HBV DNA viral load

I am just throwing this question to all the experts out there…has there been any indication of what causes HBV DNA to go up or down? Is there anything we do that can cause the DNA to go up or down…or is it just out of our control and completely just dependent on what the virus itself does?

Hi Joseph, I’m going to let a scientific expert like Thomas Tu answer your specific question. But as a nurse and someone who has “knowingly” lived with hep b for more than 30 years (meaning I wasn’t diagnosed until I was in my 30’s), my understanding that the viral DNA can go up and down, almost randomly. I know that drinking alcohol, stress, etc. can affect one’s liver enzymes (ALT). Studies have shown that people who have a drink or two before the day being tested can result in elevated ALT blood test results! I don’t think that these things would affect the DNA. But you’re asking a good question and many of us will be very interested in the answer! Always, Joan

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Hi @joseph,

Good question! Hep B DNA is interesting: it’s quite easy to measure, but tricky to figure out what is affecting it at any given time. Obviously HBV DNA goes down if you’re on treatment - that’s the whole point. But it can also go down if:

  • The virus changes into something that can replicate to a lower extent
  • Your immune system starts killing Hep B infected cells or targeting the virus itself.
  • Something affects your immune system
  • Something affects your liver

These last two can be affected by things we do (stress, diet, alcohol, other drugs, etc). It gets complicated when you involve the immune system: on one hand, we know that inflammation from the immune system can lower the virus, but also inflammation is one of the primary drivers of liver fibrosis and cancer. It’s not a simple good-guy bad-guy scenario.

So, that’s why we can’t just look at HBV DNA levels to assess how you’re doing, but we need a whole panel of tests.

Hope this helps,
Thomas

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Thanks Thomas for making science understandable! I really appreciate how you can explain things simply and in a way that’s understandable. Always, Joan

Interesting stuff…thanks for the input :slight_smile:

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