title: Loss of hepatitis B surface antigen in a real-life clinical cohort of patients with chronic hepatitis B virus infection.
abstract: OBJECTIVE
  Hepatitis B surface antigen (HBsAg) clearance is the main indicator of viral cure in patients infected with the hepatitis B virus (HBV). We sought to identify the parameters associated with HBsAg loss in a well-characterized real-life clinical cohort of chronically HBV-infected patients.
  
  
  METHODS
  Patients with chronic HBV infection were prospectively included, classified according to the disease stage, and followed up to determine parameters associated with HBsAg clearance.
  
  
  RESULTS
  In total, 315 patients were followed up for a mean of almost 6 years. At study entry, 109 (34.6%) were inactive HBsAg carriers, 204 (64.8%) had chronic active hepatitis (CAH), and two (0.6%) were immune-tolerant carriers. During follow-up, 128 (62.7%) of the 204 patients with CAH received antiviral therapy. Sixty-nine had HBeAg-positive CAH: 55 (79.7%) were treated and 14 (20.3%) untreated. One hundred thirty-five had HBeAg-negative CAH: 73 (54.1%) were treated and 62 (45.9%) untreated. Inactive carriers showed an annual HBsAg clearance incidence rate of 23.4 cases per 1000 persons-years, which was higher than that of CAH groups. The clearance incidence rates (in cases per 1000 persons-years) of CAH groups were: treated HBeAg-positive (20.7), untreated HBeAg-positive (19.1), treated HBeAg-negative (10.1), and untreated HBeAg-negative (8.1). Older age (P = 0.001) and inactive carrier status (P = 0.019) were independent predictors of HBsAg clearance.
  
  
  CONCLUSIONS
  In a well-characterized real-life clinical cohort of chronically HBV-infected patients in various disease phases, older age, and inactive HBsAg carrier status were the only predictors of HBsAg clearance, whereas anti-HBV therapy only marginally increased annual incidence of HBsAg loss.
authors.affiliation: Service d'Hépatogastroentérologie, Hôpitaux Universitaires de Strasbourg, Nouvel Hôpital Civil, Strasbourg, F-67091, France; Université de Strasbourg, Strasbourg, F-67000, France; Unité Inserm 1110, Strasbourg, F-67000, France.
authors.forename: François
authors.initials: F
authors.lastname: Habersetzer
authors.forename: Rémy
authors.initials: R
authors.lastname: Moenne-Loccoz
authors.forename: Nicolas
authors.initials: N
authors.lastname: Meyer
authors.forename: Evelyne
authors.initials: E
authors.lastname: Schvoerer
authors.forename: Pauline
authors.initials: P
authors.lastname: Simo-Noumbissie
authors.forename: Stavros
authors.initials: S
authors.lastname: Dritsas
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Baumert
authors.forename: Michel
authors.initials: M
authors.lastname: Doffoël
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000998:Antiviral Agents / Q000627:therapeutic use*; D002353:Carrier State / Q000175:diagnosis / Q000188:drug therapy*; D015331:Cohort Studies; D005260:Female; D005602:France; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000188:drug therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies
chemical_list: D000998:Antiviral Agents; D006514:Hepatitis B Surface Antigens
keywords: antiviral therapy; chronic HBV infection; chronic active hepatitis; inactive carrier state; incidence and predictive factors of HBsAg loss; real-life clinical cohort