Incidence and prediction of HBsAg seroclearance in a prospective multi‐ethnic HBeAg‐negative chronic hepatitis B cohort

Terrault, Norah A.; Wahed, A M; Feld, J.; Cooper, S.; Ghany, MG; Lisker‐Melman, Mauricio; Perrillo, Robert P.; Sterling, RK; Khalili, Mandana; Chung, Richard; Rosenthal, Philip; Fontana, RJ; Sarowar, A; Lau, Dt-Y; Wang, J; As, Lok; Janssen, H.L.A.

doi:10.1002/hep.32231

Cited by 21 publications

(18 citation statements)

References 27 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…As previously described, lower HBsAg levels were found in older HBeAgNeg patients [ 26 ]. Low levels of serum HBsAg (log ≤ 3 IU/mL) have been proposed to predict future HBsAg seroconversion [ 27 ].…”

Section: Discussionsupporting

confidence: 58%

HBV-RNA, Quantitative HBsAg, Levels of HBV in Peripheral Lymphocytes and HBV Mutation Profiles in Chronic Hepatitis B

Gozlan

Aaron

Davidov

et al. 2022

Viruses

View full text Add to dashboard Cite

A comprehensive characterization of chronic HBV (CHB) patients is required to guide therapeutic decisions. The cumulative impact of classical and novel biomarkers on the clinical categorization of these patients has not been rigorously assessed. We determined plasma HBV-RNA and HBsAg levels, HBV in peripheral lymphocytes (PBMCs) and HBV mutation profiles in CHB patients. Patient demographics (n = 139) and classical HBV biomarkers were determined during a clinical routine. HBV-RNA in plasma and HBV-DNA in PBMCs were determined by RT-PCR. HBsAg levels were determined using Architect. In samples with HBV-DNA viral load >1000 IU/mL, genotype mutations in precore (PC), basal core promoter (BCP), HBsAg and Pol regions were determined by sequencing. Most patients (n= 126) were HBeAg-negative (HBeAgNeg) with significantly lower levels of HBV-RNA, HBV-DNA and HBsAg compared to HBeAg-positive (HBeAgPos) patients (p < 0.05). HBV genotype D prevailed (61/68), and >95% had BCP/PC mutations. Escape mutations were identified in 22.6% (13/63). HBeAgNeg patients with low levels of HBsAg (log IU ≤ 3) were older and were characterized by undetectable plasma HBV-DNA and undetectable HBV-RNA but not undetectable HBV-DNA in PBMCs compared to those with high HBsAg levels. In >50% of the studied HBeAgNeg patients (66/126), the quantitation of HBsAg and HBV-RNA may impact clinical decisions. In conclusion, the combined assessment of classical and novel serum biomarkers, especially in HBeAgNeg patients, which is the largest group of CHB patients in many regions, may assist in clinical decisions. Prospective studies are required to determine the real-time additive clinical advantage of these biomarkers.

show abstract

Section: Discussionsupporting

confidence: 58%

HBV-RNA, Quantitative HBsAg, Levels of HBV in Peripheral Lymphocytes and HBV Mutation Profiles in Chronic Hepatitis B

Gozlan

Aaron

Davidov

et al. 2022

Viruses

View full text Add to dashboard Cite

show abstract

“…HBeAg and HBsAg loss are important milestones in the course of CHB, associated with improved clinical outcomes. Factors associated with spontaneous HBeAg and HBsAg loss include older age, male sex, higher ALT level, HBeAg positivity, HBV genotype A or B, lower HBV DNA, and lower HBsAg levels 25–29 . We showed that a combination of host factors (age, sex, race/ethnicity), ALT, HBV DNA, and the use of antiviral therapy were highly predictive of HBeAg loss and HBsAg loss, respectively, with AUCs > 0.9.…”

Section: Discussionmentioning

confidence: 76%

“…Factors associated with spontaneous HBeAg and HBsAg loss include older age, male sex, higher ALT level, HBeAg positivity, HBV genotype A or B, lower HBV DNA, and lower HBsAg levels. [25][26][27][28][29] We showed that a combination of host factors (age, sex, race/ethnicity), ALT, HBV DNA, and the use of antiviral therapy were highly predictive of HBeAg loss and HBsAg loss, respectively, with AUCs > 0.9. Although in unadjusted analyses, the use of antiviral therapy was associated with a higher likelihood of HBeAg and HBsAg loss, respectively; once each model controlled for HBV DNA, the direction of the association with antiviral therapy changed, likely due to the impact of antiviral therapy on HBV DNA.…”

Section: Discussionmentioning

confidence: 95%

Use of HBV RNA and to predict change in serological status and disease activity in CHB

et al. 2023

Self Cite

View full text Add to dashboard Cite

Background and Aims: Predicting changes in disease activity and serological endpoints is necessary for the management of patients with chronic hepatitis B (CHB). We examined whether HBV RNA and hepatitis B core-related antigen (HBcrAg), two specialized virological markers proposed to reflect the activity of covalently closed circular DNA, may improve the ability to predict not sustained inactive carrier phase, spontaneous alanine aminotransferase (ALT) flare, HBeAg loss, and HBsAg loss. Approach and Results: Among eligible participants enrolled in the North American Hepatitis B Research Network Adult Cohort Study, we evaluated demographic, clinical, and virologic characteristics, including HBV RNA and HBcrAg, to predict not sustained inactive carrier phase, ALT flare, HBeAg loss, and HBsAg loss through a series of Cox proportional hazard or logistic regression models, controlling for antiviral therapy use. Among the study population, 54/103 participants experienced not sustained inactive carrier phase, 41/1006 had a spontaneous ALT flare, 83/250 lost HBeAg, and 54/1127 lost HBsAg. HBV RNA or HBcrAg were predictive of all 4 events. However, their addition to models of the readily available host (age, sex, race/ethnicity), clinical (ALT, use of antiviral therapy), and viral factors (HBV DNA), which had acceptable-excellent accuracy (e.g., AUC = 0.72 for ALT flare, 0.92 for HBeAg loss, and 0.91 for HBsAg loss), provided only small improvements in predictive ability. Conclusion: Given the high predictive ability of readily available markers, HBcrAg and HBV RNA have a limited role in improving the prediction of key serologic and clinical events in patients with CHB.

show abstract

“…HBsAg seroclearance was also found to be highly associated with older age, nonasian race, inactive HBsAg carrier, HBV genotype A, lower HBV DNA, and quantitative HBsAg levels. 29 NAs suppress HBV DNA rather than directly acting on cc-cDNA. Consequently, it is very difficult for NAs to prevent the production of HBV particles and their antigens.…”

Section: Patterns and Epidemiology Of Continuous Hbsag Seroclearancementioning

confidence: 99%

An Ideal Hallmark Closest to Complete Cure of Chronic Hepatitis B Patients: High-sensitivity Quantitative HBsAg Loss

Wang¹,

Zheng²,

Yang³

et al. 2022

J Clin Transl Hepatol

View full text Add to dashboard Cite

Incidence and prediction of HBsAg seroclearance in a prospective multi‐ethnic HBeAg‐negative chronic hepatitis B cohort

Cited by 21 publications

References 27 publications

HBV-RNA, Quantitative HBsAg, Levels of HBV in Peripheral Lymphocytes and HBV Mutation Profiles in Chronic Hepatitis B

HBV-RNA, Quantitative HBsAg, Levels of HBV in Peripheral Lymphocytes and HBV Mutation Profiles in Chronic Hepatitis B

Use of HBV RNA and to predict change in serological status and disease activity in CHB

An Ideal Hallmark Closest to Complete Cure of Chronic Hepatitis B Patients: High-sensitivity Quantitative HBsAg Loss

Contact Info

Product

Resources

About