Araştırma Makalesi
BibTex RIS Kaynak Göster

Kronik hepatit B hastalarında HBV-DNA düzeylerinin biyokimyasal ve mikrobiyolojik belirteçlerle ilişkisi

Yıl 2025, Cilt: 16 Sayı: 4, 473 - 480, 01.01.2026
https://doi.org/10.18663/tjcl.1636298

Öz

Amaç: HBV-DNA seviyeleri, Kronik hepatit B (KHB) hastalığını teşhis etmek, enfeksiyon evresini belirlemek, tedaviye karar vermek ve hastalığın seyrini belirlemek için kullanılır. HBeAg aktif viral replikasyonun ve transkripsiyonun, Alanin aminotransferaz (ALT) ve Aspartat aminotransferaz (AST) karaciğer inflamasyonunun bir belirtecidir. Bu çalışma ile hastanemizde KHB ön tanısıyla takip edilen hastaların HBV-DNA düzeylerinin yaş, biyokimyasal ve mikrobiyolojik parametreler arasındaki ilişkinin araştırılması amaçlanmaktadır.
Gereç ve Yöntemler: Mayıs 2021- Mayıs 2024 tarihleri arasında hastanemizde KHB ön tanısı ile takip edilen 264 hastanın kan örneklerinden HBV-DNA, mikrobiyolojik ve biyokimyasal parametrelere ait test sonuçları retrospektif olarak incelenmiştir. HBV-DNA düzeyleri HBV-DNA Negatif (Grup 1), HBV-DNA 10-2000 IU/mL (Grup 2) ve HBV-DNA>2000 IU/mL (Grup 3) olmak üzere üç gruba ayrılmıştır. İstatistiksel analizler MedCalc (version 20.009; Ostend, Belgium) istatistik paket programı ile yapılmıştır.
Bulgular: HBV-DNA negatif hastalarda HBV-DNA 10-2000 IU/mL ve HBV-DNA >2000 IU/mL olan hastalara göre, HBV-DNA 10-2000 IU/mL olan hastalarda da HBV-DNA>2000 IU/mL olan hastalara göre HBeAg pozitifliği anlamlı derecede düşük tespit edilmiştir (p<0.05). ALT ve AST değerleri ise HBV-DNA>2000 IU/mL olan hastalarda HBV-DNA negatif ve HBV-DNA 10-2000 IU/mL olan hastalara göre anlamlı derecede yüksek saptanmıştır. HBV-DNA düzeyleri ile WBC, HGB, MCV, RDW, GGT, ALP, Total protein, albümin, PT, aPTT, INR değerleri arasında istatistiksel olarak anlamlı bir ilişki bulunmamıştır.
Sonuçlar: KHB hastalarında HBeAg ve ALT, AST değerleri ile HBV-DNA düzeyleri arasında anlamlı bir ilişki saptanmıştır. Bu parametreler birlikte KHB hastalığını teşhis edip enfeksiyon evresini oluşturmak, tedaviye karar vermek ve hastalığın seyrini belirlemek için kullanılabilir.

Kaynakça

  • Ormeci A, Aydın Y, Sumnu A, Demir K, Yılmaz E, Şahin H, et al. Predictors of treatment requirement in HBeAg-negative chronic hepatitis B patients with persistently normal alanine aminotransferase and high serum HBV DNA levels. Int J Infect Dis. 2016; 52: 68-73.
  • Lampertico P, Agarwal K, Berg T, Buti M, Janssen HLA, Papatheodoridis G, et al. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017; 67: 370-98.
  • Chao DT, Lim JK, Ayoub WS, Nguyen LH, Nguyen MH, Kim WR, et al. Systematic review with meta-analysis: the proportion of chronic hepatitis B patients with normal alanine transaminase ≤40 IU/L and significant hepatic fibrosis. Aliment Pharmacol Ther. 2014; 39: 349-58.
  • Keshvari M, Alavian SM, Sharafi H, Behnava B, Karimi-Sari H, Mahdavi MR, et al. Comparison of serum hepatitis B virus DNA and HBsAg levels between HBeAg-negative and HBeAg-positive chronic hepatitis B patients. Jundishapur J Microbiol. 2015; 8: 1-6.
  • Lok ASF, McMahon BJ, Brown RS, Wong JB, Ahmed AT, Farah W, et al. Chronic hepatitis B. Hepatology. 2007; 45: 507-39.
  • Liaw YF, Kao JH, Piratvisuth T, Chan HL, Chien RN, Liu CJ, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012; 6: 531-61.
  • Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015; 386: 1546-55.
  • Revill PA, Chisari FV, Block JM, Tavis JE, Bhatia SN, Lemoine M, et al. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol. 2019; 4: 545-58.
  • Kisseleva T, Brenner D. Molecular and cellular mechanisms of liver fibrosis and its regression. Nat Rev Gastroenterol Hepatol. 2021; 18: 151-66.
  • Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018; 67: 1560-99.
  • Liu J, Wang J, Yan X, Li J, Xia J, Zhang Y, et al. Presence of liver inflammation in Asian patients with chronic hepatitis B with normal ALT and detectable HBV DNA in absence of liver fibrosis. Hepatol Commun. 2022; 6: 855-66.
  • Sonneveld MJ, Brouwer WP, Hansen BE, Chan HL, Piratvisuth T, Jia JD, et al. Very low probability of significant liver inflammation in chronic hepatitis B patients with low ALT levels in the absence of liver fibrosis. Aliment Pharmacol Ther. 2020; 52: 1399-406.
  • Kilonzo SB, Gunda D, Ning Q, Han M. Where hepatitis B and hepatitis E meet: epidemiological and clinical aspects. Hepat Mon. 2019; 19: e96193.
  • Nguyen K, Pan C, Xia V, Hu J, Hu KQ. Clinical course of chronic hepatitis B presented with normal ALT in Asian American patients. J Viral Hepat. 2015; 22: 809-16.
  • Zhao J, Bian D, Liao H, Liu X, Wang Q, Jiang W, et al. Serum HBsAg and HBcrAg is associated with inflammation in HBeAg-positive chronic hepatitis B patients. Front Cell Infect Microbiol. 2023; 13: 1083912.
  • Gui HL, Wang H, Yang YH, Wu Y, Chen X, Zhang H, et al. Significant histopathology in Chinese chronic hepatitis B patients with persistently high–normal alanine aminotransferase. J Viral Hepat. 2010; 17(s1): 44-50.
  • Liao B, Wang Z, Lin S, Zhang J, Wang Y, Li Y, et al. Significant fibrosis is not rare in Chinese chronic hepatitis B patients with persistent normal ALT. PLoS One. 2013; 8: e78672.
  • Alam MM, Mahtab MA, Akbar SM, Kamal M, Rahman S. Hepatic necroinflammation and severe liver fibrosis in patients with chronic hepatitis B with undetectable HBV DNA and persistently normal alanine aminotransferase. Bangladesh Med Res Counc Bull. 2014; 40: 92-6.
  • Günal Ö, Barut Ş, Etikan İ, Duygu F, Tuncel U, Sünbül M. Relation between serum quantitative HBsAg, ALT and HBV DNA levels in HBeAg negative chronic HBV infection. Turk J Gastroenterol. 2014; 25: 142-6.
  • Çeviker SA, Günal Ö, Kılıç SS, Köksal E. Kronik hepatit B hastalarında serum HBV DNA düzeyleri, Hbeag durumu, biyokimyasal parametreler ile karaciğer inflamasyonu ve fibrozisin şiddeti arasındaki ilişki. KSU Med J. 2020; 15: 32-6.
  • Yuan MS. Relationship between liver function index and HBV DNA viral load among chronic hepatitis B patients with normal liver function index. Chin J Lab Diagn. 2013; 17: 2188-91.
  • Muderris T, Cirit OS. Determination of serum hepatitis B virus DNA in HBV endemic region: Clinical significance and correlation with serological markers, ALT and AST. Turk Hij Den Biyol Derg. 2016; 73: 211-20.
  • Sağlık I, Mutlu D, Ongut G, Güvenc HI, Akbaş H, Oğunc D. Kronik hepatit B enfeksiyonu olan hastalarda HBsAg ve HBeAg değerlerinin HBV DNA ve alanin aminotransferaz düzeyleri ile karşılaştırılması. Viral Hepat J. 2013; 19: 119-22.
  • Ergunay K, Balaban Y, Cosgun E, Avcı D, Erkan G, Tuncel M, et al. Epidemiologic trends in HBV infections at a reference centre in Turkey: an 11-year retrospective analysis. Ann Hepatol. 2015; 11: 672-8.
  • Huang R, Yang CC, Liu Y, Chen L, Zhang Y, Wang H, et al. Association of serum gamma-glutamyl transferase with treatment outcome in chronic hepatitis B patients. World J Gastroenterol. 2015; 21: 9957.
  • Li Q, Zhou Y, Huang C, Li W, Chen L. A novel diagnostic algorithm to predict significant liver inflammation in chronic hepatitis B virus infection patients with detectable HBV DNA and persistently normal alanine transaminase. Sci Rep. 2018; 8: 15449.
  • Wang J, Xia J, Yan X, Liu J, Li J, Zhang T, et al. The gamma-glutamyl transpeptidase to platelet ratio predicts liver inflammation in chronic hepatitis B with normal or mildly elevated alanine transaminase. Clin Res Hepatol Gastroenterol. 2020; 44: 913-22.
  • Wang HW, Wang QY, Yuan Q, Shan XY, Fu GH. Alanine aminotransferase is more sensitive to the decrease in hepatitis B virus-DNA load than other liver markers in chronic hepatitis B patients. Medicine (Baltimore). 2017; 31: e22141.
  • Karadağ Gecgel S. Comparison of HBV-DNA levels with biochemical and microbiological parameters for chronic hepatitis evaluation, Bursa, Turkey. J Med Microbiol Infect Dis. 2021; 9: 17-24.
  • Witjes CD, IJzermans JN, Van Der Eijk AA, Hansen BE, Verhoef C, De Man RA. Quantitative HBV DNA and AST are strong predictors for survival after HCC detection in chronic HBV patients. Neth J Med. 2011; 69: 508-13.
  • Nakamuta M, Kotoh K, Enjoji M, Nawata H, Ueno T, Tanabe S, et al. Effects of lamivudine on serum albumin levels correlate with pretreatment HBV-DNA levels in cirrhotic patients. Comp Hepatol. 2007; 6: 3.
  • Li J, Zhang T, Song L, Huang Y, Xu C, Chen M, et al. Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels. Hepatol Res. 2018; 48: E92-102.
  • Li X, Xing Y, Zhou D, Zhang Y, Qiao L, Liu H, et al. A non-invasive model for predicting liver inflammation in chronic hepatitis B patients with normal serum alanine aminotransferase levels. Front Med. 2021; 8: 688091.
  • Cai J, Wang K, Han T, Jiang H. Evaluation of prognostic values of inflammation-based makers in patients with HBV-related acute-on-chronic liver failure. Medicine (Baltimore). 2018; 97: e13324.
  • Jin L, Gao Y, Ye J, Zou G, Li X. Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B virus-related acute-on-chronic liver failure. Clin Lab. 2017; 63: 1403-10.
  • Mao W, Wu J. Haematologic indices in hepatitis B virus-related liver disease. Clin Chim Acta. 2020; 500: 135-42.
  • Yang SP, Chen YY, Hsu HS, Wang FD, Chen LY, Fung CP. A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study. BMC Infect Dis. 2013; 13: 1-10.

Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients

Yıl 2025, Cilt: 16 Sayı: 4, 473 - 480, 01.01.2026
https://doi.org/10.18663/tjcl.1636298

Öz

Objective: HBV-DNA levels are used to diagnose Chronic Hepatitis B (CHB), determine the stage of infection, decide on treatment and determine the course of the disease. HBeAg is a marker of active viral replication and transcription, Alanine aminotransferase (ALT) and Aspartate aminotransferase (AST) are markers of liver inflammation. This study aims to investigate the relationship between HBV-DNA levels and age, biochemical and microbiological parameters in patients followed up with a preliminary diagnosis of CHB in our hospital.
Materials and Methods: HBV-DNA, microbiological and biochemical parameters test results from blood samples of 264 patients followed up in our hospital with a preliminary diagnosis of CHB between May 2021 and May 2024 were retrospectively analyzed. HBV-DNA levels were divided into three groups as HBV-DNA Negative (Group 1), HBV-DNA 10-2000 IU/mL (Group 2) and HBV-DNA>2000 IU/mL (Group 3). Statistical analyses were performed with the MedCalc (version 20.009; Ostend, Belgium) statistical package program.
Results: HBeAg positivity was significantly lower in HBV-DNA negative patients compared to patients with HBV-DNA 10-2000 IU/mL and HBV-DNA >2000 IU/mL and in patients with HBV-DNA 10-2000 IU/mL compared to patients with HBV-DNA >2000 IU/mL (p<0.05). ALT and AST values were significantly higher in patients with HBV-DNA >2000 IU/mL compared to patients with HBV-DNA negative and HBV-DNA 10-2000 IU/mL. No statistically significant correlation was found between HBV-DNA levels and WBC, HGB, MCV, RDW, GGT, ALP, Total protein, albumin, PT, aPTT, INR values.
Conclusion: A significant relationship was found between HBeAg and ALT, AST values and HBV-DNA levels in CHB patients. These parameters can be used together to diagnose CHB disease, establish the stage of infection, decide on treatment and determine the course of the disease.

Etik Beyan

This study was approved by the Non-Interventional Scientific Research Ethics Committee of Ordu University Ethics Committee with protocol number 93 and date 12.07.2024.

Kaynakça

  • Ormeci A, Aydın Y, Sumnu A, Demir K, Yılmaz E, Şahin H, et al. Predictors of treatment requirement in HBeAg-negative chronic hepatitis B patients with persistently normal alanine aminotransferase and high serum HBV DNA levels. Int J Infect Dis. 2016; 52: 68-73.
  • Lampertico P, Agarwal K, Berg T, Buti M, Janssen HLA, Papatheodoridis G, et al. EASL 2017 Clinical Practice Guidelines on the management of hepatitis B virus infection. J Hepatol. 2017; 67: 370-98.
  • Chao DT, Lim JK, Ayoub WS, Nguyen LH, Nguyen MH, Kim WR, et al. Systematic review with meta-analysis: the proportion of chronic hepatitis B patients with normal alanine transaminase ≤40 IU/L and significant hepatic fibrosis. Aliment Pharmacol Ther. 2014; 39: 349-58.
  • Keshvari M, Alavian SM, Sharafi H, Behnava B, Karimi-Sari H, Mahdavi MR, et al. Comparison of serum hepatitis B virus DNA and HBsAg levels between HBeAg-negative and HBeAg-positive chronic hepatitis B patients. Jundishapur J Microbiol. 2015; 8: 1-6.
  • Lok ASF, McMahon BJ, Brown RS, Wong JB, Ahmed AT, Farah W, et al. Chronic hepatitis B. Hepatology. 2007; 45: 507-39.
  • Liaw YF, Kao JH, Piratvisuth T, Chan HL, Chien RN, Liu CJ, et al. Asian-Pacific consensus statement on the management of chronic hepatitis B: a 2012 update. Hepatol Int. 2012; 6: 531-61.
  • Schweitzer A, Horn J, Mikolajczyk RT, Krause G, Ott JJ. Estimations of worldwide prevalence of chronic hepatitis B virus infection: a systematic review of data published between 1965 and 2013. Lancet. 2015; 386: 1546-55.
  • Revill PA, Chisari FV, Block JM, Tavis JE, Bhatia SN, Lemoine M, et al. A global scientific strategy to cure hepatitis B. Lancet Gastroenterol Hepatol. 2019; 4: 545-58.
  • Kisseleva T, Brenner D. Molecular and cellular mechanisms of liver fibrosis and its regression. Nat Rev Gastroenterol Hepatol. 2021; 18: 151-66.
  • Terrault NA, Lok ASF, McMahon BJ, Chang KM, Hwang JP, Jonas MM, et al. Update on prevention, diagnosis, and treatment of chronic hepatitis B: AASLD 2018 hepatitis B guidance. Hepatology. 2018; 67: 1560-99.
  • Liu J, Wang J, Yan X, Li J, Xia J, Zhang Y, et al. Presence of liver inflammation in Asian patients with chronic hepatitis B with normal ALT and detectable HBV DNA in absence of liver fibrosis. Hepatol Commun. 2022; 6: 855-66.
  • Sonneveld MJ, Brouwer WP, Hansen BE, Chan HL, Piratvisuth T, Jia JD, et al. Very low probability of significant liver inflammation in chronic hepatitis B patients with low ALT levels in the absence of liver fibrosis. Aliment Pharmacol Ther. 2020; 52: 1399-406.
  • Kilonzo SB, Gunda D, Ning Q, Han M. Where hepatitis B and hepatitis E meet: epidemiological and clinical aspects. Hepat Mon. 2019; 19: e96193.
  • Nguyen K, Pan C, Xia V, Hu J, Hu KQ. Clinical course of chronic hepatitis B presented with normal ALT in Asian American patients. J Viral Hepat. 2015; 22: 809-16.
  • Zhao J, Bian D, Liao H, Liu X, Wang Q, Jiang W, et al. Serum HBsAg and HBcrAg is associated with inflammation in HBeAg-positive chronic hepatitis B patients. Front Cell Infect Microbiol. 2023; 13: 1083912.
  • Gui HL, Wang H, Yang YH, Wu Y, Chen X, Zhang H, et al. Significant histopathology in Chinese chronic hepatitis B patients with persistently high–normal alanine aminotransferase. J Viral Hepat. 2010; 17(s1): 44-50.
  • Liao B, Wang Z, Lin S, Zhang J, Wang Y, Li Y, et al. Significant fibrosis is not rare in Chinese chronic hepatitis B patients with persistent normal ALT. PLoS One. 2013; 8: e78672.
  • Alam MM, Mahtab MA, Akbar SM, Kamal M, Rahman S. Hepatic necroinflammation and severe liver fibrosis in patients with chronic hepatitis B with undetectable HBV DNA and persistently normal alanine aminotransferase. Bangladesh Med Res Counc Bull. 2014; 40: 92-6.
  • Günal Ö, Barut Ş, Etikan İ, Duygu F, Tuncel U, Sünbül M. Relation between serum quantitative HBsAg, ALT and HBV DNA levels in HBeAg negative chronic HBV infection. Turk J Gastroenterol. 2014; 25: 142-6.
  • Çeviker SA, Günal Ö, Kılıç SS, Köksal E. Kronik hepatit B hastalarında serum HBV DNA düzeyleri, Hbeag durumu, biyokimyasal parametreler ile karaciğer inflamasyonu ve fibrozisin şiddeti arasındaki ilişki. KSU Med J. 2020; 15: 32-6.
  • Yuan MS. Relationship between liver function index and HBV DNA viral load among chronic hepatitis B patients with normal liver function index. Chin J Lab Diagn. 2013; 17: 2188-91.
  • Muderris T, Cirit OS. Determination of serum hepatitis B virus DNA in HBV endemic region: Clinical significance and correlation with serological markers, ALT and AST. Turk Hij Den Biyol Derg. 2016; 73: 211-20.
  • Sağlık I, Mutlu D, Ongut G, Güvenc HI, Akbaş H, Oğunc D. Kronik hepatit B enfeksiyonu olan hastalarda HBsAg ve HBeAg değerlerinin HBV DNA ve alanin aminotransferaz düzeyleri ile karşılaştırılması. Viral Hepat J. 2013; 19: 119-22.
  • Ergunay K, Balaban Y, Cosgun E, Avcı D, Erkan G, Tuncel M, et al. Epidemiologic trends in HBV infections at a reference centre in Turkey: an 11-year retrospective analysis. Ann Hepatol. 2015; 11: 672-8.
  • Huang R, Yang CC, Liu Y, Chen L, Zhang Y, Wang H, et al. Association of serum gamma-glutamyl transferase with treatment outcome in chronic hepatitis B patients. World J Gastroenterol. 2015; 21: 9957.
  • Li Q, Zhou Y, Huang C, Li W, Chen L. A novel diagnostic algorithm to predict significant liver inflammation in chronic hepatitis B virus infection patients with detectable HBV DNA and persistently normal alanine transaminase. Sci Rep. 2018; 8: 15449.
  • Wang J, Xia J, Yan X, Liu J, Li J, Zhang T, et al. The gamma-glutamyl transpeptidase to platelet ratio predicts liver inflammation in chronic hepatitis B with normal or mildly elevated alanine transaminase. Clin Res Hepatol Gastroenterol. 2020; 44: 913-22.
  • Wang HW, Wang QY, Yuan Q, Shan XY, Fu GH. Alanine aminotransferase is more sensitive to the decrease in hepatitis B virus-DNA load than other liver markers in chronic hepatitis B patients. Medicine (Baltimore). 2017; 31: e22141.
  • Karadağ Gecgel S. Comparison of HBV-DNA levels with biochemical and microbiological parameters for chronic hepatitis evaluation, Bursa, Turkey. J Med Microbiol Infect Dis. 2021; 9: 17-24.
  • Witjes CD, IJzermans JN, Van Der Eijk AA, Hansen BE, Verhoef C, De Man RA. Quantitative HBV DNA and AST are strong predictors for survival after HCC detection in chronic HBV patients. Neth J Med. 2011; 69: 508-13.
  • Nakamuta M, Kotoh K, Enjoji M, Nawata H, Ueno T, Tanabe S, et al. Effects of lamivudine on serum albumin levels correlate with pretreatment HBV-DNA levels in cirrhotic patients. Comp Hepatol. 2007; 6: 3.
  • Li J, Zhang T, Song L, Huang Y, Xu C, Chen M, et al. Role of quantitative hepatitis B core antibody levels in predicting significant liver inflammation in chronic hepatitis B patients with normal or near‐normal alanine aminotransferase levels. Hepatol Res. 2018; 48: E92-102.
  • Li X, Xing Y, Zhou D, Zhang Y, Qiao L, Liu H, et al. A non-invasive model for predicting liver inflammation in chronic hepatitis B patients with normal serum alanine aminotransferase levels. Front Med. 2021; 8: 688091.
  • Cai J, Wang K, Han T, Jiang H. Evaluation of prognostic values of inflammation-based makers in patients with HBV-related acute-on-chronic liver failure. Medicine (Baltimore). 2018; 97: e13324.
  • Jin L, Gao Y, Ye J, Zou G, Li X. Clinical usefulness of measuring red blood cell distribution width in patients with hepatitis B virus-related acute-on-chronic liver failure. Clin Lab. 2017; 63: 1403-10.
  • Mao W, Wu J. Haematologic indices in hepatitis B virus-related liver disease. Clin Chim Acta. 2020; 500: 135-42.
  • Yang SP, Chen YY, Hsu HS, Wang FD, Chen LY, Fung CP. A risk factor analysis of healthcare-associated fungal infections in an intensive care unit: a retrospective cohort study. BMC Infect Dis. 2013; 13: 1-10.
Toplam 37 adet kaynakça vardır.

Ayrıntılar

Birincil Dil İngilizce
Konular Bulaşıcı Hastalıklar, Gastroenteroloji ve Hepatoloji
Bölüm Araştırma Makalesi
Yazarlar

Ahmet Burak Gürpınar 0000-0003-3227-4682

Hacer Özlem Kalaycı 0000-0003-2358-6764

Gönderilme Tarihi 9 Şubat 2025
Kabul Tarihi 19 Ekim 2025
Yayımlanma Tarihi 1 Ocak 2026
Yayımlandığı Sayı Yıl 2025 Cilt: 16 Sayı: 4

Kaynak Göster

APA Gürpınar, A. B., & Kalaycı, H. Ö. (2026). Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients. Turkish Journal of Clinics and Laboratory, 16(4), 473-480. https://doi.org/10.18663/tjcl.1636298
AMA Gürpınar AB, Kalaycı HÖ. Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients. TJCL. Ocak 2026;16(4):473-480. doi:10.18663/tjcl.1636298
Chicago Gürpınar, Ahmet Burak, ve Hacer Özlem Kalaycı. “Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients”. Turkish Journal of Clinics and Laboratory 16, sy. 4 (Ocak 2026): 473-80. https://doi.org/10.18663/tjcl.1636298.
EndNote Gürpınar AB, Kalaycı HÖ (01 Ocak 2026) Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients. Turkish Journal of Clinics and Laboratory 16 4 473–480.
IEEE A. B. Gürpınar ve H. Ö. Kalaycı, “Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients”, TJCL, c. 16, sy. 4, ss. 473–480, 2026, doi: 10.18663/tjcl.1636298.
ISNAD Gürpınar, Ahmet Burak - Kalaycı, Hacer Özlem. “Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients”. Turkish Journal of Clinics and Laboratory 16/4 (Ocak2026), 473-480. https://doi.org/10.18663/tjcl.1636298.
JAMA Gürpınar AB, Kalaycı HÖ. Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients. TJCL. 2026;16:473–480.
MLA Gürpınar, Ahmet Burak ve Hacer Özlem Kalaycı. “Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients”. Turkish Journal of Clinics and Laboratory, c. 16, sy. 4, 2026, ss. 473-80, doi:10.18663/tjcl.1636298.
Vancouver Gürpınar AB, Kalaycı HÖ. Relationship of HBV-DNA levels with biochemical and microbiological markers in chronic hepatitis B patients. TJCL. 2026;16(4):473-80.


e-ISSN: 2149-8296

The content of this site is intended for health care professionals. All the published articles are distributed under the terms of

Creative Commons Attribution Licence,

which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.