title: Viral determinants of hepatitis B surface antigen seroclearance in hepatitis B e antigen-negative chronic hepatitis B patients.
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.
authors: Department of Medicine and Therapeutics and Institute of Digestive Disease, The Chinese University of Hong Kong. hlychan@cuhk.edu.hk
authors: Henry Lik-Yuen
authors: HL
authors: Chan
authors: Grace Lai-Hung
authors: GL
authors: Wong
authors: Chi-Hang
authors: CH
authors: Tse
authors: Hoi-Yun
authors: HY
authors: Chan
authors: Vincent Wai-Sun
authors: VW
authors: Wong
mesh_terms: D000410:Alanine Transaminase / Q000097:blood; D006528:Carcinoma, Hepatocellular / Q000209:etiology; D004279:DNA, Viral / Q000097:blood*; D005500:Follow-Up Studies; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000150:complications / Q000276:immunology* / Q000821:virology; D006801:Humans; D008113:Liver Neoplasms / Q000209:etiology; D008137:Longitudinal Studies
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D000410:Alanine Transaminase