How Is It Measured?: What Is HBV DNA and

Hepatitis B Fact Sheet
B V
H
A Publication of the Hepatitis C Support Project
a series of fact sheets written by experts in the field of liver disease
Written by: Chistine M. Kukka HBV Project Manager
What Is HBV DNA and

How Is It Measured?
H epatitis B virus DNA (HBV DNA) carries the genetic blue-
print of the virus. How many HBV DNA particles or units
are found in a blood sample indicates how rapidly the virus is
IU/mL may be considered for
treatment and frequent moni-
toring, such as every three to
reproducing in the liver. six months. Those who test
negative for HBeAg and have
To measure HBV DNA, also called viral load, a laboratory a viral load of 2,000 IU/mL or
measures how many HBV DNA units are found in a milliliter higher, should also be moni-
(about one drop) of blood. This result is written in international tored frequently and consid-
units per milliliter or IU/mL. High levels of HBV DNA, which can ered for treatment.
range from thousands up to millions or even billions, indicate a
high rate of HBV replication. Low or undetectable levels less Low levels of HBV DNA do
than 2,000 IU/mL indicate an inactive infection. not necessarily mean that a
person is not experiencing
Keeping track of HBV DNA levels over months and years is liver damage from the infec-
an important way to monitor HBV infection and to find out tion. A doctor must also con-
if treatment is needed, or if ongoing antiviral treatment has sider age, how long a person
has been infected, and other
stopped working due to viral resistance.
indications of liver damage,
such as alanine transami-
The World Health Organization established the international nase (ALT) levels, which rise
unit to measure HBV DNA, but some labs still use copies in- above normal when liver cells
stead of units. There are about 5 to 6 HBV DNA copies in ev- are damaged.
ery international unit. It is critical to know viral load when de-
ciding if treatment is needed. While no one knows exactly how
much HBV DNA is needed to cause liver damage, research-
ers suggest that people who test positive for the hepatitis B
e antigen (HBeAg) and have a viral load exceeding 20,000
www.hbvadvocate.org
Hepatitis B Fact Sheet HBV Fact Series 2
HBV DNA
When people, especially children, are in the immune tolerant tests can be conducted as
stage of hepatitis B, their HBV DNA levels can reach billions frequently as every month
because their immune systems havent yet recognized or be- or every three months if liver
gun to fight the infection. HBV DNA levels can also fluctuate, damage is present or if treat-
an HBV DNA test captures viral load only at the time the test ment is occurring, or every
is taken. six to 12 months if there his-
torically has been no sign of
Keeping track of HBV DNA levels over months and years is an liver damage and there is a
important way to monitor HBV infection and to find out if treat- low viral load.
ment is needed, or if ongoing antiviral treatment has stopped
working due to viral resistance. A one- or two-log decrease
in viral load (from 100,000
to 10,000 or 1,000 IU/mL for
Immune Tolerance :
example) generally means
During the immune tolerant stage of HBV ALT an antiviral is working. But a
levels can remain low even when the liver is inflamed one- or two-log increase may
or develops scar tissue. mean an antiviral has stopped
working and that viral resis-
tance has developed. An un-
detectable viral load (which
How HBV DNA Is Reported means fewer HBV DNA than
Because there are so many HBV DNA in a drop of blood, labo- a labs equipment can iden-
ratories use a math equation to report viral load. Instead of tify) generally is lower than
writing 100,000 IU/mL, labs may report it as one to the fifth about 300 IU/mL.
power or 10 5 or 5 log. In mathematical jargon, a log equals
a number multiplied by 10. If you have a viral load of 10 5 cop-
ies/mL, it is actually, 10 X 10 X 10 X 10 X 10 or 100,000.
Doctors monitor HBV DNA levels more frequently if liver dam-

age is occurring or if a patient is on treatment. HBV DNA
HCSP VERSION 2.0 September 2010
The information in this fact sheet is designed to help you understand and man- Executive Director,
age HBV and is not intended as medical advice. All persons with HBV should Editor-in-Chief, HCSP Publications
consult a medical practitioner for diagnosis and treatment of HBV. Alan Franciscus
For more information about hepatitis B, visit the following websites. Managing Editor / Webmaster
Hepatitis B Foundation: www.hepb.org HIVandHepatitis.com C.D. Mazoff, PhD
This information is provided by the Hepatitis C Support Project a nonprofit organization for HCV education, support and advocacy.
Reprint permission is granted and encouraged with credit to the Hepatitis C Support Project. 2010 Hepatitis C Support Project
www.hbvadvocate.org

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What Is HBV DNA and

Doctors monitor HBV DNA levels more frequently if liver dam-

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