title: A persistently low HBV DNA level is a predictor of spontaneous HBsAg clearance in patients with chronic hepatitis B.
abstract: OBJECTIVE
  The incidence and predictors of spontaneous hepatitis B surface-antigen (HBsAg) seroclearance in patients with chronic hepatitis B virus (HBV) were evaluated.
  
  
  METHODS
  A total of 1427 patients with chronic HBV infection, who were followed between 1994 and 2013, were investigated in this retrospective study. All data were extracted from patient files.
  
  
  RESULTS
  Spontaneous HBsAg seroclearance occurred in 84 patients during 8798 person-years of follow-up. The patients were categorized into 3 groups at follow-up based on HBV DNA features as continuously <100 copies/mL (Group A), 0-10,000 copies/mL (Group B), and 0 to >10,000 copies/mL (Group C). Alanine aminotransferase features in the 2 groups were categorized as continuously normal (<40 U/L) and 0 to >40 U/L. Spontaneous HBsAg seroclearance was seen primarily in patients with Group A HBV DNA features, and continuously low HBV DNA values were the main predictor of HBsAg seroclearance (P < 0.001).
  
  
  CONCLUSIONS
  These results suggest that a continuously low viral load is the most important factor affecting spontaneous HBsAg seroclearance.
authors: Department of Infectious Disease and Clinical Microbiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors: Alpay
authors: A
authors: Ari
authors: Department of Infectious Disease and Clinical Microbiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors: Şebnem
authors: Ş
authors: Çalik
authors: Department of Infectious Disease and Clinical Microbiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors: Selma
authors: S
authors: Tosun
authors: Department of Microbiology and Clinical Microbiology, İzmir Bozyaka Training and Research Hospital, İzmir, Turkey.
authors: Sibel
authors: S
authors: Özsu Yilmaz
mesh_terms: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens; D006515:Hepatitis B virus; D019694:Hepatitis B, Chronic; D006801:Humans; D012189:Retrospective Studies
chemical_list: D004279:DNA, Viral; D006514:Hepatitis B Surface Antigens; D006513:Hepatitis B e Antigens
keywords: HBV DNA; Spontaneous HBsAg seroclearance; incidence; predictor