What difference between HBsAg Quantitative and HBVDNA quantitation

Both are quantitaton ..
So .. HBsAg quantitative quantitiy of what?
and .. HBVDNA (PCR) quantity of what?

[JoieTan]

They describing different part of the virus. It's easier to understand if you have an image about how the HBV virus infect a cell and replicate its copy. Feel free for anyone to correct these description.

In simplistic way, outside the liver cell, HBV virus has 3 part:
1. The DNA - HBV DNA
2. The envelope / capsul that protects the DNA - HBeAg
3. The outer skin / surface surrounding the the envelope - HBsAg

Hepatitis B Virus need to have all 3parts in order to be able to infect another liver cell

The simplistic description of virus replication process is
1. Mature HBV enters a liver cell
2. It inject its HBV-DNA, and transform HBV-DNA into cccDNA
3. cccDNA then are used to produce two templates, one to produce HBsAg, one to produce HBV-DNA + HBeAg.
4. After producing 3 parts, then they are assembled and exit from the liver cell
5. The liver cell IS NOT destroyed in the process.

What is important to understand is that
1. Most antiviral drug like entecavir only disrupt the production of template to produce HBV DNA. production of HBsAg is untouched.
2. cccDNA still resides in the liver cell, cannot be destroyed by antiviral drugs
3. It is not the virus that destroy the liver cell, it is our own immune system that destroy liver cell when it recognized the liver cell is infected
4. When liver cell is not recognizing the infection (it is called immune-tolerant phase) our liver is not damaged by the Hepatitis B virus

So why the test ?
1. Research papers shows that HBsAg quantity correlates with quantity of cccDNA in the liver cell. The logic is that since HBsAg production is not disrupted by antivirus, it is therefore a good measure of how many liver cell has been infected with HBV. (infected does not mean harm when we are at immune-tolerant phase)
2. HBV DNA is used to measure how many mature virus in the blood ready to infect new liver cell.

So if HBV DNA is low/undetecable, that DOES NOT mean there is no virus in the liver.
It just mean that there is less mature virus in our blood that can infect the liver cell

The capability of producing the virus however, is determined by cccDNA, whose quantity correlates with the HBsAg quantity (as researched).

[stef2011]

mainly hbsag quantity will tell you if you have an immune response, chances to clear virus and an idea of quantity of infected cells even if this last thing is very poor

hbvdna will tell you nothing about infection, it can be used to see if antivirals are working on hbvdna or not (not on infection, hbvdna and infection are not correlated)

it was used also for liver damage and liver cancer risk but today we have fibroscan....

[OrientS]

Thank you for your valuable information,

[4est]

I like JoieTan description ... did anybody has any comments on it ?

What exactly is hbvdna ?
I remember that @StephenCastlecrag said in one post "The serum hbvdna is actually the viral dna inside a virion" so in this case the hbvdna is not the number "hoe many mature virus in the blood ready to infect new liver cell." like JoieTan said.

did anybody can clarify this for me ? and update / corect JoieTan  simplified description

[4est]

I understand that in immune-tolerant phase no treatment is desired. But why ?

base on this description (the one that @JoieTan did), in the immune-tolerant phase virus will multiply and it is ignored (not see) by the immune system, so as a result of that a huge number of HBV DNA will be detected in blood, and all this huge number that is in blood will eventually infect liver cells without any harm to this cell.

Immune-tolerant phase is a transitory phase, that means that you will exit from this one at some point and enter in immune clearance phase and in this phase the immune system will try to eliminate the virus and destroy the infected cells. So I supposed that if many cells were infected in immune-tolerant phase destroying this cells in immune clearance phase will result in a bigger fibroses.  

So why we should not treat in immune tolerant phase to have less infected cells. (One answer that i have is because of the high possibility to have mutation. Immune tolerant phase is a high replication phase so if we treat this will result a higher possibility to get mutation)

[stef2011]

So why we should not treat in immune tolerant phase

because without an immune response no  drugs work and it is not possible to decrease hbvdna

maybe a combo of interferon+rep9ac+tenofovir+entecavir

[Amlak]

I have been in this site reading quite a lot of valuable comments since i found out that i have a chronic Hep B(1 month ago). Now i feel like i am lonely and my eyes did stop picturing my future. I have a girlfriend who lives in Canada and I live in England. It was her who told me to get tested when she comes to see me couple of months ago. I never had any idea about this bloody virus that i have been told i have it in my blood. When i did my test all i was worrying about was HIV. My all results became negative apart from this bloody virus at least i am thankful that it’s not HIV.
There are many question passes through my head in ever seconds. One, its about my girlfriend. When i told her that i have chronic hep b, she tired to cheer me up and she told me that she will never leave me and she even said that she will def  marry me as we planned it but i just still have a doubt if she will change her ideas or something???? Second, which is my main pain is, will i ever get rid of this virus????
The nurse told me i am healthy carrier and she told my body has already produced antibody to the virus. Does that mean i have a chance to clear the virus naturally or does it mean i have a possibility of clearing the virus if i start treatment???
Please i need your suggestions.
All we want in life is at least to be healthy and i hope you all out there are happy or will be happy with your health condition. Many Thanks!

[stef2011]

your thoughts are the results of the science of panic that someone "drug makers or goverment" (probably the second one" did

hbv is a virus that makes no damage to our body, it is never cronic (chronic) and needs to drugs on adults (only about 5% gets cronic (chronic) hbv as adults and these are people with no immune system like those with aids or those under drugs..adiction (addiction) or immune suppressive drugs).you, as most of us, got hbv at birth and in this case the cronicity rate is inverse, 90% cronic (chronic)

as to being infected, the virus makes no damage on most and antioxidants therapy are showing to reverse even cirrhosis, so you just need antioxidants if you want to prevent any liver damage whatsoever the virus phase (hepatitistechnologies) and monitor liver damage by fibroscan
since ll antivirals, like for hiv,, are useless on virus take them only if fibroscan finds liver damage or if you dont like antioxidant therapy.

antioxidant therapy is the best choice if  you can afford because this benefits all organs and prevents almost all todays diseases like cancer, diabetes and so on

you are also lucky you are in europe, canada and US has very little tools to monitor hbv, US especially the wrost in the world.
UK is the worst in western europe as helathcare but fibroscan is available, the main tests in order of importance are:
fibroscan
hbsag quantity by abbott architect with diluition iniu/ml
hbvdna pcr
liver function blood tests

follow our community on drugs, the only hbv cure is replicor rep9ac but no pharma company wants to pay for appoval so only available on trials.
we are also trying gcmaf which is made in europe, an immune activator made by the finest european biolabs, itt has no sides and it is  cancer/hiv cure, still checking if it can clear hbv

as regards your girl if she is from western conutries she should be vaccinated, if not she just makes vaccina and virus is like water for her.it is also good to check if she has got it already, very easy to catch according to countires if not vaccinated, of course she cleared already since only birth/very young infection is not cleared

[4est]

"So why we should not treat in immune tolerant phase

because without an immune response no  drugs work and it is not possible to decrease hbvdna"

- so, should I understand that nucs stop the DNA multiplication and implicitly the number of viruses in blood and the  immune system will destroy the one that exist.

[stef2011]

yes immune system is needed the nuc alone cant stop the virus

[stef2011]

also remember that actually nucs just lower replication, they don t stop replication and dont stop infections on new cells.....they are very very weak drugs i think perfectly designed to perpetuate infection and our money expense