Highly sensitive nucleic acid detection and transaminase level in treatment decisions for Chinese patients with cirrhosis caused by hepatitis

OBJECTIVE: To explore the usefulness of highly sensitive nucleic acid detection for assisting with the accurate antiviral treatment of patients with cirrhosis that was caused by hepatitis. METHODS: There were 377 patients with hepatitis B with cirrhosis and 119 patients with hepatitis C with cirrhosis, either as hospitalized patients and outpatients, who were enrolled into the study. Among them, 299 were men and 197 were women between 23 and 82 years of age. All patients were examined using a domestic HBV DNA/HCV RNA test, which was negative in 162 cirrhosis with hepatitis B and 54 cirrhosis with hepatitis C patients (HBV DNA/HCV RNA <500 IU/mL). Prediction and analysis of the HBV DNA load using alanine aminotransferase (ALT) level was based on receiver operating characteristics (ROC) curve analysis. RESULTS: For patients with hepatitis C with cirrhosis, after the antiviral therapy, ALT, HCV RNA, and Child–Pugh grade were significantly improved compared with before treatment. ROC analysis results showed that an ALT level of 29 IU/mL was the most sensitive cutoff value to judge a positive HBV DNA load (sensitivity 1.0, specificity 0.237, Youden index 0.763). CONCLUSION: Precise detection for patients with cirrhosis caused by hepatitis is required for accurate therapy.