Factors associated with natural seroclearance of hepatitis B surface antigen and prognosis after seroclearance: a prospective follow-up study.
OBJECTIVE
Although the natural seroclearance rate of Hepatitis B surface antigen (HBsAg) is reported to be 0.4-2% in western countries, this is not well known in Korea. This study aimed to elucidate the rate of natural HbsAg seroclearance, factors associated with seroclearance and prognosis after seroclearance.


METHODS
In 1999, 250 chronic HBsAg carriers without any history of antiviral treatment and without any evidence of liver cirrhosis or hepatocellular carcinoma were selected. Follow-up HBsAg/ anti-HBs tests were performed annually till 2004. During a mean follow-up period of 48 months, 24 patients were lost and 11 received antiviral treatment. Finally, 215 patients completed the study.


RESULTS
HBsAg seroclearance was observed in 11 patients (6 males, 5 females). One-year seroclearance rate was 1.4%. All patients who achieved seroclearance were HBeAg (-)/HBV DNA (-) at the time of enrollment. Additionally, old age and normal serum alanine aminotransferase (ALT) level were the factors associated with seroclearance (p < 0.05, respectively). During the follow-up period, only mild transient elevations of ALT were observed in 4 patients and no serious complications were observed.


CONCLUSIONS
Natural seroclearance occurred exclusively in patients who were HBeAg (-)/HBV-DNA (-), and annual rate of natural HBsAg seroclearance was 1.4%. No significant complications were observed after seroclearance.
Kim
Jeong Hwan
JH
Department of Internal Medicine, Konkuk University School of Medicine, Seoul, Korea.
Lee
Joon Hyoek
JH
Park
Sang Jong
SJ
Bae
Mun Hee
MH
Kim
Ji Hyang
JH
Kim
Do Young
DY
Kim
Jong Kyu
JK
Choi
Moon Seok
MS
Koh
Kwang Cheol
KC
Paik
Seung Woon
SW
Yoo
Byung Chul
BC
D000328:Adult; D000368:Aged; D005260:Female; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006801:Humans; D007723:Korea; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011446:Prospective Studies; D055815:Young Adult
D006514:Hepatitis B Surface Antigens