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Loss of hepatitis B surface antigen in a real‐life clinical cohort of patients with chronic hepatitis B virus infection
Author(s) -
Habersetzer François,
MoenneLoccoz Rémy,
Meyer Nicolas,
Schvoerer Evelyne,
SimoNoumbissie Pauline,
Dritsas Stavros,
Baumert Thomas F.,
Doffoël Michel
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.12661
Subject(s) - medicine , gastroenterology , hepatitis b virus , cohort , incidence (geometry) , hepatitis b , immunology , virus , physics , optics
Background & Aims Hepatitis B surface antigen ( HB sAg) clearance is the main indicator of viral cure in patients infected with the hepatitis B virus ( HBV ). We sought to identify the parameters associated with HB sAg loss in a well‐characterized real‐life clinical cohort of chronically HBV ‐infected patients. Methods Patients with chronic HBV infection were prospectively included, classified according to the disease stage, and followed up to determine parameters associated with HB sAg clearance. Results In total, 315 patients were followed up for a mean of almost 6 years. At study entry, 109 (34.6%) were inactive HB sAg carriers, 204 (64.8%) had chronic active hepatitis ( CAH ), and two (0.6%) were immune‐tolerant carriers. During follow‐up, 128 (62.7%) of the 204 patients with CAH received antiviral therapy. Sixty‐nine had HB eAg‐positive CAH : 55 (79.7%) were treated and 14 (20.3%) untreated. One hundred thirty‐five had HB eAg‐negative CAH : 73 (54.1%) were treated and 62 (45.9%) untreated. Inactive carriers showed an annual HB sAg clearance incidence rate of 23.4 cases per 1000 persons‐years, which was higher than that of CAH groups. The clearance incidence rates (in cases per 1000 persons‐years) of CAH groups were: treated HB eAg‐positive (20.7), untreated HB eAg‐positive (19.1), treated HB eAg‐negative (10.1), and untreated HB eAg‐negative (8.1). Older age ( P = 0.001) and inactive carrier status ( P = 0.019) were independent predictors of HB sAg clearance. Conclusion In a well‐characterized real‐life clinical cohort of chronically HBV ‐infected patients in various disease phases, older age, and inactive HB sAg carrier status were the only predictors of HB sAg clearance, whereas anti‐ HBV therapy only marginally increased annual incidence of HB sAg loss.