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Conference Paper: Increase risk of HBeAg-negative chronic hepatitis B with older age at HBeAg seroconversion

TitleIncrease risk of HBeAg-negative chronic hepatitis B with older age at HBeAg seroconversion
Authors
Issue Date2009
PublisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep
Citation
The International Liver Congress TM 2009. 44 Annual Meeting of the European Association for the Study of the Liver, Copenhagen, Denmark, 22–26 April 2009. In Journal of Hepatology, 2009, v. 50 n. Suppl 1, p. S137 How to Cite?
AbstractBackground: Recent evidence suggests that delayed HBeAg seroconversion is associated with poorer outcome. We aim to determine the incidence of HBeAg-negative chronic hepatitis B (CHB) according to the age at which HBeAg seroconversion occurs. Methods: Chronic hepatitis B patients with natural HBeAg seroconversion and over 12 months follow-up after HBeAg-seroconversion, and without complications, were included. Patients were followed 3−6 monthly with liver biochemistry. HBV DNA and liver stiffness measurements by transient elastography were determined at the time of last follow-up. HBeAgnegative CHB was defined as a combination of ALT elevation above the upper limit of normal on more than one occasion for the entire duration of follow-up after HBeAg seroconversion, and HBV DNA >5 log copies/mL. Results: In total, 228 patients were included with a median follow-up (after HBeAg seroconversion) of 103 months (range, 12–247), of which 118 (52%) were male. The median age was 42 years (range, 21−74). The median age at HBeAg-seroconversion was 32 years (range, 6−64). Seventy-five (33%) and 137 (60%) patients had HBV DNA >5 log and >4 log copies/mL respectively. HBeAg-negative CHB was identified in 51 (22%) patients. In patients with evidence of HBeAg-negative CHB, the median age at HBeAg conversion was significantly higher compared to those with persistently normal ALT or HBV DNA <5 log copies/mL (38 vs 31 years respectively, p<0.001). In patients who seroconverted at age 20, 21−30, 31−40, 41−50, and >50, the rate of HBeAg-negative CHB was 12%, 15%, 21%, 39%, and 75% respectively (p = 0.002). There was no significant difference between males and females with respect to the age at HBeAg seroconversion (34 vs 32 years respectively, p = 0.90), and rate of HBeAg-negative CHB (25% vs 19% respectively, p = 0.25). Patients with HBeAg-negative CHB had higher median liver stiffness compared to those with persistently normal ALT or HBV DNA level <5 log copies/mL (9.0 vs 5.5 kPa respectively, p<0.001). Conclusion: In Asian patients, older age at HBeAg seroconversion, but not gender, was associated with higher rate of HBeAg-negative chronic hepatitis B. Patients with HBeAg-negative CHB had a higher liver stiffness compared to those without evidence of active disease.
Persistent Identifierhttp://hdl.handle.net/10722/62379
ISSN
2014 Impact Factor: 11.336
2014 SCImago Journal Rankings: 3.477

 

DC FieldValueLanguage
dc.contributor.authorFung, JYY-
dc.contributor.authorLai, CL-
dc.contributor.authorWong, DKH-
dc.contributor.authorYuen, JCH-
dc.contributor.authorYuen, RMF-
dc.date.accessioned2010-07-13T03:59:59Z-
dc.date.available2010-07-13T03:59:59Z-
dc.date.issued2009-
dc.identifier.citationThe International Liver Congress TM 2009. 44 Annual Meeting of the European Association for the Study of the Liver, Copenhagen, Denmark, 22–26 April 2009. In Journal of Hepatology, 2009, v. 50 n. Suppl 1, p. S137-
dc.identifier.issn0168-8278-
dc.identifier.urihttp://hdl.handle.net/10722/62379-
dc.description.abstractBackground: Recent evidence suggests that delayed HBeAg seroconversion is associated with poorer outcome. We aim to determine the incidence of HBeAg-negative chronic hepatitis B (CHB) according to the age at which HBeAg seroconversion occurs. Methods: Chronic hepatitis B patients with natural HBeAg seroconversion and over 12 months follow-up after HBeAg-seroconversion, and without complications, were included. Patients were followed 3−6 monthly with liver biochemistry. HBV DNA and liver stiffness measurements by transient elastography were determined at the time of last follow-up. HBeAgnegative CHB was defined as a combination of ALT elevation above the upper limit of normal on more than one occasion for the entire duration of follow-up after HBeAg seroconversion, and HBV DNA >5 log copies/mL. Results: In total, 228 patients were included with a median follow-up (after HBeAg seroconversion) of 103 months (range, 12–247), of which 118 (52%) were male. The median age was 42 years (range, 21−74). The median age at HBeAg-seroconversion was 32 years (range, 6−64). Seventy-five (33%) and 137 (60%) patients had HBV DNA >5 log and >4 log copies/mL respectively. HBeAg-negative CHB was identified in 51 (22%) patients. In patients with evidence of HBeAg-negative CHB, the median age at HBeAg conversion was significantly higher compared to those with persistently normal ALT or HBV DNA <5 log copies/mL (38 vs 31 years respectively, p<0.001). In patients who seroconverted at age 20, 21−30, 31−40, 41−50, and >50, the rate of HBeAg-negative CHB was 12%, 15%, 21%, 39%, and 75% respectively (p = 0.002). There was no significant difference between males and females with respect to the age at HBeAg seroconversion (34 vs 32 years respectively, p = 0.90), and rate of HBeAg-negative CHB (25% vs 19% respectively, p = 0.25). Patients with HBeAg-negative CHB had higher median liver stiffness compared to those with persistently normal ALT or HBV DNA level <5 log copies/mL (9.0 vs 5.5 kPa respectively, p<0.001). Conclusion: In Asian patients, older age at HBeAg seroconversion, but not gender, was associated with higher rate of HBeAg-negative chronic hepatitis B. Patients with HBeAg-negative CHB had a higher liver stiffness compared to those without evidence of active disease.-
dc.languageeng-
dc.publisherElsevier BV. The Journal's web site is located at http://www.elsevier.com/locate/jhep-
dc.relation.ispartofJournal of Hepatology-
dc.rights© <year>. This manuscript version is made available under the CC-BY-NC-ND 4.0 license http://creativecommons.org/licenses/by-nc-nd/4.0/-
dc.titleIncrease risk of HBeAg-negative chronic hepatitis B with older age at HBeAg seroconversion-
dc.typeConference_Paper-
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0168-8278&volume=50&issue=Suppl 1&spage=S137&epage=&date=2009&atitle=Increase+risk+of+HBeAg-negative+chronic+hepatitis+B+with+older+age+at+HBeAg+seroconversionen_HK
dc.identifier.emailFung, JYY: jfung@HKUCC.hku.hk-
dc.identifier.emailLai, CL: hrmelcl@hku.hk-
dc.identifier.emailWong, DKH: danywong@hku.hk-
dc.identifier.emailYuen, JCH: jchyuen@HKUCC.hku.hk-
dc.identifier.emailYuen, RMF: mfyuen@hkucc.hku.hk-
dc.identifier.authorityFung, JYY=rp00518-
dc.identifier.authorityLai, CL=rp00314-
dc.identifier.authorityWong, DKH=rp00492-
dc.identifier.authorityYuen, RMF=rp00479-
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1016/S0168-8278(09)60361-5-
dc.identifier.hkuros161375-
dc.identifier.hkuros158499-
dc.identifier.volume50-
dc.identifier.issueSuppl 1-
dc.identifier.spageS137-
dc.identifier.epageS137-
dc.publisher.placeNetherlands-

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