Short-term spontaneous fluctuations of HBV DNA levels in a Senegalese population with chronic hepatitis B

BACKGROUND: We evaluated the short-term spontaneous fluctuations of HBV DNA and HBsAg levels in Senegalese patients with chronic infection with hepatitis B virus and normal ALT and determined factors related to these fluctuations. METHOD: A total of 87 patients with persistent normal ALT values were enrolled in the study. Serum samples were obtained at three different visits, with an interval of 2 months (M0, M2, and M4), and without initiating anti HBV treatment. Levels of HBV DNA, quantitative HBsAg, ALT and AST, genotyping and viral DNA mutations were analyzed. RESULTS: Among the 87 patients, genotype E was predominant (75%). The median HBV DNA level was 2.9 log(10) IU/mL [2.2-3.4], 2.7 log(10) IU/mL [2.1-3.6] and 2.7 log(10) IU/mL [2.1-3.4] at M0, M2 and M4, respectively. The values ranged from <1.1 to 7 log(10) IU/mL and 55 (63%) had HBV DNA fluctuations ≥ 0.5 log(10) IU/mL between two visits. Patients in whom HBV DNA fluctuated ≥0.5 log(10) IU/mL between M0 and M2 also had significant fluctuations between M2 and M4, while patients with stable HBV DNA between M0 and M2 showed a stable viral load between M2 and M4. The only factor found to be associated with HBV DNA fluctuations ≥ 0.5 log(10) IU/mL was a low BMI (<21 kg/ m(2)). HBsAg levels were not correlated with HBV DNA levels. CONCLUSION: Sixty-three percent of the enrolled Senegalese population showed a large, short-term fluctuation of HBV DNA levels. Such fluctuations may have an impact on therapeutic management, requiring closer monitoring.