Comparison of Real-Time PCR Assays for Monitoring Serum Hepatitis B Virus DNA Levels during Antiviral Therapy

Hui, Chee–Kin; Bowden, Scott; Zhang, Haiying; Wong, Anita; Lewin, Sharon R.; Rousseau, Frank; Momméja-Marin, Hervé; Lee, Nikki P.; Luk, John M.; Locarnini, Stephen; Leung, Nancy; Naoumov, Nikolai V.; Lau, George

doi:10.1128/jcm.02544-05

Cited by 12 publications

(10 citation statements)

References 17 publications

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“…Currently, this early preemptive approach with the use of lamivudine has been adopted by the major HBV treatment guidelines [120][121][122]. It remains speculative whether monitoring the serum HBV DNA at a closer interval, with a more sensitive HBV DNA assay, would improve the situation [123]. The major concerns related to the use of this early preemptive approach have been the prolonged use of lamivudine and the unnecessary treatment for some patients who may not develop HBV reactivation.…”

Section: Preemptive Use Of Nucleoside Analoguesmentioning

confidence: 99%

Hepatitis B reactivation after chemotherapy: two decades of clinical research

Lau

2008

Hepatol Int

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102

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Hepatitis due to hepatitis B virus reactivation after cytotoxic or immunosuppressive therapy is a serious cause of liver-related morbidity and mortality. With the characterization of the underlying pathogenesis, much progress in the management of this important clinical problem has been made in the past 2 decades. By year 2008, it is mandatory to screen for hepatitis B surface antigen status before initiating intensive chemotherapy or immunosuppressive therapy. All those who are hepatitis B surface antigen positive should be started on preemptive nucleos(t)ide analogues. However, there remains important issues, such as the type and duration of nucleos(t)ide analogue therapy, which need to be understood. As not all hepatitis B surface antigen-positive patients will suffer from HBV reactivation, it is therefore useful to identify risk factors related to HBV reactivation so that patients will not be treated unnecessarily with nucleos(t)ide analogues. To date, a high baseline level of viral replication, as reflected by high serum HBV DNA level, positive serum hepatitis B e antigen, and a high intrahepatic covalently closed circular DNA level, is the most important predictor for HBV reactivation. Recently, there has been an increased awareness of reactivation of occult hepatitis B virus, especially in hepatitis B virus endemic area, such as the Asia-Pacific region. Careful epidemiological study will be needed to clarify the impact of occult hepatitis B infection in patients treated with cytotoxic or immunosuppressive therapy. How important is the problem?Over the past 20 years of clinical practice at Queen Mary Hospital, we have seen a lot of progress in the management of hepatitis due to HBV reactivation in hepatitis B surface antigen carriers [1][2][3][4][5]. In the past, we saw patients who died of fulminant hepatic failure after being administered a few courses of cytotoxic therapy to treat their life-threatening lymphoma [6][7][8][9] and breast cancer [10][11][12] if they were also hepatitis B surface antigen positive. At that time, the literature report of this important clinical issue was scanty. The first report in the field was published by Wand et al. [13] who studied the effects of antitumor chemotherapeutic agents on hepatitis antigen (HBAg) and antibody (HBAb) in 25 patients with myeloproliferative and in 60 patients with lymphoproliferative disorders. This elegant study was performed at the time when only antigen and antibody associated with viral hepatitis could be semiquantified [14]. In those patients who had HBAg at the time of initiation of chemotherapy, bone marrow suppression by chemotherapeutic agents was associated with a marked increase in HBAg titer, which was then followed by hepatocellular damage, as manifested by an elevation in serum transaminase enzymes [13]. Since then, this important observation was further confirmed in other studies [8,15,16], with the rate of HBV reactivation ranging from 19% to 48%. Among them, one-quarter to half would be complicated, with severe hepatitis...

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Section: Preemptive Use Of Nucleoside Analoguesmentioning

confidence: 99%

Hepatitis B reactivation after chemotherapy: two decades of clinical research

Lau

2008

Hepatol Int

Self Cite

102

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“…These advances have been demonstrated to translate into better clinical performance as manifested by better detection of low virus concentrations and elimination of specimen dilution for a large proportion of specimens with high viral loads (43,56).…”

Section: Molecular Tests For Hbv Quantification: Available Assays Andmentioning

confidence: 99%

“…Significant variability in quantification among different assays can occur randomly (39,69) despite the standardization of reporting units and the finding of generally good correlation between different assays (56,77,122). Patients should therefore be monitored with a single assay.…”

Section: Molecular Tests For Hbv Quantification: Available Assays Andmentioning

confidence: 99%

“…Automated extraction methods with COBAS AmpliPrep (Roche Diagnostics) and MagNAPure (Roche Diagnostics) have been reported for RealArt HBV LC PCR reagents (Artus HBV PCR; QIAGEN Diagnostics) (56,135) and COBAS TaqMan reagents (39,51,124). Manual column methods have also been reported for use with COBAS TaqMan reagents (84,146).…”

Section: Molecular Tests For Hbv Quantification: Available Assays Andmentioning

confidence: 99%

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Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Valsamakis

2007

Clin Microbiol Rev

137

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SUMMARY Hepatitis B virus (HBV) is an enveloped virus with a small (3.2-kb) partially double-stranded DNA genome that causes acute and chronic infections. The impact of these infections on public health worldwide is enormous, with an estimated prevalence of 2 billion acute infections and 360 million chronic infections globally. This review focuses on chronic hepatitis B and the molecular assays used in its diagnosis and management. Background information, including that about features of the hepatitis B virion, viral replication, and epidemiology of infection, that is important for understanding chronic hepatitis B and molecular diagnostic tests for HBV is provided. To facilitate an understanding of the utility of molecular testing for chronic hepatitis B, the four stages of chronic hepatitis B infection that are currently recognized, as well as an additional entity, occult hepatitis B, that can be diagnosed only by sensitive nucleic acid amplification methods, are reviewed in detail, including available therapeutic agents. The molecular diagnostic content focuses on tests for HBV DNA quantification, genotyping, and mutation detection (including precore/core promoter and antiviral resistance mutations). The discussion of these tests encompasses their current utility and performance characteristics, drawing from current clinical guidelines and other studies from the literature. In recognition of the continual evolution of this field, the final section describes emerging molecular markers with future diagnostic potential.

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“…This technology has been used for more than a decade for the identification of microorganisms, such as commonly occurring Mycobacterium species and the dimorphic fungi, in positive culture samples [17][18][19][20][21]. Another technology, target-capture technology, used predominantly for the detection of viruses (HPV, cytomegalovirus, and hepatitis B virus), could also be used for the detection of bacteria and fungi in positive blood culture samples [22][23][24][25].…”

Section: Direct Hybridizationmentioning

confidence: 99%

Molecular Diagnostics for the Detection and Characterization of Microbial Pathogens

Procop

2007

Clinical Infectious Diseases

102

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New and advanced methods of molecular diagnostics are changing the way we practice clinical microbiology, which affects the practice of medicine. Signal amplification and real-time nucleic acid amplification technologies offer a sensitive and specific result with a more rapid turnaround time than has ever before been possible. Numerous methods of postamplification analysis afford the simultaneous detection and differentiation of numerous microbial pathogens, their mechanisms of resistance, and the construction of disease-specific assays. The technical feasibility of these assays has already been demonstrated. How these new, often more expensive tests will be incorporated into routine practice and the impact they will have on patient care remain to be determined. One of the most attractive uses for such techniques is to achieve a more rapid characterization of the infectious agent so that a narrower-spectrum antimicrobial agent may be used, which should have an impact on resistance patterns.

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Comparison of Real-Time PCR Assays for Monitoring Serum Hepatitis B Virus DNA Levels during Antiviral Therapy

Cited by 12 publications

References 17 publications

Hepatitis B reactivation after chemotherapy: two decades of clinical research

Hepatitis B reactivation after chemotherapy: two decades of clinical research

Molecular Testing in the Diagnosis and Management of Chronic Hepatitis B

Molecular Diagnostics for the Detection and Characterization of Microbial Pathogens

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