Predictive Factors for Early HBeAg Seroconversion in Acute Exacerbation of HBeAg-Positive Chronic Hepatitis B Patients

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Gastroenterology. 2008 Nov 27. [Epub ahead of print]

Predictive Factors for Early HBeAg Seroconversion in Acute Exacerbation of

HBeAg-Positive Chronic Hepatitis B Patients.

Kim HS, Kim HJ, Shin WG, Kim KH, Lee JH, Kim HY, Jang MK.

Department of Internal Medicine, Seoul, Republic of Korea.

BACKGROUND & AIMS: This study aimed to identify the predictors for early

hepatitis B e antigen (HBeAg) seroconversion following acute exacerbation (AE)

in patients with HBeAg-positive chronic hepatitis B (CHB) with genotype C.

METHODS: A total of 151 patients with HBeAg-positive CHB and AE were

consecutively enrolled. AE was defined as an elevation of alanine

aminotransferase level to more than 5 times the upper limit of normal and more

than twice the patients' baseline value. Early HBeAg seroconversion was defined

as HBeAg loss and the appearance of hepatitis B e antibody within 6 months of

AE. Clinical and laboratory data were compared between an early HBeAg

seroconversion group and a nonearly HBeAg seroconversion group. RESULTS: All

patients had genotype C hepatitis B virus (HBV). Early HBeAg seroconversion

occurred in 35.5% (39/110). Under univariate analysis, age (P = .082),

transmission mode (P = .033), disease status (P = .063), and serum HBV DNA level

(P < .001) were associated with early HBeAg seroconversion. Multivariate

analysis showed that transmission modes (nonvertical vs vertical; relative risk,

3.681; 95% confidence interval, 1.279-10.592; P = .016) and serum HBV DNA levels

(7 log [copies/mL]; relative risk, 6.891; 95% confidence interval, 2.165-21.935;

P = .001) were independent predictors. CONCLUSIONS: Patients with CHB with

genotype C may have a higher chance of early HBeAg seroconversion after AE in

the context of nonvertical transmission and/or had low serum HBV DNA levels (