Hepatitis B surface antigen level complements viral load in predicting viral reactivation in spontaneous HBeAg seroconverters
Journal
Journal of Gastroenterology and Hepatology (Australia)
Journal Volume
29
Journal Issue
6
Pages
1242-1249
Date Issued
2014
Author(s)
Yang W.-T
Wang C.-C
Kuo S.F.-T
Abstract
Background and Aims: The level of hepatitis B surface antigen (HBsAg) has been shown to complement hepatitis B virus (HBV)-DNA level in predicting disease progression in hepatitis B e antigen (HBeAg)-negative patients, especially those with low viral loads. Whether this finding could be seen in spontaneous HBeAg seroconverters remains unclear. Methods: A retrospective cohort of 390 Taiwanese spontaneous HBeAg seroconverters with a mean follow-up period of 7.4 years was enrolled. The relationships between HBV-DNA/HBsAg levels and HBeAg-negative hepatitis/active viral replication (HBV-DNA level ?2000IU/mL) were investigated. Results: In the overall cohort, serum HBV-DNA level served as a better predictor for HBeAg-negative hepatitis compared with HBsAg level. However, in those with HBV-DNA level <2000IU/mL, a higher HBsAg level was associated with a higher risk of HBeAg-negative hepatitis (P=0.015). Multivariate analysis showed the hazard ratio of HBsAg level ?1000IU/mL versus <1000IU/mL was 4.1 (95% confidence interval: 1.3-13.6). When using the end-point of active viral replication, HBsAg ?1000IU/mL remained as an independent risk factor, with a hazard ratio of 2.5 (95% confidence interval: 1.1-5.9). Conclusions: In spontaneous HBeAg seroconverters with HBV-DNA level <2000IU/mL, HBsAg level ?1000IU/mL is associated with increased risks of HBeAg-negative hepatitis and active viral replication. Combining HBV-DNA <2000IU/mL and HBsAg level <1000IU/mL may be used to define minimal viral activity. ? 2014 Journal of Gastroenterology and Hepatology Foundation and Wiley Publishing Asia Pty Ltd.
SDGs
Other Subjects
hepatitis B surface antigen; hepatitis B(e) antigen; virus DNA; biological marker; hepatitis B surface antigen; hepatitis B(e) antigen; adult; article; controlled study; female; follow up; hepatitis B; Hepatitis B virus; human; infection risk; major clinical study; male; nonhuman; priority journal; retrospective study; risk factor; seroconversion; Taiwan; virus load; virus reactivation; virus replication; blood; cohort analysis; disease course; genetics; hepatitis B; Hepatitis B virus; immunology; physiology; serology; time; virology; virus activation; virus load; virus replication; Adult; Biological Markers; Cohort Studies; Disease Progression; DNA, Viral; Female; Follow-Up Studies; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic; Humans; Male; Retrospective Studies; Serologic Tests; Time Factors; Viral Load; Virus Activation; Virus Replication
Publisher
Blackwell Publishing
Type
journal article