title: HBsAg may reappear following reactivation in individuals with spontaneous HBsAg seroclearance 8 years previously.
abstract: HBsAg reappearance may constitute not only a risk for liver disease but also an infectious source. We aimed to determine whether HBsAg may reappear after spontaneous HBsAg seroclearance. A cohort of 2999 HBsAg-positive subjects aged 30-55 years was recruited in Guangxi, China in 2004. HBsAg was tested every 6 months from July 2004 to June 2007, then, one more time in December 2013. The results showed that spontaneous HBsAg seroclearance occurred in 41 subjects in the first 3 years, giving a 0·54% annual seroclearance rate. Thirteen of the 41 subjects were randomly tested for HBsAg in 2013. Four subjects became HBsAg positive. S gene sequences of HBV were analysed from serum collected before seroclearance and after reappearance, respectively, for subject QS840 (11 and 12 clones), subject TN98 (13 and 13 clones) and subject WX227 (10 and 8 clones). Serotype, subgenotype and amino-acid substitution pattern in each sample collected after reappearance was observed in the sample collected before HBsAg seroclearance. Nucleotide similarity between the two sequences from each subject was >99% and five sequences from subject TN98 were the same. In conclusion, following reactivation, HBsAg may reappear in individuals with spontaneous HBsAg seroclearance many years previously.
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: Q Y
authors.initials: QY
authors.lastname: Chen
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: X Y
authors.initials: XY
authors.lastname: Wang
authors.affiliation: Division of Medicine,UCL Medical School,London,UK.
authors.forename: T J
authors.initials: TJ
authors.lastname: Harrison
authors.affiliation: Guangdong Provincial Institute of Public Health, Guangdong Provincial Center for Disease Control and Prevention,Guangzhou,China.
authors.forename: X
authors.initials: X
authors.lastname: He
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: L P
authors.initials: LP
authors.lastname: Hu
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: K W
authors.initials: KW
authors.lastname: Li
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: H H
authors.initials: HH
authors.lastname: Jia
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: Q L
authors.initials: QL
authors.lastname: Yang
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: C
authors.initials: C
authors.lastname: Wang
authors.affiliation: Guangxi Zhuang Autonomous Region Center for Disease Prevention and Control, Guangxi Key Laboratory for the Prevention and Control of Viral Hepatitis,Nanning,Guangxi,China.
authors.forename: Z L
authors.initials: ZL
authors.lastname: Fang
mesh_terms: D000328:Adult; D002681:China; D015331:Cohort Studies; D005260:Female; D005838:Genotype; D006509:Hepatitis B / Q000473:pathology*; D006514:Hepatitis B Surface Antigens / Q000097:blood* / Q000235:genetics; D006515:Hepatitis B virus / Q000145:classification / Q000235:genetics / Q000302:isolation & purification / Q000502:physiology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D012008:Recurrence; D017422:Sequence Analysis, DNA; D013995:Time; D014775:Virus Activation
chemical_list: D006514:Hepatitis B Surface Antigens
keywords: Genotypes; HBsAg; hepatitis B virus (HBV); mutations; reappearance; seroclearance; serotype