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