Premium
Longitudinal profiles of highly sensitive hepatitis B surface antigen levels: re‐evaluation of HB sAg seroclearance
Author(s) -
Seto WaiKay,
Tanaka Yasuhito,
Wong Danny K.H.,
Shinkai Noboru,
Cheung KaShing,
Liu Kevin S.H.,
Fung James,
Lai ChingLung,
Yuen ManFung
Publication year - 2016
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.12980
Subject(s) - medicine , gastroenterology , hbsag , hepatitis b virus , chronic hepatitis , immunology , virus
Background & Aims Serologic profiles after hepatitis B surface antigen ( HB sAg) seroclearance in chronic hepatitis B ( CHB ) have not been well‐studied. Methods We employed a highly sensitive HB sAg (hs‐ HB sAg) assay (lower detection limit 0.5 mIU /ml), 100 times more sensitive than conventional HB sAg measurements. CHB patients achieving HB sAg seroclearance defined by conventional assays were followed up for serum hs‐ HB sAg, HBV DNA and antibody to HB sAg (anti‐ HB s) levels at 0 months, 6–12 months and 3–5 years after HB sAg seroclearance. Factors associated with hs‐ HB sAg detectability were determined. Results One hundred and nine patients were recruited; 94 (86.2%) were followed up to years 3–5; and 25 patients (22.9%) were on nucleoside analogue therapy for a median duration of 6.0 (range 1.5–12.7) years before HB sAg seroclearance. Detectable hs‐ HB sAg was noted in 88 (80.7%), 60 (55.0%) and 20 (21.3%) patients at 0 months, 6–12 months and 3–5 years respectively. At years 3–5, genotype B patients, when compared to genotype C patients, had a higher anti‐ HB s positive rate (63.2% and 41.1% respectively, P = 0.036). Serum anti‐ HB s positivity, when compared to persistent anti‐ HB s negativity, was associated with a lower rate of hs‐ HB sAg detection (7.4% and 40% respectively, P < 0.001). Multivariate analysis showed anti‐ HB s negativity at years 3–5 to be independently associated with persistently positive hs‐ HB sAg ( P = 0.007, odds ratio 7.1, 95% confidence interval 1.7–29.3). Conclusion Serum hs‐ HB sAg could detect HB sAg presence in a substantial proportion of CHB after HB sAg seroclearance defined by conventional assays, especially among anti‐ HB s negative individuals. Serum hs‐ HB sAg could potentially assist differentiating HB sAg‐negative CHB from individuals with only past HBV exposure without carrier state.