https://scholars.lib.ntu.edu.tw/handle/123456789/113852
Title: | Incidence and Determinants of Spontaneous Hepatitis B Surface Antigen Seroclearance: A Community-Based Follow-up Study | Authors: | YANG, HWAI-I LEE, MEEI-SHYUAN LU, SHENG-NAN JEN, CHIN-LAN WANG, LI-YU YOU, SAN-LIN CHEN, CHIEN-JEN REVEAL-HBV Study Group (CHYI-FENG JAN) |
Keywords: | Spontaneous HBsAg Seroclearance;Incidence;Determinants | Issue Date: | 2010 | Start page/Pages: | 474-482 | Source: | Gastroenterology | Abstract: | BACKGROUND & AIMS: Seroclearance of hepatitis B surface antigen (HBsAg) is one of the most important clinical outcomes for chronic hepatitis B treatment trials. Few studies have explored the incidence and determinants of spontaneous seroclearance using a long-term follow-up study. This study aimed to examine the natural history and predictors of HBsAg seroclearance. METHODS: A total of 3087 individuals with chronic hepatitis B virus infection were enrolled between 1991 and 1992 in this community- based study . Serum samples collected at baseline and follow-up examinations were tested for HBsAg, hepatitis B e antigen ( HBeAg), serum hepatitis B virus (HBV)-DNA levels, and anti- hepatitis C virus serostatus . Cox proportional hazards models were used to estimate HBsAg seroclearance rate ratios associated with various determinants. RESULTS: HBsAg seroclearance occurred in 562 participants during 24,829 person- years of follow-up evaluation, giving a 2.26% annual seroclearance rate. HBV-DNA levels at baseline and follow-up evaluation were the most significant predictor of seroclearance. Higher HBV viral loads conferred lower HBsAg seroclearance rates (P < .001). A spontaneous decrease in follow-up HBV-DNA level (>= 3 log) was associated significantly with seroclearance, showing an adjusted odds ratio of 4.17 (95% confidence interval, 2.55-6.82). Among those with seroclearance, 95.8% had undetectable HBV-DNA levels before seroclearance. Cumulative incidence of HBsAg seroclearance at 60 and 100 months after serum HBV-DNA level decreased to undetectable was 25.8% and 51.3%, respectively . CONCLUSIONS: This study reveals determinants of HBsAg seroclearance, and suggests that a low viral load is an important factor affecting the natural seroclearance of HBsAg, indicating significant clinical implications for the treatment of chronic HBV. |
URI: | http://ntur.lib.ntu.edu.tw//handle/246246/235833 | DOI: | 10.1053/j.gastro.2010.04.048 | SDG/Keyword: | hepatitis B surface antigen; hepatitis B(e) antigen; hepatitis C antibody; virus DNA; biological marker; hepatitis B surface antigen; hepatitis B(e) antigen; virus DNA; adult; article; blood sampling; chronic hepatitis; controlled study; female; follow up; hepatitis B; Hepatitis B virus; human; major clinical study; male; nonhuman; population based case control study; priority journal; proportional hazards model; seroprevalence; virus load; age; aged; blood; genetics; health survey; hepatitis B; Hepatitis B virus; immunology; incidence; Kaplan Meier method; middle aged; prognosis; prospective study; risk assessment; risk factor; serology; sex difference; Taiwan; time; Adult; Age Factors; Aged; Biological Markers; DNA, Viral; Female; Follow-Up Studies; Hepatitis B e Antigens; Hepatitis B Surface Antigens; Hepatitis B virus; Hepatitis B, Chronic; Hepatitis C Antibodies; Humans; Incidence; Kaplan-Meiers Estimate; Male; Middle Aged; Population Surveillance; Prognosis; Proportional Hazards Models; Prospective Studies; Risk Assessment; Risk Factors; Serologic Tests; Sex Factors; Taiwan; Time Factors; Viral Load |
Appears in Collections: | 流行病學與預防醫學研究所 |
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