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Conference Paper: Large scale longitudinal study of chronic hepatitis B patients with hepatitis B surface antigen seroclearance

TitleLarge scale longitudinal study of chronic hepatitis B patients with hepatitis B surface antigen seroclearance
Authors
Issue Date2007
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
The 58th Annual Meeting of the American Association of the Study of Liver Diseases (AASLD 2007) - The Liver Meeting® 2007, Boston, MA. 2-6 November 2007. In Journal of Hepatology, 2007, v. 46 suppl. S1, p. 637A, abstract no. 900 How to Cite?
AbstractBACKGROUND AND AIM: Seroclearance of hepatitis B surface antigen (HBsAg) is a rare event in chronic hepatitis B patients. We conducted a large scale longitudinal study investigating the virological, histological and clinical aspects, including the risk of development of hepatocellular carcinoma (HCC) in patients with HBsAg seroclearance. PATIENTS AND METHODS: Two hundred and ninety-eight patients (211 male and 87 female; median age on presentation: 43.1 years) with HBsAg seroclearance were recruited and followed up every 3 – 6 months for clinical assessment. Intrahepatic HBV DNA and covalently closed circular DNA (cccDNA) were measured by real-time PCR. Serum HBV DNA was measured by the Artus HBV RG Test (QIAGEN, Germany). Liver stiffness was assessed by FibroScan (Echosens, France). RESULTS: The median age of HBsAg seroclearance was 49.6 years. The median follow-up duration was 108.9 months and the median follow-up duration after HBsAg seroclearance was 36.4 months. Liver biopsies were performed on 29 patients (median time of biopsy: 48.6 months after HBsAg seroclearance). All have detectable intrahepatic HBV DNA (median: 1.68 copies/cell), and cccDNA were detectable in 23 patients (79.3%, median: 0.03 copies/cell). Of the 29 patients with liver biopsy, 9 and 16 patients had sera available within 1 year and between 5 – 10 years after HBsAg seroclearance, respectively, for HBV DNA analysis. All 9 patients had undetectable HBV DNA (<1.1 IU/mL) within 1 year of HBsAg seroclearance, and 4/16 patients had detectable HBV DNA levels between 5 – 10 years of HBsAg seroclearance (median: 2.37 IU/mL). Of the 26 patients with adequate liver tissues for histological examination, 4 had mild fibrosis (F1) and 5 had minimal necroinflammation. FibroScan was performed on 76 and 78 patients who had HBsAg seroclearance at age <50 and ≥50 years respectively. Significant fibrosis (liver stiffness > 8.1 kPa) was observed only in 7.9% (6/76) patients with HBsAg seroclearance at age <50 compared to 29.5% (23/78) patients with HBsAg seroclearance at age ≥50 (p = 0.001). Seven patients developed HCC (median age: 69.3). Kaplan-Meier analysis showed that the chance of HCC development in patients with HBsAg seroclearance at age <50 was significantly less than those with HBsAg seroclearance at age ≥50 (p = 0.004). Conclusion: Although serum HBV DNA was detectable in only a small proportion of patients with HBsAg seroclearance, intrahepatic HBV DNA was still present in all patients. Nevertheless, patients who cleared HBsAg at age <50 had significantly less fibrosis and lower chance of HCC development than those with HBsAg seroclearance at ≥50 years.
Persistent Identifierhttp://hdl.handle.net/10722/102094
ISSN
2015 Impact Factor: 10.59
2015 SCImago Journal Rankings: 4.570

 

DC FieldValueLanguage
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorFung, JYYen_HK
dc.contributor.authorBut, Den_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorFung, FKCen_HK
dc.contributor.authorYoung, JLPen_HK
dc.contributor.authorYuen, RMFen_HK
dc.date.accessioned2010-09-25T20:16:49Z-
dc.date.available2010-09-25T20:16:49Z-
dc.date.issued2007en_HK
dc.identifier.citationThe 58th Annual Meeting of the American Association of the Study of Liver Diseases (AASLD 2007) - The Liver Meeting® 2007, Boston, MA. 2-6 November 2007. In Journal of Hepatology, 2007, v. 46 suppl. S1, p. 637A, abstract no. 900en_HK
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/102094-
dc.description.abstractBACKGROUND AND AIM: Seroclearance of hepatitis B surface antigen (HBsAg) is a rare event in chronic hepatitis B patients. We conducted a large scale longitudinal study investigating the virological, histological and clinical aspects, including the risk of development of hepatocellular carcinoma (HCC) in patients with HBsAg seroclearance. PATIENTS AND METHODS: Two hundred and ninety-eight patients (211 male and 87 female; median age on presentation: 43.1 years) with HBsAg seroclearance were recruited and followed up every 3 – 6 months for clinical assessment. Intrahepatic HBV DNA and covalently closed circular DNA (cccDNA) were measured by real-time PCR. Serum HBV DNA was measured by the Artus HBV RG Test (QIAGEN, Germany). Liver stiffness was assessed by FibroScan (Echosens, France). RESULTS: The median age of HBsAg seroclearance was 49.6 years. The median follow-up duration was 108.9 months and the median follow-up duration after HBsAg seroclearance was 36.4 months. Liver biopsies were performed on 29 patients (median time of biopsy: 48.6 months after HBsAg seroclearance). All have detectable intrahepatic HBV DNA (median: 1.68 copies/cell), and cccDNA were detectable in 23 patients (79.3%, median: 0.03 copies/cell). Of the 29 patients with liver biopsy, 9 and 16 patients had sera available within 1 year and between 5 – 10 years after HBsAg seroclearance, respectively, for HBV DNA analysis. All 9 patients had undetectable HBV DNA (<1.1 IU/mL) within 1 year of HBsAg seroclearance, and 4/16 patients had detectable HBV DNA levels between 5 – 10 years of HBsAg seroclearance (median: 2.37 IU/mL). Of the 26 patients with adequate liver tissues for histological examination, 4 had mild fibrosis (F1) and 5 had minimal necroinflammation. FibroScan was performed on 76 and 78 patients who had HBsAg seroclearance at age <50 and ≥50 years respectively. Significant fibrosis (liver stiffness > 8.1 kPa) was observed only in 7.9% (6/76) patients with HBsAg seroclearance at age <50 compared to 29.5% (23/78) patients with HBsAg seroclearance at age ≥50 (p = 0.001). Seven patients developed HCC (median age: 69.3). Kaplan-Meier analysis showed that the chance of HCC development in patients with HBsAg seroclearance at age <50 was significantly less than those with HBsAg seroclearance at age ≥50 (p = 0.004). Conclusion: Although serum HBV DNA was detectable in only a small proportion of patients with HBsAg seroclearance, intrahepatic HBV DNA was still present in all patients. Nevertheless, patients who cleared HBsAg at age <50 had significantly less fibrosis and lower chance of HCC development than those with HBsAg seroclearance at ≥50 years.-
dc.languageengen_HK
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatologyen_HK
dc.rightsJournal of Hepatology. Copyright © Elsevier BV.-
dc.titleLarge scale longitudinal study of chronic hepatitis B patients with hepatitis B surface antigen seroclearanceen_HK
dc.typeConference_Paperen_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailFung, JYY: jfung@sicklehut.comen_HK
dc.identifier.emailHung, IFN: ifnhung@yahoo.com.hken_HK
dc.identifier.emailYuen, JCH: jchyuen@HKUCC.hku.hken_HK
dc.identifier.emailFung, FKC: fredericfung@hotmail.comen_HK
dc.identifier.emailYoung, JLP: jlpyoung@hku.hken_HK
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hken_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityFung, JYY=rp00518en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityYuen, RMF=rp00479en_HK
dc.description.naturelink_to_OA_fulltext-
dc.identifier.doi10.1002/hep.22020-
dc.identifier.hkuros144458en_HK
dc.identifier.volume46en_HK
dc.identifier.issuesuppl. S1-
dc.identifier.spage637A, abstract no. 900en_HK
dc.identifier.epage637A, abstract no. 900-
dc.publisher.placeThe Netherlands-

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