ANALYSIS OF THE DNA OF THE HEPATITIS-B VI RUS (HBV) IN THE SERUM AND MONONUCLEAR-CELLS OF THE PERIPHERAL-BLOOD IN SUBJECTS WITH CHRONIC INFECTION BY THE HBV

BACKGROUND: Viral replication is one of the determining factors of the natural history of infection by the hepatitis B virus (HBV). The clin ical significance of the viremia and the DNA HBV findings in mononucle ar cells was therefore analyzed. METHODS: The epidemiologic history, l iver function tests and the Knodell index were analyzed in 117 patient s with chronic hepatitis B (CHB) and 33 healthy HBV carriers. The DNA- HBV was studied in serum and mononuclear cells by dot-blot and polymer ase chain reaction (PCR). RESULTS: The DNA HBV was detected by dot-blo t in 62/117 subjects with and in CHB 3/33 healthy carriers. Viremis wa s determined by PCR in 107/117 patients with CHB and in 22/23 healthy carriers. Both aspartate aminotransferase (AST) as well as alanine ami notransferase (ALT) and the Knodell index were greater in the patients with positive DNA-HBV dot blot. No significant differences were obser ved in the liver function tests and Knodell index with regard to the v iremia detectable exclusively by PCR. In the mononuclear cells of peri pheral blood, DNA HBV was observed in 62% by dot blot and in 95% by PC R. The presence of DNA HBV by dot-blot in these cells was associated t o greater disease activity. CONCLUSIONS: The activity of chronic hepat itis B was correlated with the presence of high viremic levels with no direct relation being observed between low grade viremia and disease aggressivity. The finding of DNA HBV by dot-blot in mononuclear cells was associated with a greater activity of chronic hepatitis B, with th ese results being in agreement with the serologic data reported.