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Hepatitis B surface antigen loss and sustained viral suppression in Asian chronic hepatitis B patients: A community‐based real‐world study
Author(s) -
Wong R. J.,
Nguyen M. T.,
Trinh H. N.,
Chan C.,
Huynh A.,
Ly M. T.,
Nguyen H. A.,
Nguyen K. K.,
Torres S.,
Yang J.,
Liu B.,
Garcia R. T.,
Bhuket T.,
Baden R.,
Levitt B.,
Silveira E.,
Gish R. G.
Publication year - 2017
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.12736
Subject(s) - hbsag , medicine , hbeag , hepatitis b virus , viral load , seroconversion , hepatitis b , immunology , virus , gastroenterology , population , virology , environmental health
Summary Community‐based real‐world outcomes on effectiveness of antiviral therapies for chronic hepatitis B virus ( CHB ) in Asians are limited. Whether hepatitis B surface antigen ( HB sAg) loss correlates with undetectable virus and alanine aminotransferase ( ALT ) normalization on treatment or what predicts risk of seroreversion or detectable virus after stopping therapy is unclear. We aim to evaluate rates and predictors of HB sAg loss, seroconversion, ALT normalization and undetectable HBV DNA , including HB sAg seroreversion or re‐emergence of HBV DNA among Asian CHB patients. We retrospectively evaluated 1072 CHB adults on antiviral therapy at two community gastroenterology clinics from 1997 to 2015. Rates of HB sAg loss, ALT normalization, achieving undetectable HBV DNA and developing surface antibody (anti‐ HB s) were stratified by HB eAg status. Following HB sAg loss, HB sAg seroreversion or re‐emergence of detectable HBV DNA was analysed. With median treatment of 76.7 months, the overall rate of HB sAg loss was 4.58%, with similar HB sAg loss rates between HB eAg‐positive and HB eAg‐negative patients (4.44% vs 4.71%, P =.85) in a predominantly Asian population (98.1%). Among HB sAg loss patients, 33.3% developed anti‐ HB s, 95.8% achieved undetectable virus and 66.0% normalized ALT . No significant baseline or on‐treatment predictors of HB sAg loss were observed. While six patients who achieved HB sAg loss had seroreversion with re‐emergence of HB sAg positivity, viral load remained undetectable, demonstrating the sustainability of viral suppression. Among a large community‐based real‐world cohort of Asian CHB patients treated with antiviral therapy, rate of HB sAg loss was 4.58%. Despite only 33.3% of HB sAg loss patients achieving anti‐ HB s, nearly all patients achieved sustained undetectable virus.