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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
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TitleA large case-control study on the predictability of hepatitis B surface antigen levels three years before hepatitis B surface antigen seroclearance
 
AuthorsSeto, WK1
Wong, DKH1
Fung, J1
Hung, IFN1
Fong, DYT1
Yuen, JCH1
Tong, T1
Lai, CL1
Yuen, MF1
 
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/
 
CitationHepatology, 2012, v. 56 n. 3, p. 812-819 [How to Cite?]
DOI: http://dx.doi.org/10.1002/hep.25718
 
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.
 
ISSN0270-9139
2013 Impact Factor: 11.190
 
DOIhttp://dx.doi.org/10.1002/hep.25718
 
ISI Accession Number IDWOS:000308046700005
 
ReferencesReferences in Scopus
 
DC FieldValue
dc.contributor.authorSeto, WK
 
dc.contributor.authorWong, DKH
 
dc.contributor.authorFung, J
 
dc.contributor.authorHung, IFN
 
dc.contributor.authorFong, DYT
 
dc.contributor.authorYuen, JCH
 
dc.contributor.authorTong, T
 
dc.contributor.authorLai, CL
 
dc.contributor.authorYuen, MF
 
dc.date.accessioned2012-09-05T05:32:50Z
 
dc.date.available2012-09-05T05:32:50Z
 
dc.date.issued2012
 
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.
 
dc.description.naturelink_to_subscribed_fulltext
 
dc.identifier.citationHepatology, 2012, v. 56 n. 3, p. 812-819 [How to Cite?]
DOI: http://dx.doi.org/10.1002/hep.25718
 
dc.identifier.doihttp://dx.doi.org/10.1002/hep.25718
 
dc.identifier.eissn1527-3350
 
dc.identifier.epage819
 
dc.identifier.hkuros203194
 
dc.identifier.isiWOS:000308046700005
 
dc.identifier.issn0270-9139
2013 Impact Factor: 11.190
 
dc.identifier.issue3
 
dc.identifier.pmid22422518
 
dc.identifier.scopuseid_2-s2.0-84865535075
 
dc.identifier.spage812
 
dc.identifier.urihttp://hdl.handle.net/10722/163509
 
dc.identifier.volume56
 
dc.languageeng
 
dc.publisherJohn Wiley & Sons, Inc. The Journal's web site is located at http://www.hepatology.org/
 
dc.publisher.placeUnited States
 
dc.relation.ispartofHepatology
 
dc.relation.referencesReferences in Scopus
 
dc.subjectAntiviral Therapy
 
dc.subjectHepatitis B Virus
 
dc.subjectNucleos(T)Ide Analogue
 
dc.titleA large case-control study on the predictability of hepatitis B surface antigen levels three years before hepatitis B surface antigen seroclearance
 
dc.typeArticle
 
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<contributor.author>Hung, IFN</contributor.author>
<contributor.author>Fong, DYT</contributor.author>
<contributor.author>Yuen, JCH</contributor.author>
<contributor.author>Tong, T</contributor.author>
<contributor.author>Lai, CL</contributor.author>
<contributor.author>Yuen, MF</contributor.author>
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<description.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-na&#239;ve, 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 &lt; 0.001). Median HBsAg and HBV DNA levels declined significantly until HBsAg seroclearance (P &lt; 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 &lt;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 &#8805;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 &lt;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. &#169; 2012 American Association for the Study of Liver Diseases.</description.abstract>
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Author Affiliations
  1. The University of Hong Kong