Analysis of hepatitis B viral load decline under potent therapy: Complex decay profiles observed

  • Sharon R. Lewin
  • , Ruy M. Ribeiro
  • , Tomos Walters
  • , George K. Lau
  • , Scott Bowden
  • , Stephen Locarnini
  • , Alan S. Perelson

Research output: Contribution to journalArticlepeer-review

230 Scopus citations

Abstract

We used a new real-time polymerase chain reaction (PCR)-based assay that is sensitive, has a wide dynamic linear range, and is highly reproducible to quantify hepatitis B virus (HBV) DNA in the serum of infected individuals undergoing potent antiviral therapy. In addition, we made frequent measurements of viral load after initiation of treatment and maintained follow-up to about 12 weeks. To analyze the data we used a new model of HBV decay, which takes into account that existing drug treatments do not completely block de novo infection and the possibility of noncytolytic loss of infected cells. On initiation of therapy, there was a mean delay of 1.6 days followed by a biphasic or muliphasic decay of plasma HBV DNA. The slope of the first phase varied considerably, with one individual having rapid decay, corresponding to a virion half-life of 1 hour, but others showing half-lives of up to 92 hours. Individuals either had a slow second-phase decline (tl/2 = 7.2 ± 1.2 days) or a flat second phase. Some individuals exhibited a complex "staircase pattern" of decay, with further phases of viral DNA decline and phases with little change in viral load.

Original languageEnglish
Pages (from-to)1012-1020
Number of pages9
JournalHepatology
Volume34
Issue number5
DOIs
StatePublished - 2001
Externally publishedYes

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