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Article: HBsAg Seroclearance in Chronic Hepatitis B in Asian Patients: Replicative Level and Risk of Hepatocellular Carcinoma

TitleHBsAg Seroclearance in Chronic Hepatitis B in Asian Patients: Replicative Level and Risk of Hepatocellular Carcinoma
Authors
Issue Date2008
PublisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastro
Citation
Gastroenterology, 2008, v. 135 n. 4, p. 1192-1199 How to Cite?
AbstractBackground & Aims: Our aims were to study the virologic, histologic, and clinical outcome in chronic hepatitis B (CHB) patients with hepatitis B surface antigen (HBsAg) seroclearance. Methods: We determined the age of HBsAg seroclearance that is associated with a lower risk for hepatocellular carcinoma (HCC) in 298 CHB patients (median follow-up, 108 months). The following virologic and histologic features were also determined: liver stiffness (n = 229), liver histology, serum HBV DNA levels over time (n = 265), intrahepatic HBV DNA with covalently closed circular DNA (cccDNA) levels, and messenger RNA (mRNA) expression. Results: The median age of HBsAg seroclearance was 49.6 years. Seven (2.4%) patients developed HCC. Cumulative risk for HCC was higher in patients with HBsAg seroclearance at ages ≥50 years compared with those with HBsAg seroclearance at ages <50 (P = .004) years. Of these 2 groups of patients, 29.5% and 7.9%, respectively, had significant fibrosis by liver stiffness measurement (P = .001), and 15.4% of patients had mild histologic fibrosis. Intrahepatic total HBV DNA and cccDNA were detected in 100% and 79.3% of patients, respectively. All patients had undetectable surface and precore/pregenomic RNA transcripts. One (9.1%) patient had X mRNA expression. Serum HBV DNA were detectable in 13.4%, 6.1%, and 3.7% of patients within 1 year and 5-10 and >10 years after HBsAg seroclearance, respectively, and 82.1% patients had persistently normal alanine aminotransferase levels. Conclusions: HBV persisted at low replicative and transcriptional levels after HBsAg seroclearance. HBsAg seroclearance at age <50 years was associated with a lower risk for the development of HCC. © 2008 AGA Institute.
Persistent Identifierhttp://hdl.handle.net/10722/59189
ISSN
2015 Impact Factor: 18.187
2015 SCImago Journal Rankings: 7.170
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorYuen, Men_HK
dc.contributor.authorWong, DKen_HK
dc.contributor.authorFung, Jen_HK
dc.contributor.authorIp, Pen_HK
dc.contributor.authorBut, Den_HK
dc.contributor.authorHung, Ien_HK
dc.contributor.authorLau, Ken_HK
dc.contributor.authorYuen, JCen_HK
dc.contributor.authorLai, Cen_HK
dc.date.accessioned2010-05-31T03:44:42Z-
dc.date.available2010-05-31T03:44:42Z-
dc.date.issued2008en_HK
dc.identifier.citationGastroenterology, 2008, v. 135 n. 4, p. 1192-1199en_HK
dc.identifier.issn0016-5085en_HK
dc.identifier.urihttp://hdl.handle.net/10722/59189-
dc.description.abstractBackground & Aims: Our aims were to study the virologic, histologic, and clinical outcome in chronic hepatitis B (CHB) patients with hepatitis B surface antigen (HBsAg) seroclearance. Methods: We determined the age of HBsAg seroclearance that is associated with a lower risk for hepatocellular carcinoma (HCC) in 298 CHB patients (median follow-up, 108 months). The following virologic and histologic features were also determined: liver stiffness (n = 229), liver histology, serum HBV DNA levels over time (n = 265), intrahepatic HBV DNA with covalently closed circular DNA (cccDNA) levels, and messenger RNA (mRNA) expression. Results: The median age of HBsAg seroclearance was 49.6 years. Seven (2.4%) patients developed HCC. Cumulative risk for HCC was higher in patients with HBsAg seroclearance at ages ≥50 years compared with those with HBsAg seroclearance at ages <50 (P = .004) years. Of these 2 groups of patients, 29.5% and 7.9%, respectively, had significant fibrosis by liver stiffness measurement (P = .001), and 15.4% of patients had mild histologic fibrosis. Intrahepatic total HBV DNA and cccDNA were detected in 100% and 79.3% of patients, respectively. All patients had undetectable surface and precore/pregenomic RNA transcripts. One (9.1%) patient had X mRNA expression. Serum HBV DNA were detectable in 13.4%, 6.1%, and 3.7% of patients within 1 year and 5-10 and >10 years after HBsAg seroclearance, respectively, and 82.1% patients had persistently normal alanine aminotransferase levels. Conclusions: HBV persisted at low replicative and transcriptional levels after HBsAg seroclearance. HBsAg seroclearance at age <50 years was associated with a lower risk for the development of HCC. © 2008 AGA Institute.en_HK
dc.languageengen_HK
dc.publisherWB Saunders Co. The Journal's web site is located at http://www.elsevier.com/locate/gastroen_HK
dc.relation.ispartofGastroenterologyen_HK
dc.subject.meshAdolescenten_HK
dc.subject.meshAdulten_HK
dc.subject.meshAgeden_HK
dc.subject.meshAged, 80 and overen_HK
dc.subject.meshAsian Continental Ancestry Group - statistics & numerical dataen_HK
dc.subject.meshCarcinoma, Hepatocellular - ethnology - pathology - virologyen_HK
dc.subject.meshChilden_HK
dc.subject.meshChild, Preschoolen_HK
dc.subject.meshDNA, Viral - blooden_HK
dc.subject.meshFemaleen_HK
dc.subject.meshFollow-Up Studiesen_HK
dc.subject.meshHepatitis B Antibodies - blooden_HK
dc.subject.meshHepatitis B Surface Antigens - immunologyen_HK
dc.subject.meshHepatitis B virus - genetics - immunology - isolation & purificationen_HK
dc.subject.meshHepatitis B, Chronic - ethnology - immunology - pathologyen_HK
dc.subject.meshHong Kong - epidemiologyen_HK
dc.subject.meshHumansen_HK
dc.subject.meshInfanten_HK
dc.subject.meshLiver - pathology - virologyen_HK
dc.subject.meshLiver Cirrhosis - ethnology - pathology - virologyen_HK
dc.subject.meshLiver Neoplasms - ethnology - pathology - virologyen_HK
dc.subject.meshLongitudinal Studiesen_HK
dc.subject.meshMaleen_HK
dc.subject.meshMiddle Ageden_HK
dc.subject.meshRisk Factorsen_HK
dc.subject.meshSeroepidemiologic Studiesen_HK
dc.titleHBsAg Seroclearance in Chronic Hepatitis B in Asian Patients: Replicative Level and Risk of Hepatocellular Carcinomaen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0016-5085&volume=135&issue=4&spage=1192&epage=9&date=2008&atitle=HBsAg+Seroclearance+in+Chronic+Hepatitis+B+in+Asian+Patients:+Replicative+Level+and+Risk+of+Hepatocellular+Carcinomaen_HK
dc.identifier.emailYuen, M:mfyuen@hkucc.hku.hken_HK
dc.identifier.emailWong, DK:danywong@hku.hken_HK
dc.identifier.emailFung, J:jfung@sicklehut.comen_HK
dc.identifier.emailHung, I:ivanhung@hkucc.hku.hken_HK
dc.identifier.emailLai, C:hrmelcl@hku.hken_HK
dc.identifier.authorityYuen, M=rp00479en_HK
dc.identifier.authorityWong, DK=rp00492en_HK
dc.identifier.authorityFung, J=rp00518en_HK
dc.identifier.authorityHung, I=rp00508en_HK
dc.identifier.authorityLai, C=rp00314en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1053/j.gastro.2008.07.008en_HK
dc.identifier.pmid18722377-
dc.identifier.scopuseid_2-s2.0-53049107213en_HK
dc.identifier.hkuros150699en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-53049107213&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume135en_HK
dc.identifier.issue4en_HK
dc.identifier.spage1192en_HK
dc.identifier.epage1199en_HK
dc.identifier.eissn1528-0012-
dc.identifier.isiWOS:000259982800027-
dc.publisher.placeUnited Statesen_HK
dc.identifier.scopusauthoridYuen, M=7102031955en_HK
dc.identifier.scopusauthoridWong, DK=7401535819en_HK
dc.identifier.scopusauthoridFung, J=23091109300en_HK
dc.identifier.scopusauthoridIp, P=7003622683en_HK
dc.identifier.scopusauthoridBut, D=24343113400en_HK
dc.identifier.scopusauthoridHung, I=7006103457en_HK
dc.identifier.scopusauthoridLau, K=25121234200en_HK
dc.identifier.scopusauthoridYuen, JC=7102620480en_HK
dc.identifier.scopusauthoridLai, C=7403086396en_HK

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