Viral Determinants of Hepatitis B Surface Antigen Seroclearance in Hepatitis B e Antigen–Negative Chronic Hepatitis B Patients

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http://jid.oxfordjournals.org/content/204/3/408.abstract?etoc

Viral Determinants of Hepatitis B Surface Antigen Seroclearance in Hepatitis B e

Antigen–Negative Chronic Hepatitis B Patients

Henry Lik-Yuen Chan,

Grace Lai-Hung Wong,

Chi-Hang Tse,

Hoi-Yun Chan and

Wai-Sun Wong

+ Author Affiliations

Department of Medicine and Therapeutics and Institute of Digestive Disease, The

Chinese University of Hong Kong

Correspondence: Henry LY Chan, MD, Department of Medicine and Therapeutics, 9/F

Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong SAR, China

(hlychan@...).

Abstract

Background. We studied whether quantification of serum HBsAg and HBV DNA

levels could predict spontaneous HBsAg clearance in patients with negative

hepatitis B e antigen (HBeAg).

Methods. Serum HBsAg and HBV DNA levels were measured at baseline among a

longitudinal cohort of 103 HBeAg-negative patients recruited since 1997.

Results. Twelve (12%) patients developed HBsAg seroclearance after 88 ± 26

months (range, 21–139) of follow-up. At baseline, the serum HBsAg level among

patients who cleared HBsAg (1.30 ± 1.27 log IU/mL) was significantly lower than

those who did not clear HBsAg (2.96 ± 0.84 log IU/mL; P < .001). The area under

receiver operating characteristics (ROC) curve for serum HBsAg to predict HBsAg

seroclearance was 0.90 (95% confidence interval [CI], 0.83–0.97; P < .001).

Nine (75%) of 12 patients who had HBsAg seroclearance versus 8 (9%) of 91 who

remained HBsAg-positive had serum HBsAg ≤100 IU/mL at the baseline (P < .001).

An HBsAg cutoff of ≤100 IU/mL had 75% sensitivity and 91% specificity to

predict HBsAg seroclearance. Baseline serum HBV DNA could not predict HBsAg

seroclearance; the area under ROC curve was 0.64 (95% CI, 0.46–0.81; P = .13).

Conclusions. Single-point serum HBsAg level can predict the chance of HBsAg

seroclearance in chronic hepatitis B patients with negative HBeAg.

Received November 14, 2010.

Accepted March 28, 2011.

[Guest guest]

http://jid.oxfordjournals.org/content/204/3/408.abstract?etoc

Viral Determinants of Hepatitis B Surface Antigen Seroclearance in Hepatitis B e

Antigen–Negative Chronic Hepatitis B Patients

Henry Lik-Yuen Chan,

Grace Lai-Hung Wong,

Chi-Hang Tse,

Hoi-Yun Chan and

Wai-Sun Wong

+ Author Affiliations

Department of Medicine and Therapeutics and Institute of Digestive Disease, The

Chinese University of Hong Kong

Correspondence: Henry LY Chan, MD, Department of Medicine and Therapeutics, 9/F

Prince of Wales Hospital, 30-32 Ngan Shing Street, Shatin, Hong Kong SAR, China

(hlychan@...).

Abstract

Background. We studied whether quantification of serum HBsAg and HBV DNA

levels could predict spontaneous HBsAg clearance in patients with negative

hepatitis B e antigen (HBeAg).

Methods. Serum HBsAg and HBV DNA levels were measured at baseline among a

longitudinal cohort of 103 HBeAg-negative patients recruited since 1997.

Results. Twelve (12%) patients developed HBsAg seroclearance after 88 ± 26

months (range, 21–139) of follow-up. At baseline, the serum HBsAg level among

patients who cleared HBsAg (1.30 ± 1.27 log IU/mL) was significantly lower than

those who did not clear HBsAg (2.96 ± 0.84 log IU/mL; P < .001). The area under

receiver operating characteristics (ROC) curve for serum HBsAg to predict HBsAg

seroclearance was 0.90 (95% confidence interval [CI], 0.83–0.97; P < .001).

Nine (75%) of 12 patients who had HBsAg seroclearance versus 8 (9%) of 91 who

remained HBsAg-positive had serum HBsAg ≤100 IU/mL at the baseline (P < .001).

An HBsAg cutoff of ≤100 IU/mL had 75% sensitivity and 91% specificity to

predict HBsAg seroclearance. Baseline serum HBV DNA could not predict HBsAg

seroclearance; the area under ROC curve was 0.64 (95% CI, 0.46–0.81; P = .13).

Conclusions. Single-point serum HBsAg level can predict the chance of HBsAg

seroclearance in chronic hepatitis B patients with negative HBeAg.

Received November 14, 2010.

Accepted March 28, 2011.