title: Predicting Hepatitis B Virus (HBV) Surface Antigen Seroclearance in HBV e Antigen-Negative Patients With Chronic Hepatitis B: External Validation of a Scoring System.
abstract: BACKGROUND
  Hepatitis B virus (HBV) surface antigen (HBsAg) seroclearance is the ultimate serological end point in chronic hepatitis B. This study aimed to develop and validate a prediction score for spontaneous HBsAg seroclearance in HBV e antigen (HBeAg)-negative patients with chronic hepatitis B due to HBV genotype B or C.
  
  
  METHODS
  The development cohort included 2491 untreated participants from the community-based REVEAL-HBV study, who were HBeAg negative, anti-hepatitis C virus negative, and cirrhosis free. The independent validation cohort consisted of 1934 hospital-based individuals from the National Taiwan University Hospital. Clinical markers included in the model were age and serum HBV DNA and HBsAg levels. Cox proportional hazards regression models were used to create the prediction model.
  
  
  RESULTS
  A prediction score ranging from 0 to 27 was developed. Predicted probabilities of 5- and 10-year HBsAg seroclearance ranged from 0.95% to 30.49% and from 2.58% to 62.52%, respectively. When applied to the independent validation cohort, the areas under the receiver operating characteristic curves for the 5- and 10-year prediction of HBsAg seroclearance in the validation cohort were 0.82 (95% confidence interval [CI], .76-.88) and 0.74 (95% CI, .70-.78). Model fit was still adequate, according to Hosmer-Lemeshow goodness of fit tests.
  
  
  CONCLUSIONS
  A clinically applicable prediction score for HBsAg seroclearance was developed and externally validated. This model can assist clinicians in further stratifying risk groups.
authors.affiliation: Genomics Research Center, Academia Sinica.
authors.forename: Jessica
authors.initials: J
authors.lastname: Liu
authors.affiliation: Division of Gastroenterology, Department of Internal Medicine, Taipei Tzuchi Hospital, The Buddhist Tzuchi Medical Foundation School of Medicine, Tzu Chi University, Hualien.
authors.forename: Tai-Chung
authors.initials: TC
authors.lastname: Tseng
authors.affiliation: Genomics Research Center, Academia Sinica Molecular and Genomic Epidemiology Center, China Medical University Hospital Taichung Graduate Institute of Clinical Medical Science, China Medical University, Taichung.
authors.forename: Hwai-I
authors.initials: HI
authors.lastname: Yang
authors.affiliation: Institute of Clinical Medicine, National Yang Ming University.
authors.forename: Mei-Hsuan
authors.initials: MH
authors.lastname: Lee
authors.affiliation: Roche Diagnostics, Basel, Switzerland.
authors.forename: Richard
authors.initials: R
authors.lastname: Batrla-Utermann
authors.affiliation: Genomics Research Center, Academia Sinica.
authors.forename: Chin-Lan
authors.initials: CL
authors.lastname: Jen
authors.affiliation: Department of Gastroenterology, Chang-Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.affiliation: MacKay College of Medicine.
authors.forename: Li-Yu
authors.initials: LY
authors.lastname: Wang
authors.affiliation: Genomics Research Center, Academia Sinica.
authors.forename: San-Lin
authors.initials: SL
authors.lastname: You
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine.
authors.forename: Pei-Jer
authors.initials: PJ
authors.lastname: Chen
authors.affiliation: Genomics Research Center, Academia Sinica Graduate Institute of Epidemiology and Preventative Medicine, College of Public Health, National Taiwan University, Taipei.
authors.forename: Chien-Jen
authors.initials: CJ
authors.lastname: Chen
authors.affiliation: Division of Gastroenterology and Hepatology, Department of Internal Medicine Hepatitis Research Center Graduate Institute of Clinical Medicine, National Taiwan University College of Medicine.
authors.forename: Jia-Horng
authors.initials: JH
authors.lastname: Kao
mesh_terms: D000328:Adult; D000368:Aged; D015331:Cohort Studies; D004279:DNA, Viral / Q000097:blood / Q000235:genetics; D005260:Female; D005838:Genotype; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006513:Hepatitis B e Antigens / Q000097:blood*; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics; D019694:Hepatitis B, Chronic / Q000175:diagnosis* / Q000821:virology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012720:Severity of Illness Index; D013624:Taiwan
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens
keywords: epidemiology; prediction model; viral hepatitis