HBsAg seroclearance in chronic hepatitis B in the Chinese: virological, histological, and clinical aspects.
Few studies have examined Chinese patients with chronic hepatitis B who exhibit hepatitis B surface antigen (HBsAg) seroclearance. We comprehensively studied the biochemical, virological, histological, and clinical aspects of 92 patients with HBsAg seroclearance (median follow-up, 126 months). Ninety-two HBsAg-positive controls matched for age, sex, and duration of follow-up were also recruited. Liver biochemistry, serum hepatitis B virus (HBV) DNA levels, and development of clinical complications were monitored. Intrahepatic total and covalently closed circular (ccc) HBV DNA were measured quantitatively in 16 patients. HBV genotype was determined in 30 patients. The mean age at HBsAg seroclearance was 48.8 (+ 13.81) years. There was a significant improvement in serum alanine aminotransferase levels after HBsAg seroclearance (p<0.0001). Patients with genotype B had a higher chance of HBsAg seroclearance than those with genotype C (P =.014). Ninety-eight percent of patients had undetectable serum HBV DNA. Thirty-seven percent of patients had low titer of intrahepatic HBV DNA, mainly in the form of cccDNA (71%-100%). All 14 patients with liver biopsies had near normal histology. There was no difference in the risk of development of hepatocellular carcinoma (HCC) between patients with and without HBsAg seroclearance. However, the mean age of HBsAg seroclearance was significantly older in patients with HCC than in patients without HCC (P =.016). In conclusion, patients with HBsAg seroclearance had favorable biochemical, virological, and histological parameters. Intrahepatic HBV DNA level was low and predominantly in the form of cccDNA. However, HCC could still develop, particularly in patients with cirrhosis who had HBsAg seroclearance at an older age.
Yuen
Man-Fung
MF
Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China.
Wong
Danny Ka-Ho
DK
Sablon
Erwin
E
Tse
Eric
E
Ng
Irene Oi-Lin
IO
Yuan
He-Jun
HJ
Siu
Chung-Wah
CW
Sander
Tamara J
TJ
Bourne
Eric J
EJ
Hall
Jeff G
JG
Condreay
Lynn D
LD
Lai
Ching-Lung
CL
D000328:Adult; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D004279:DNA, Viral / Q000032:analysis; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000276:immunology*; D006515:Hepatitis B virus / Q000235:genetics / Q000276:immunology; D019694:Hepatitis B, Chronic / Q000097:blood* / Q000150:complications / Q000276:immunology* / Q000473:pathology / Q000821:virology; D006801:Humans; D008099:Liver / Q000737:chemistry / Q000473:pathology; D008103:Liver Cirrhosis / Q000209:etiology; D008113:Liver Neoplasms / Q000209:etiology; D008297:Male
D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens