Serum Hepatitis B Surface Antigen Levels Predict Surface Antigen Loss in Hepatitis B e Antigen Seroconverters

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Gastroenterology. 2011 Apr 28. [Epub ahead of print]

Serum Hepatitis B Surface Antigen Levels Predict Surface Antigen Loss in

Hepatitis B e Antigen Seroconverters

Tseng TC, Liu CJ, Su TH, Wang CC, Chen CL, Chen PJ, Chen DS, Kao JH.

Source

Division of Gastroenterology, Department of Internal Medicine, Buddhist Tzu Chi

General Hospital Taipei Branch, Taipei; Graduate Institute of Clinical Medicine,

National Taiwan University College of Medicine and National Taiwan University

Hospital, Taipei, Taiwan.

Abstract

BACKGROUND & AIMS:

Loss of hepatitis B surface antigen (HBsAg) usually indicates that hepatitis B

virus (HBV) infection has been cured. However, little is known about factors

predicting HBsAg loss in patients who spontaneously clear hepatitis B e antigen

(HBeAg).

METHODS:

We studied 390 Taiwanese HBeAg-positive patients with chronic hepatitis who had

spontaneously cleared HBeAg (seroconversion) during follow-up. Serum levels of

HBV DNA and HBsAg were determined 1 year after HBeAg seroconversion, and their

relationships with subsequent HBsAg loss were investigated.

RESULTS:

In a mean follow-up of 7.4 years, the average annual rate of HBsAg loss was

0.62%. Serum levels of HBsAg and HBV DNA were inversely associated with HBsAg

loss in a dose-response manner. Compared with patients with HBsAg levels ™1000

IU/mL, the HBsAg loss rate was higher for those with HBsAg levels of 100 to 999

and <100 IU/mL, with hazard ratios of 4.4 (95% confidence interval, 1.1-17.0)

and 24.3 (8.7-67.5), respectively. Among those who underwent HBsAg loss within 6

years of follow-up, serum HBsAg levels were a better predictor than HBV DNA

levels by receiver operating characteristic curve analysis (area under the

receiver operating characteristic curve, 0.90 vs 0.69; P = .012); an HBsAg level

<100 IU/mL predicted HBsAg loss within 6 years with a diagnostic accuracy of

91.5%, sensitivity of 83.3%, specificity of 92.1%, positive predictive value of

45.5%, and negative predictive value of 98.6% in patients with an HBV DNA level

<200 IU/mL.

CONCLUSIONS:

Low serum levels of HBsAg, alone or in combination with HBV DNA levels, 1 year

after HBeAg seroconversion can predict HBsAg loss in patients with HBV genotype

B or C infection.

Copyright ¿ 2011 AGA Institute. Published by Elsevier Inc. All rights reserved.

PMID: 21672542 [PubMed - as supplied by publisher]