QUANTITATIVE ASSESSMENT OF SERUM HEPATITIS-B E-ANTIGEN, IGM HEPATITIS-B CORE ANTIBODY AND HBV DNA IN MONITORING THE RESPONSE TO TREATMENT IN PATIENTS WITH CHRONIC HEPATITIS-B

Virological response to treatment of chronic hepatitis B is defined as the loss of serum hepatitis B virus DNA (HBV DNA) and hepatitis B e a ntigen (HBeAg). The quantitative measurement of HBV DNA is useful for monitoring and predicting the response to therapy with interferon-alph a (IFN-alpha). In this study, we evaluated whether quantitative measur ement of serum HBeAg and IgM antibody to hepatitis B core antigen (HBc Ab) could also be used in this manner. Using a microparticle-capture e nzyme immunoassay (IMx), a standard curve of fluorescence rate vs HBeA g concentration was constructed to provide quantitative results. The I gM HBcAb index was also measured using a microparticle enzyme immunoas say and serum HBV DNA was measured by a solution hybridization assay. We studied 48 patients who were initially positive for HBeAg and HBV D NA and who were treated with IFN-alpha 2b. Their sera were serially ev aluated for HBeAg concentration, and results were compared with HBV DN A levels. In the 14 patients who responded to IFN, similar disappearan ce curves were observed with good intraindividual correlation between the levels of the two markers, In the 34 non-responders, HBeAg levels decreased during treatment but never became negative; HBV DNA levels a lso decreased during treatment and became transiently undetectable in six patients, falsely suggesting treatment success, The IgM HBcAb inde x paralleled changes in alanine aminotransferase (ALT) concentration a nd did not provide additional information. Multiple logistic regressio n indicated that baseline ALT and HBeAg concentrations were independen t predictors of the response to treatment. and the addition of neither HBV DNA nor IgM HBcAb improved the model. We conclude that quantitati ve measurement of HBeAg provides information similar to that of HBV DN A in monitoring and predicting the response to treatment; this techniq ue could be readily adaptable to clinical laboratories.