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Article: A large case-control study on the predictability of hepatitis B surface antigen levels three years before hepatitis B surface antigen seroclearance

TitleA large case-control study on the predictability of hepatitis B surface antigen levels three years before hepatitis B surface antigen seroclearance
Authors
KeywordsAntiviral Therapy
Hepatitis B Virus
Nucleos(T)Ide Analogue
Issue Date2012
PublisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
Citation
Hepatology, 2012, v. 56 n. 3, p. 812-819 How to Cite?
Abstract
The kinetics of hepatitis B surface antigen (HBsAg) levels preceding spontaneous HBsAg seroclearance has not been fully investigated. The kinetics of HBsAg and hepatitis B virus (HBV) DNA of 203 treatment-naïve, hepatitis B e antigen (HBeAg)-negative patients with spontaneous HBsAg seroclearance were compared with 203 age- and sex-matched HBeAg-negative controls. Serum samples at 3 years, 2 years, 1 year, and 6 months before HBsAg seroclearance and at the time of HBsAg loss were tested. Median HBsAg levels at these respective time points before HBsAg seroclearance were 23.5, 3.51, 0.524, and 0.146 IU/mL. For all time points, patients with HBsAg seroclearance had significantly lower median HBsAg and HBV DNA levels, compared to those of the controls (all P < 0.001). Median HBsAg and HBV DNA levels declined significantly until HBsAg seroclearance (P < 0.001). Although median HBsAg levels also decreased significantly with time (P = 0.006) in controls, median HBV DNA levels remained similar (P = 0.414). Serum HBsAg levels, followed by HBsAg log reduction, were the best predictors of HBsAg seroclearance, with an area under the receiving operator characteristic (AUROC) of 0.833 (95% confidence interval [CI]: 0.792-0.873) and 0.803 (95% CI: 0.755-0.849), respectively. The optimal cut-off HBsAg level and HBsAg reduction to predict HBsAg seroclearance were <200 IU/mL (sensitivity, 84.2%; specificity, 73.4%) and 0.5 log IU/mL/year (sensitivity, 62.8%; specificity, 88.7%), respectively. For patients with HBsAg levels ≥200 IU/mL, an annual 0.5-log reduction was highly predictive of subsequent HBsAg seroclearance (AUROC, 0.867; 95% CI: 0.778-0.956). Conclusion: To conclude, serum HBsAg <200 IU/mL and 0.5-log reduction in HBsAg were predictive of HBsAg seroclearance within 3 years of follow-up. These parameters may serve as good indicators for the consideration of treatment duration and cessation for chronic hepatitis B. © 2012 American Association for the Study of Liver Diseases.
Persistent Identifierhttp://hdl.handle.net/10722/163509
ISSN
2013 Impact Factor: 11.190
ISI Accession Number ID
References

 

Author Affiliations
  1. The University of Hong Kong
DC FieldValueLanguage
dc.contributor.authorSeto, WKen_HK
dc.contributor.authorWong, DKHen_HK
dc.contributor.authorFung, Jen_HK
dc.contributor.authorHung, IFNen_HK
dc.contributor.authorFong, DYTen_HK
dc.contributor.authorYuen, JCHen_HK
dc.contributor.authorTong, Ten_HK
dc.contributor.authorLai, CLen_HK
dc.contributor.authorYuen, MFen_HK
dc.date.accessioned2012-09-05T05:32:50Z-
dc.date.available2012-09-05T05:32:50Z-
dc.date.issued2012en_HK
dc.identifier.citationHepatology, 2012, v. 56 n. 3, p. 812-819en_HK
dc.identifier.issn0270-9139en_HK
dc.identifier.urihttp://hdl.handle.net/10722/163509-
dc.description.abstractThe kinetics of hepatitis B surface antigen (HBsAg) levels preceding spontaneous HBsAg seroclearance has not been fully investigated. The kinetics of HBsAg and hepatitis B virus (HBV) DNA of 203 treatment-naïve, hepatitis B e antigen (HBeAg)-negative patients with spontaneous HBsAg seroclearance were compared with 203 age- and sex-matched HBeAg-negative controls. Serum samples at 3 years, 2 years, 1 year, and 6 months before HBsAg seroclearance and at the time of HBsAg loss were tested. Median HBsAg levels at these respective time points before HBsAg seroclearance were 23.5, 3.51, 0.524, and 0.146 IU/mL. For all time points, patients with HBsAg seroclearance had significantly lower median HBsAg and HBV DNA levels, compared to those of the controls (all P < 0.001). Median HBsAg and HBV DNA levels declined significantly until HBsAg seroclearance (P < 0.001). Although median HBsAg levels also decreased significantly with time (P = 0.006) in controls, median HBV DNA levels remained similar (P = 0.414). Serum HBsAg levels, followed by HBsAg log reduction, were the best predictors of HBsAg seroclearance, with an area under the receiving operator characteristic (AUROC) of 0.833 (95% confidence interval [CI]: 0.792-0.873) and 0.803 (95% CI: 0.755-0.849), respectively. The optimal cut-off HBsAg level and HBsAg reduction to predict HBsAg seroclearance were <200 IU/mL (sensitivity, 84.2%; specificity, 73.4%) and 0.5 log IU/mL/year (sensitivity, 62.8%; specificity, 88.7%), respectively. For patients with HBsAg levels ≥200 IU/mL, an annual 0.5-log reduction was highly predictive of subsequent HBsAg seroclearance (AUROC, 0.867; 95% CI: 0.778-0.956). Conclusion: To conclude, serum HBsAg <200 IU/mL and 0.5-log reduction in HBsAg were predictive of HBsAg seroclearance within 3 years of follow-up. These parameters may serve as good indicators for the consideration of treatment duration and cessation for chronic hepatitis B. © 2012 American Association for the Study of Liver Diseases.en_HK
dc.languageengen_US
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/en_HK
dc.relation.ispartofHepatologyen_HK
dc.subjectAntiviral Therapyen_US
dc.subjectHepatitis B Virusen_US
dc.subjectNucleos(T)Ide Analogueen_US
dc.titleA large case-control study on the predictability of hepatitis B surface antigen levels three years before hepatitis B surface antigen seroclearanceen_HK
dc.typeArticleen_HK
dc.identifier.emailSeto, WK: wkseto2@hku.hken_HK
dc.identifier.emailWong, DKH: danywong@hku.hken_HK
dc.identifier.emailFung, J: jfung@sicklehut.comen_HK
dc.identifier.emailHung, IFN: ivanhung@hkucc.hku.hken_HK
dc.identifier.emailFong, DYT: dytfong@hku.hken_HK
dc.identifier.emailLai, CL: hrmelcl@hku.hken_HK
dc.identifier.emailYuen, MF: mfyuen@hku.hken_HK
dc.identifier.authoritySeto, WK=rp01659en_HK
dc.identifier.authorityWong, DKH=rp00492en_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityHung, IFN=rp00508en_HK
dc.identifier.authorityFong, DYT=rp00253en_HK
dc.identifier.authorityLai, CL=rp00314en_HK
dc.identifier.authorityYuen, MF=rp00479en_HK
dc.description.naturelink_to_subscribed_fulltexten_US
dc.identifier.doi10.1002/hep.25718en_HK
dc.identifier.pmid22422518-
dc.identifier.scopuseid_2-s2.0-84865535075en_HK
dc.identifier.hkuros203194-
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-84865535075&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume56en_HK
dc.identifier.issue3en_HK
dc.identifier.spage812en_HK
dc.identifier.epage819en_HK
dc.identifier.eissn1527-3350-
dc.identifier.isiWOS:000308046700005-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridSeto, WK=23390675900en_HK
dc.identifier.scopusauthoridWong, DKH=7401535819en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridHung, IFN=7006103457en_HK
dc.identifier.scopusauthoridFong, DYT=35261710300en_HK
dc.identifier.scopusauthoridYuen, JCH=7102620480en_HK
dc.identifier.scopusauthoridTong, T=55303885400en_HK
dc.identifier.scopusauthoridLai, CL=7403086396en_HK
dc.identifier.scopusauthoridYuen, MF=7102031955en_HK

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