Correlation between HBV viral load and other paraclinical parameters in patients with chronic hepatitis B

Silvia Donica; Cristina Nicoleta Ciurea; Mihaela Alexandra Budianu; Anca Cighir; Razvan Lucian Coșeriu; Alexandrina Maria Bunea; Adrian Man

doi:10.2478/amma-2025-0036

Silvia Donica Medical Microbiology Laboratory, Mureș Clinical County Hospital, Târgu Mureș, Romania
Cristina Nicoleta Ciurea Microbiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Târgu Mureș, Romania; https://orcid.org/0000-0003-2262-7456
Mihaela Alexandra Budianu Epidemiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Târgu Mureș, Romania
Anca Cighir Microbiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Târgu Mureș, Romania;
Razvan Lucian Coșeriu Microbiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Târgu Mureș, Romania; Medical Microbiology Laboratory, Mureș Clinical County Hospital, Târgu Mureș, Romania;
Alexandrina Maria Bunea Medical Microbiology Laboratory, Mureș Clinical County Hospital, Târgu Mureș, Romania
Adrian Man Microbiology Department, George Emil Palade University of Medicine, Pharmacy, Science, and Technology of Targu Mures, 540142 Tărgu Mureș, Romania Medical Microbiology Laboratory, Mureș Clinical County Hospital, Târgu Mureș, Romania; https://orcid.org/0000-0001-5281-0601

DOI: https://doi.org/10.2478/amma-2025-0036

Keywords: Hepatitis B virus, Viral load, Paraclinical markers

Abstract

Background
Hepatitis B virus (HBV) infections cause approximately 1.2 million deaths yearly, mainly due to complications such as hepatocellular carcinoma and cirrhosis. The key marker used to monitor HBV viraemia and guide treatment is the viral load, often unavailable in resource-limited settings. This study aimed to find surrogate markers predicting hepatitis viral activity, valuable in areas with limited access to molecular diagnostics.

Methods
A retrospective observational study of 178 chronic hepatitis B patients was conducted at Târgu Mureș Clinical County Hospital between April 2022 and April 2025. The dataset included demographic data, hepatitis B viral load, serological viral markers, blood counts, liver function tests and coagulation parameters. Exclusion criteria consisted of duplicate samples, as well as those with detectable viral loads but missing laboratory determinations. Univariable logistic regression assessed associations between the abnormal serological parameters and the odds of viral DNA detectability.

Results
Out of 218 samples tested for hepatitis B viral load, 178 were included in the final analysis. Detectable viral DNA was found in 64 (35.96%) patients. Viral load positivity was significantly associated with positive HBsAg (OR = 41.7, 95% CI: 5.50-315.70, p<0.0001), elevated AST levels (OR = 2.46, 95% CI:1.23-4.92, p=0.01), and negative HBeAb (OR = 0.3, 95% CI: 0.09-0.94, p=0.04). Other tested associations were not statistically significant.

Conclusion

HBsAg, HBeAb, and AST were significantly associated with hepatitis B DNA detectability, highlighting their potential use in settings lacking molecular assays. Further research with larger cohorts may help identify accessible predictors of viral replication and disease progression.