Effect Of Adefovir Therapy On The Serum Covalently Closed Circular (ccc) DNA Of Chronic Hepatitis B Infection And The Clinical Research On Relationship Of The Covalently Closed Circular (ccc) DNA Of Chronic Hepatitis B Infection And Other Related Factors

Objective:To study the relationship between serum HBV cccDNA and serum AST,ALT and serum HBV-DNA of patients with chronic hepatitis B infection.To investigate the impact of Adefovir therapy on serum covalently closed-circular DNA(cccDNA) for patients with chronic hepatitis B infection.Methods:Using Real-time fluorescence quantitative polymerase chain reaction(FQ-PCR) to detect the level of serum HBV cccDNA,HBV-DNA,ALTA and AST of chronic hepatitis B.A total of 40 patients were randomly assigned to receive Adefovir or Other non-anti-viral drugs in a ratio of 1:1.All the patients were treated for 52 weeks and followed by another 52 weeks.Serum HBV cccDNA and HBV-DNA levels were detected with real-time polymerase chain reaction(PCR) at the time of 0,26 and 52 W. Results:Of all the 91 patients,serum ALT abnormalities were 79 cases of which 53 cases was detected with HBV cccDNA and the detection rate was 67.09%.Compared with the normal serum ALT test,the detection rate is statistically significant(P=0.001＜0.05).of all the 91 patients,serum AST abnormalities were 59 cases of which 41 cases were detected with HBV cccDNA,and the detection rate was 69.49%,which was also statistically significant(P=0.015＜0.05),compared with the normal serum AST test.When the replication level of HBV-DNA was less than 10⁴ copies/ml,the detection rate of serum HBV cccDNA was 11.11%.When the replication level of HBV-DNA was 104^4～6 copies/ml,the detection rate of serum HBV cccDNA was 53.33%.When the replication level of HBV-DNA was higher than 10⁶ copies/ml,the detection rate of serum HBV cccDNA was 86.05%.With the comparison of the three different HBV-DNA replication levels of serum HBV-DNA above,the detection rate of cccDNA showed statistical significance((P= 0.000＜0.05).Before the treatment(0 W),20 patients of the observing group showed the median level of serum HBV cccDNA 8.29×10⁶ copies/ml, Comparing with the control group was insignificant(P＞0.05);patients' serum HBV cccDNA respectively showed median of 2.61×10⁴ copies/ml and 7.78×10³ copies/ml after receiving adefovir for half a year(26 W) and one year(52 W),Comparing with the starting point was significant(P＜0.05 for both).Patients' serum HBV cccDNA averagely decreased 2.502logs and 3.028logs after receiving adefovir for half a year and one year, comparing with the control group was significant(P＜0.05 for both).Conclusion:Serum ALT,AST level and serum HBV-DNA level are both positively related with the serum HBV cccDNA detection rate.The dynamic detection of the HBV cccDNA is an important indicator in clinical treatment and monitoring.:Adefovir has a significant effect on serum HBV cccDNA;Serum HBV cccDNA can be used as virus resistance for the important indicators of monitoring,and Long-term Anti-virus treatment of the important reference for index. Objective Aim to understand marker of hepatitis B virus(HBV-M) "three-antibody positive" patients with HBV-DNA replication and liver biochemical changes and analysis of its clinical significance.Methods Application of real-time quantitative polymerase chain reaction(FQ-PCR) to detect the "three- antibody positive" patients with HBV-DNA content;quantitative detection of HBV-M using time-resolved fluorescence immunoassay analysis.Results among 211 cases of the "three antibody - positive" patients,48 cases have HBV-DNA replication,accounting for 22.75 percent,compared with the control group it was significant(P＜0.05);among 211 cases of the "three antibody -positive" patients,73 cases have liver biochemical abnormalities which accounts for 34.60%,compared with the control group there were no significant differences(P＞0.05);there are 14 cases have liver biochemical abnormalities and HBV-DNA replication at the same time,accounting for 6.64 percent,compared with the control group it was significant(P＜0.05);"Three antibody -positive" reach the peak from the age of 20-year-old to 50-year-old,with an average age of 34.6 years old.Conclusions "Three antibody -positive" HBV infection is one form of the performance, in the past time,it is generally considered to be infected with the hepatitis B virus recovery process,but some cases have shown that viral replication and liver biochemical abnormalities still exist among them,and it is infectious;In the clinical,epidemiological and prognosis,we should pay attention to these patients.