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Long‐term outcome in Caucasian patients with chronic hepatitis B virus infection after HB sAg seroclearance
Author(s) -
Lauret Eugenia,
GonzálezDiéguez María L.,
Rodríguez Mercedes,
González Marta,
Melón Santiago,
Rodrigo Luis,
Rodríguez Manuel
Publication year - 2015
Publication title -
liver international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.873
H-Index - 110
eISSN - 1478-3231
pISSN - 1478-3223
DOI - 10.1111/liv.12461
Subject(s) - medicine , cirrhosis , gastroenterology , clearance , hepatitis b virus , hepatitis b , single center , virus , immunology , urology
Abstract Background & Aims The natural course after hepatitis B surface antigen ( HB sAg) seroclearance in Caucasian patients with chronic hepatitis B virus ( HBV ) infection is not well‐defined. To investigate the clinical characteristics and outcome in a series of European Caucasian patients with chronic HBV infection according to HB sAg response over time. Methods A total of 612 patients with compensated chronic HBV infection and without other cause of liver disease were prospectively followed up. Seventy‐eight subjects cleared HB sAg and 534 remained HB sAg‐positive. Clinical and virological examinations were periodically performed and development of cirrhosis and liver‐related complications was monitored during a mean follow‐up time of 9.9 years. Results After HB sAg seroclearance, serum HBV DNA was undetectable in 38 patients in whom it was tested and HB sAg reappearance was observed in two subjects (2.6%). At 15 years of follow‐up, the cumulative probability of developing a liver‐related complication was 11.6% in HB sAg‐positive patients and 1.8% in those with HB sAg loss ( P = 0.03), although this benefit was limited to patients with cirrhosis ( P < 0.001) and to those who received therapy ( P < 0.01). Among patients without cirrhosis and among those who did not receive therapy, the probability was not different between those who cleared the HB sAg and those who did not ( P = 0.3 and P = 0.5 respectively). Conclusion Hepatitis B surface antigen loss confers a significant clinical benefit in Caucasian subjects with HBV ‐related cirrhosis and in those with chronic HBV infection who receive antiviral therapy. However, HB sAg reappearance can be observed in selected cases.