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Spontaneous HBeAg seroclearance increased chances for HBsAg seroclearance

Patients with chronic hepatitis B virus infection and positive for the hepatitis B e antigen had a greater chance of hepatitis B surface antigen seroclearance after experiencing spontaneous seroclearance of the hepatitis B e antigen, according to data from a recent study.  

Researchers, including Man-Fung Yuen, MBBS, MD, PhD, chair and professor of Gastroenterology and Hepatology, The University of Hong Kong, and colleagues collected clinical data from 775 patients enrolled at the Hepatitis and Liver Clinic of Queen Mary Hospital, Hong Kong, between September 2005 and September 2007 to determine any factors associated with HBsAg seroclearance. Every patient underwent HBeAg seroclearance and were followed until January 2013. Patients were divided into three groups: group 1 consisted of patients that underwent HBeAg seroclearance and did not undergo or require treatment (n=428); group 2 included patients who received treatment-induced HBeAg seroclearance (n=197); and group 3 included patients who experienced spontaneous HBeAg seroclearance but needed antiviral therapy after seroclearance (n=150).

Man-Fung Yuen

Forty-five patients underwent HBsAg seroclearance with a median time of 139 months from HBeAg seroclearance to HBsAg seroclearance. All patients were still HBsAg-negative at the end of follow-up. The rate of reaching HBsAg seroclearance after HBeAg seroclearance increased with time (0.3% at 1 year vs. 23.6% at 25 years).

HBsAg seroclearance was highest among patients in group 1 compared with patients in group 2 or 3. The HBsAg seroclearance rate at 25 years was 38% in group 1, 14.9% in group 2 and 0% in group 3 patients (P<.001). Multivariate analysis showed stable HBeAg antibodies and HBsAg levels were predictors of HBsAg seroclearance (P=.008).

“Chronic hepatitis B patients who do not require antiviral treatment to achieve HBeAg seroclearance have the highest rate of subsequent HBsAg seroclearance, occurring in 38% of patients  after 25 years of HBeAg seroclearance,” Yuen told Healio.com/Hepatology. “The HBsAg level 1 year after HBeAg seroclearance has a high predictive value for subsequent HBsAg seroclearance.”  – by Melinda Stevens

Disclosure: The researchers report no relevant financial disclosures.