Long-term presence of HBV in the sera of chronic hepatitis B patients with HBsAg seroclearance.
OBJECTIVE
The aim of this study was to elucidate the presence of serum hepatitis B virus (HBV) DNA at a prolonged time after seroclearance of hepatitis B surface antigen (HBsAg).


METHODS
Seventy Japanese patients who had been observed for >5 years after HBsAg seroclearance were included in this study. Anti-HBs, anti-HBe and anti-HBc antibodies were measured 0, 5 and 10 years after HBsAg seroclearance. Serum HBV DNA was measured using nested polymerase chain reaction (PCR) at 0, 5 and 10 years after HBsAg seroclearance. The PCR detection of serum HBV DNA using the X gene and core gene primers was done. The HBV DNA was regarded as positive when PCR detection of HBV DNA using either or both the X gene and core gene primers was positive. A multivariate regression analysis was used to assess the factors contributing to the positivity of serum HBV DNA 5 years after HBsAg seroclearance: the factors examined included age, gender, histological findings, HBV genotype, aminotransferase, total protein and interferon administration.


RESULTS
The titers of 200-fold diluted serum anti-HBc were 6.5 +/- 4.0 at 0 year after HBsAg seroclearance, 1.8 +/- 1.4 at 5 years and 0.9 +/- 0.7 at 10 years. The titers of 200-fold diluted serum anti-HBc decreased 5 and 10 years after HBsAg seroclearance with statistical significance. The positive rate of HBV DNA by the nested PCR was 71.4% (50/70) at 0 year after HBsAg seroclearance, 21.4% (15/70) at 5 years and 14.3% (3/21) at 10 years. However, there were no significant factors contributing to the positivity of serum HBV DNA 5 years after HBsAg seroclearance.


CONCLUSIONS
Our results suggest that serum HBV DNA disappears with an incidence of 10-20% 5 and 10 years after HBsAg seroclearance.
Arase
Yasuji
Y
Department of Gastroenterology, Toranomon Hospital, Tokyo, Japan. es9y-ars@asahi-net.or.jp
Suzuki
Fumitaka
F
Suzuki
Yoshiyuki
Y
Saitoh
Satoshi
S
Kobayashi
Masahiro
M
Akuta
Norio
N
Someya
Takashi
T
Hosaka
Tetsuya
T
Sezaki
Hitomi
H
Sato
Junko
J
Kobayashi
Mariko
M
Ikeda
Kenji
K
Kumada
Hiromitsu
H
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D044466:Asian People; D004279:DNA, Viral / Q000097:blood* / Q000235:genetics; D005260:Female; D006510:Hepatitis B Antibodies / Q000097:blood; D006512:Hepatitis B Core Antigens / Q000235:genetics; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000235:genetics / Q000302:isolation & purification*; D019694:Hepatitis B, Chronic / Q000453:epidemiology / Q000821:virology*; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016133:Polymerase Chain Reaction; D012044:Regression Analysis; D012307:Risk Factors; D044967:Serum / Q000821:virology*; D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins / Q000235:genetics; D014766:Viremia
D004279:DNA, Viral; D006510:Hepatitis B Antibodies; D006512:Hepatitis B Core Antigens; D006514:Hepatitis B Surface Antigens; D015534:Trans-Activators; D054334:Viral Regulatory and Accessory Proteins; C057628:hepatitis B virus X protein