversion. At week 52, HBV viral DNA rebounded, with the mean HBV viral DNA reduction climbed to 2.90 lg copies/ml compared to the baseline, even though 4 patients showed HBV DNA negative, ALT normalization and HBeAg seroconversion at this time point. At week 68, 80, 92, mean HBV viral DNA reduction became 3.51,3.81 and 4.01 lg copies/ml, respectively. Additionally, four, six and six patients turned to be HBV DNA negative, ALT recovery and HBeAg seroconversion, respectively. HBV viral DNA titor in 9 patients dropped significantly around week 16-40, but no significant reduction in viral DNA titer was observed in other 7 patients. Conclusions The change of HBV viral DNA load in 16 patients treated with ADV is closely associated with those of their serum ALT levels. Particularly, a significant rebound in viral DNA load was noticed at week 52, a phenomenon not seen in previous reports. Key words: Hepatitis,type B;  Chronicity;  Adefovir dipivoxil;  Polymerase chain reaction