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postgraduate thesis: Host and viral predictive factors of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients
Title | Host and viral predictive factors of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients |
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Authors | |
Advisors | |
Issue Date | 2022 |
Publisher | The University of Hong Kong (Pokfulam, Hong Kong) |
Citation | Kan, K. [簡嘉穎]. (2022). Host and viral predictive factors of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. |
Abstract | Spontaneous seroclearance of hepatitis B surface antigen (HBsAg) is a rare
event that occurs in patients that are chronically infected with the hepatitis B virus.
Due to the favourable prognosis and the substantially reduced hepatocellular
carcinoma risk that accompany HBsAg seroclearance, it is seen as the functional cure
and ultimate treatment endpoint of chronic hepatitis B (CHB) and has therefore
attracted great research interest.
This is a retrospective study that aims to identify host and viral factors that are
associated with HBsAg seroclearance. It utilized plasmas from 120 CHB patients
who cleared HBsAg (S-losers) and 120 age- and sex-matched CHB patients who
remained HBsAg-positive (controls) collected from 2015 – 2021 in the Queen Mary
Hospital, Hong Kong. The levels of several biomarkers were compared between the
s-loser and control groups cross-sectionally at the time of HBsAg seroclearance (Year
0). Retrospective samples collected at up to 10 years before HBsAg seroclearance
were also analysed and compared. Lower levels of anti-HBc and IP-10 are found
respectively to be associated with HBsAg seroclearance since 8 – 10 and 3 – 5 years
ago (p<0.05). A significant trend of declining plasma anti-HBc begins 8 – 5 years
prior to HBsAg seroclearance (p<0.01). Higher levels of HBV spliced variants Sp1
and Sp3 are associated with HBsAg seroclearance since 8 – 10 years ago (p<0.05).
ROC curve analysis reveals that plasma anti-HBc and IP-10 levels at multiple time
points before HBsAg seroclearance return AUC greater than 0.7 – plasma anti-HBc
levels, at the cut-off value of 82.50 COI, can effectively predict HBsAg seroclearance
within 1 year with 68.3 sensitivity and 90.0 specificity, whereas plasma IP-10 levels,
at the cut-off value of 29.452pg/ml, can predict HBsAg seroclearance within 1 – 3
years with 52.0 sensitivity and 83.7 specificity, suggesting potential clinical utilities
of anti-HBc and IP-10 in predicting HBsAg seroclearance. |
Degree | Master of Philosophy |
Subject | Hepatitis associated antigen |
Dept/Program | Medicine |
Persistent Identifier | http://hdl.handle.net/10722/313722 |
DC Field | Value | Language |
---|---|---|
dc.contributor.advisor | Mak, LY | - |
dc.contributor.advisor | Yuen, RMF | - |
dc.contributor.advisor | Seto, WKW | - |
dc.contributor.author | Kan, Karin | - |
dc.contributor.author | 簡嘉穎 | - |
dc.date.accessioned | 2022-06-26T09:32:40Z | - |
dc.date.available | 2022-06-26T09:32:40Z | - |
dc.date.issued | 2022 | - |
dc.identifier.citation | Kan, K. [簡嘉穎]. (2022). Host and viral predictive factors of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients. (Thesis). University of Hong Kong, Pokfulam, Hong Kong SAR. | - |
dc.identifier.uri | http://hdl.handle.net/10722/313722 | - |
dc.description.abstract | Spontaneous seroclearance of hepatitis B surface antigen (HBsAg) is a rare event that occurs in patients that are chronically infected with the hepatitis B virus. Due to the favourable prognosis and the substantially reduced hepatocellular carcinoma risk that accompany HBsAg seroclearance, it is seen as the functional cure and ultimate treatment endpoint of chronic hepatitis B (CHB) and has therefore attracted great research interest. This is a retrospective study that aims to identify host and viral factors that are associated with HBsAg seroclearance. It utilized plasmas from 120 CHB patients who cleared HBsAg (S-losers) and 120 age- and sex-matched CHB patients who remained HBsAg-positive (controls) collected from 2015 – 2021 in the Queen Mary Hospital, Hong Kong. The levels of several biomarkers were compared between the s-loser and control groups cross-sectionally at the time of HBsAg seroclearance (Year 0). Retrospective samples collected at up to 10 years before HBsAg seroclearance were also analysed and compared. Lower levels of anti-HBc and IP-10 are found respectively to be associated with HBsAg seroclearance since 8 – 10 and 3 – 5 years ago (p<0.05). A significant trend of declining plasma anti-HBc begins 8 – 5 years prior to HBsAg seroclearance (p<0.01). Higher levels of HBV spliced variants Sp1 and Sp3 are associated with HBsAg seroclearance since 8 – 10 years ago (p<0.05). ROC curve analysis reveals that plasma anti-HBc and IP-10 levels at multiple time points before HBsAg seroclearance return AUC greater than 0.7 – plasma anti-HBc levels, at the cut-off value of 82.50 COI, can effectively predict HBsAg seroclearance within 1 year with 68.3 sensitivity and 90.0 specificity, whereas plasma IP-10 levels, at the cut-off value of 29.452pg/ml, can predict HBsAg seroclearance within 1 – 3 years with 52.0 sensitivity and 83.7 specificity, suggesting potential clinical utilities of anti-HBc and IP-10 in predicting HBsAg seroclearance. | - |
dc.language | eng | - |
dc.publisher | The University of Hong Kong (Pokfulam, Hong Kong) | - |
dc.relation.ispartof | HKU Theses Online (HKUTO) | - |
dc.rights | The author retains all proprietary rights, (such as patent rights) and the right to use in future works. | - |
dc.rights | This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License. | - |
dc.subject.lcsh | Hepatitis associated antigen | - |
dc.title | Host and viral predictive factors of spontaneous hepatitis B surface antigen seroclearance in chronic hepatitis B patients | - |
dc.type | PG_Thesis | - |
dc.description.thesisname | Master of Philosophy | - |
dc.description.thesislevel | Master | - |
dc.description.thesisdiscipline | Medicine | - |
dc.description.nature | published_or_final_version | - |
dc.date.hkucongregation | 2022 | - |
dc.identifier.mmsid | 991044545290703414 | - |