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Hepatitis B surface antigen level complements viral load in predicting viral reactivation in spontaneous HBeAg seroconverters
Author(s) -
Tseng TaiChung,
Liu ChunJen,
Yang WanTing,
Chen ChiLing,
Yang HungChih,
Su TungHung,
Wang ChiaChi,
Kuo Stephanie FangTzu,
Liu ChenHua,
Chen PeiJer,
Chen DingShinn,
Kao JiaHorng
Publication year - 2014
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.12502
Subject(s) - medicine , virology , viral load , hbeag , immunology , viral hepatitis , antigen , viral disease , antibody , hepatitis b virus , virus , hbsag
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 T aiwanese 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 ≥ 2000 IU /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 < 2000 IU /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 ≥ 1000 IU /mL versus < 1000 IU /mL was 4.1 (95% confidence interval: 1.3–13.6). When using the end‐point of active viral replication, HBsAg ≥ 1000 IU /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 < 2000 IU /mL, HBsAg level ≥ 1000 IU /mL is associated with increased risks of HBeAg ‐negative hepatitis and active viral replication. Combining HBV ‐ DNA < 2000 IU /mL and HBsAg level < 1000 IU /mL may be used to define minimal viral activity.