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Hepatitis B PCR
Last reviewed: 05.07.2025
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HBV is normally absent from the material.
Approximately 5-10% of cases of cirrhosis and other chronic liver diseases are caused by chronic viral hepatitis B. Markers of the activity of such diseases are HB e Ag and viral DNA in the blood serum.
PCR allows to determine HBV DNA in the test material (blood, liver puncture) both qualitatively and quantitatively. Qualitative determination of HBV in the material allows to confirm the presence of the virus in the patient's body and thus establishes the pathogenesis of the disease. Quantitative method of determining the HBV DNA content in the test material provides important information on the intensity of the disease, the effectiveness of treatment and the development of resistance to antiviral drugs. For the diagnosis of viral hepatitis by PCR in blood serum, test systems are currently used, their sensitivity is 50-100 copies in a sample, which allows detecting the virus at a concentration of 5×10 3 -10 4 copies / ml. PCR in viral HBV is certainly necessary to judge viral replication. Viral DNA in the blood serum is detected in 50% of patients in the absence of HB e Ag. Blood serum, as well as lymphocytes and hepatobiopsy specimens can serve as material for detecting HBV DNA. The evaluation of HBV DNA test results is largely similar to that described for viral hepatitis C.
Detection of HBV DNA in the material using PCR is necessary in the following cases:
- resolution of questionable serological test results;
- identification of the acute stage of the disease in comparison with the previous infection or contact;
- monitoring the effectiveness of antiviral treatment.
There is a relationship between the outcome of acute viral hepatitis B and the concentration of HBV DNA in the patient's blood. At a low level of viremia (less than 0.5 pg/mcl), the process of chronicization of the infection is close to zero, at a concentration of HBV DNA from 0.5 to 2 pg/ml, the process becomes chronic in 25-30% of patients, and at a high level of viremia (more than 2 pg/ml), acute viral hepatitis B most often becomes chronic.
Indications for the treatment of chronic viral hepatitis B with interferon alpha should be considered the presence of markers of active viral replication (detection of HB s Ag, HB e Ag and HBV DNA in the blood serum over the previous 6 months). The criterion for assessing the effectiveness of treatment is the disappearance of HB e Ag and HBV DNA in the blood, which is usually accompanied by normalization of transaminase activity and long-term remission of the disease.
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