The Relationship between Serum Hepatitis B Virus DNA Level and Liver Fibrosis Status among Patients with Chronic HBV Infection in Chumphon: Findings from the National Surveillance Program
Jerdnapang Prapruetkit, MD¹
Affiliation : ¹ Division of Gastroenterology, Department of Medicine, Chumphon Khet Udomsakdi Hospital, Chumphon, Thailand
Objective: To determine the prevalence and screening coverage of hepatitis B virus (HBV) infection, examine the relationship between HBV DNA level and liver fibrosis, and assess antiviral treatment among patients with chronic HBV infection in Chumphon Province.
Materials and Methods: This descriptive cross-sectional study included individuals born before 1992 and high-risk groups screened between October 2024 and June 2025 across all 11 districts of Chumphon Province. Data included HBV serology, HBV DNA level, liver fibrosis assessed by the aspartate aminotransferase-to-platelet ratio index (APRI) and ultrasonography, and antiviral treatment.
Results: Among 23,040 individuals screened (99.9% of the target), 462 were newly HBsAg-positive, yielding a prevalence of 2.0%, comparable with the national prevalence of 1.7%. Of these, 408 continued follow-up; median age was 54 years, and females predominated. HBV DNA ≥2,000 IU/mL was present in 48.3%. Higher viral load was significantly associated with greater fibrosis: APRI >0.5 occurred in 62.7% versus 37.3%, and APRI >1.0 in 94.3% versus 5.7% (p<0.001). Overall, 36.3% had significant fibrosis and 10.1% had cirrhosis, predominantly in the high-viral-load group. Among 149 patients who underwent ultrasonography, cirrhosis and hepatocellular carcinoma were detected in 11.5% and 1.3%, respectively, exclusively in the high-viral-load group. Tenofovir alafenamide was prescribed to 37.2% overall and 72.6% of patients with high viral loads.
Conclusion: Higher HBV DNA levels were associated with greater liver fibrosis, cirrhosis, and hepatocellular carcinoma. These findings support proactive HBV screening and improved access to antiviral therapy. Combining HBV DNA measurement, APRI, and liver ultrasonography may facilitate risk stratification and early detection of advanced liver disease, supporting efforts toward viral hepatitis elimination.
Received 20 November 2025 | Revised 22 March 2026 | Accepted 1 April 2026
J Med Assoc Thai 2026;109(10):835-44
Keywords : Hepatitis B virus; HBV DNA viral load; APRI; Cirrhosis; Hepatocellular carcinoma; Chumphon Province
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