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lüll Serum HBV DNA as a marker of efficacy during therapy for chronic HBV infection: analysis and review of the literature Mommeja-Marin H; Mondou E; Blum MR; Rousseau FHepatology 2003[Jun]; 37 (6): 1309-19Currently, compounds under evaluation for treatment of chronic hepatitis B virus (HBV) infection are evaluated with liver histology as the primary end point for efficacy. However, because of practical limitations in serial liver biopsies, there is a need for alternate markers to assess efficacy over shorter periods of time. Considering the direct correlation between viral replication and disease progression during human immunodeficiency virus and hepatitis C virus infection, we explored whether such a correlation exists for HBV infection. We reviewed the literature and conducted an analysis to investigate the relationship between absolute or treatment-induced changes in HBV DNA levels and other accepted markers of disease activity. A total of 26 prospective studies met our selection criteria, including 33 evaluable treatment arms. The study treatments consisted of nucleosides and/or interferon regimens and control arms. We found statistically significant and consistent correlations between viral load level or change and histologic grading and biochemical and serologic response. Our analysis suggests that a treatment-induced reduction in HBV DNA level can be used for assessing efficacy of treatment regimens. Further, we observed that quantitative HBV DNA has a broader dynamic range than histology, allowing demonstration of differences between 2 active treatments of unequal potency. The analysis showed stronger results in studies using nucleoside regimens and in hepatitis B e antigen (HBeAg)-positive patients. In conclusion, the goal of anti-HBV therapy should be profound and durable viral suppression, as defined by very sensitive assays. Additional prospective studies are needed to precisely determine the desirable level of viremia to attain.|Alanine Transaminase/blood[MESH]|Biomarkers/blood[MESH]|DNA, Viral/*blood[MESH]|Hepatitis B Surface Antigens/blood[MESH]|Hepatitis B e Antigens/blood[MESH]|Hepatitis B virus/*genetics/immunology[MESH]|Hepatitis B, Chronic/*blood/*drug therapy/pathology/virology[MESH]|Humans[MESH]|Interferons/*therapeutic use[MESH]|Nucleosides/*therapeutic use[MESH]|Treatment Outcome[MESH]|Viral Load[MESH] |