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Higher lifetime chance of spontaneous surface antigen loss in hepatitis B carriers with genotype C infection
Author(s) -
Tseng T.C.,
Liu C.J.,
Chen C.L.,
Yang W.T.,
Yang H.C.,
Su T.H.,
Wang C.C.,
Kuo S. F.T.,
Liu C.H.,
Chen P.J.,
Chen D.S.,
Kao J.H.
Publication year - 2015
Publication title -
alimentary pharmacology and therapeutics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.308
H-Index - 177
eISSN - 1365-2036
pISSN - 0269-2813
DOI - 10.1111/apt.13170
Subject(s) - hbsag , medicine , hepatitis b virus , hbeag , genotype , hepatitis b , viral load , immunology , virology , hazard ratio , gastroenterology , confidence interval , virus , biology , genetics , gene
Summary Background Clearance of hepatitis B surface antigen ( HB sAg) indicates clinical control of hepatitis B virus ( HBV ) infection. However, little is known about the impact of viral genomic variations on HB sAg loss. Methods We explored the association between viral genomic factors and HB sAg loss in 2121 HB eAg‐negative patients. HBV pre‐core stop codon (1896) and basal core promoter (BCP) (1762/1764) sequences were determined in patients with HBV DNA ≥200 IU / mL ( N = 1693). The effect of HBV genotype on HB sAg loss was further validated in the whole cohort of 3445 HB sAg carriers. Results The cumulative lifetime (age 28–75 years) incidence of HB sAg loss was 50.4% in 2121 HB eAg‐negative patients. We found that genotype C, but not pre‐core stop codon or BCP mutants, was associated with HB sAg loss. Compared to genotype B patients, genotype C patients had higher lifetime chance of HB sAg loss, with hazard ratio of 1.8 (95% confidence interval: 1.4–2.4). Multivariable analysis showed that male sex, elevated ALT levels, lower serum HBV DNA and HB sAg levels, and genotype C infection were associated with higher chance of HB sAg loss independently. We then performed sensitivity analysis, which re‐included HB eAg‐positive, cirrhotic and treatment‐experienced patients, and confirmed the robustness of our results in 3445 HB sAg carriers. Conclusion Genotype C infection, compared to genotype B, is associated with a higher lifetime chance of HB sAg loss in Asian HBV carriers.