Predictors of HBsAg Seroclearance in HBeAg-Negative Chronic Hepatitis B Patients

Kwak, Min‐Sun; Cho, Eun-Ju; Jang, Eunsun; Lee, Jeong-Hoon; Yu, Su Jong; Kim, Yoon Jun; Yoon, Jung‐Hwan; Lee, Hyo‐Suk

doi:10.1159/000333211

Cited by 13 publications

(13 citation statements)

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“…Accompanied with qHBsAg level decreasing gradually over times, lower levels of qHBsAg or rapid reduction rate of qHBsAg would eventually lead to HBsAg seroclearance or seroconversion [16]. Another important finding was the HBV DNA level and their reductions, which had previously been considered as powerful predictors for HBsAg seroclearance in pre-qHBsAg era [6], [8]. Liu et al found that decrease in HBV DNA levels was the most important predictor of HBsAg seroclearance [8].…”

Section: Discussionmentioning

confidence: 99%

“…Earlier HBsAg seroclearance or seroconversion is likely resulted in a better prognosis because of lower HBV replication as well as less liver damage [1], [2]. A few studies have explored the incidence of spontaneous HBsAg seroclearance in CHB patients of both Asian and European populations using long-term follow-up cohorts and the annual incidence ranges from 0.62% to 2.26% [3], [4], [5], [6], [7], [8]. Because of the more rarity of spontaneous HBsAg seroconversion, compared to HBsAg seroclearance, the incidence and long-term outcomes of CHB patients experiencing this event remain disputed.…”

Section: Introductionmentioning

confidence: 99%

“…Previous studies had demonstrated that lowering HBV DNA level was an important predictor for spontaneous HBsAg seroclearance [5], [6], [8], [13]. Furthermore, with the technological advances of quantitative HBsAg (qHBsAg), it has been suggested as a promising new marker in monitoring immunological response in both treated and untreated CHB patients, as well as a potential predictor of liver disease progression [14].…”

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Artificial Neural Network Accurately Predicts Hepatitis B Surface Antigen Seroclearance

et al. 2014

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Background & AimsHepatitis B surface antigen (HBsAg) seroclearance and seroconversion are regarded as favorable outcomes of chronic hepatitis B (CHB). This study aimed to develop artificial neural networks (ANNs) that could accurately predict HBsAg seroclearance or seroconversion on the basis of available serum variables.MethodsData from 203 untreated, HBeAg-negative CHB patients with spontaneous HBsAg seroclearance (63 with HBsAg seroconversion), and 203 age- and sex-matched HBeAg-negative controls were analyzed. ANNs and logistic regression models (LRMs) were built and tested according to HBsAg seroclearance and seroconversion. Predictive accuracy was assessed with area under the receiver operating characteristic curve (AUROC).ResultsSerum quantitative HBsAg (qHBsAg) and HBV DNA levels, qHBsAg and HBV DNA reduction were related to HBsAg seroclearance (P<0.001) and were used for ANN/LRM-HBsAg seroclearance building, whereas, qHBsAg reduction was not associated with ANN-HBsAg seroconversion (P = 0.197) and LRM-HBsAg seroconversion was solely based on qHBsAg (P = 0.01). For HBsAg seroclearance, AUROCs of ANN were 0.96, 0.93 and 0.95 for the training, testing and genotype B subgroups respectively. They were significantly higher than those of LRM, qHBsAg and HBV DNA (all P<0.05). Although the performance of ANN-HBsAg seroconversion (AUROC 0.757) was inferior to that for HBsAg seroclearance, it tended to be better than those of LRM, qHBsAg and HBV DNA.ConclusionsANN identifies spontaneous HBsAg seroclearance in HBeAg-negative CHB patients with better accuracy, on the basis of easily available serum data. More useful predictors for HBsAg seroconversion are still needed to be explored in the future.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Artificial Neural Network Accurately Predicts Hepatitis B Surface Antigen Seroclearance

et al. 2014

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“…HBs-Ag seroclearance may occur either after the acute phase that takes few months or after years of chronic infection [24,27,28]. -The seronegative OBI do not present anti-HBc and anti-HBs antibodies; anti-HBs antibodies progressively could be disappeared with an anti-HBc seroconversion over time without development of detectable HBs-Ag [24,29].…”

Section: Occult Hepatitis B Infectionsmentioning

confidence: 99%

Occult Hepatitis Infection in Transfusion Medicine: Screening Policy and Assessment of Current Use of Anti-HBc Testing

Esposito

Sabia

Iannone

et al. 2017

Transfus Med Hemother

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HBV still represents a global risk factor in transfusion medicine. The residual risk of HBV is not limited to pre-seroconversion window period but it extends to donors with occult HBV infection (OBI) characterized by the presence of HBV DNA in liver and by the absence of the virus surface antigen. Each country developed an appropriate blood screening policy according to local HBV prevalence, yields of infectious units per different screening methods and cost-effectiveness. We underline the need of maintaining a high level of attention for OBI carrier identification in all blood banks worldwide where the screening procedures are generally based on a combination of both serological markers and nucleic acid amplification test. In this context, markers such as hepatitis B surface antibodies and hepatitis B core antibodies (anti-HBc) might be useful, although the use of this latter is highly debated and still controversial. Our aim is to give an overview on the relevant diagnostic approaches for the routine screening for HBV focusing on the feasibility of anti-HBc testing as precautionary measure in preventing OBI transmission worldwide. In our tailored algorithm, the loss of about 1% of ‘anti-HBc only' donors, does not significantly affect the blood supply while improving recipient safety.

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“…A Korean study demonstrated that the overall annual HBsAg seroclearance rate was 1.8%, but the annual HBsAg seroclearance rate of the older-aged group was higher, i.e., the annual seroclearance rate was 2.69% among patients aged over 60, whereas the annual seroclearance rate was 1.91% among the patients aged between 40 and 59. The cumulative probabilities of HBsAg seroclearance were 1.2%, 3.8% and 8.7% for patients who were followed for 1, 3 and 5 years, respectively [15]. The annual HBsAg seroclearance rate in our study was 0.48%, i.e., 8 patients exhibited HBsAg seroclearance in the 1645 person-years study, and the rate was 0.3%, i.e., 5 patients exhibited HBsAg seroclearance in the 1624 person-years study.…”

Section: Discussionmentioning

confidence: 99%

Factors Predicting HBsAg Seroclearance and Alanine Transaminase Elevation in HBeAg-Negative Hepatitis B Virus-Infected Patients with Persistently Normal Liver Function

Chien¹,

Wang

Kee

et al. 2016

PLoS ONE

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BackgroundA certain proportion of hepatitis B virus (HBV)-infected patients with persistently normal alanine transaminase (ALT) levels have significant fibrosis. Using liver stiffness measurements (Fibroscan®) and laboratory data, including serum ALT, quantitative HBsAg (qHBsAg), and HBV DNA, we attempted to predict the natural histories of these patients.MethodsNon-cirrhotic HBeAg-negative chronic hepatitis B patients with persistently normal ALT were followed up prospectively with the end points of HBsAg seroclearance and ALT elevation above the upper limit of normal. The factors that were predictive of the end points were identified.ResultsA total of 235 patients with an average age of 48.1 +/- 10.7 years were followed up for 7 years. Eight patients (3.4%) lost HBsAg, and 15 patients (6.4%) experienced ALT elevation. The overall cumulative HBsAg seroclearances were 0.4%, 1.3% and 2.3% at years 1, 3 and 5, respectively. Regarding HBsAg seroclearance, the qHBsAg (< 30 IU/ml) cutoff resulted in a hazard ratio (HR) of 19.6 with a 95% confidence interval (CI) of 2.2–166.7 (P = 0.008). The baseline ALT level (odd ratio (OR) 1.075, 95% CI 1.020–1.132, P = 0.006) and a qHBsAg above 1000 IU/ml (3.7, 1.1–12.4, P = 0.032) were associated with ALT elevation. Limited to men, the baseline liver stiffness (1.6, 1.0–2.5, P = 0.031) and a qHBsAg above 1000 IU/ml (10.4, 2.1–52.4, P = 0.004) were factors that were independently associated with ALT elevation.ConclusionA low qHBsAg level predicted HBsAg clearance. Baseline ALT and a qHBsAg above 1000 IU/ml were independent predictive factors for ALT elevation. Among the men, the independent predictive factors for ALT elevation were qHBsAg and liver stiffness.

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Predictors of HBsAg Seroclearance in HBeAg-Negative Chronic Hepatitis B Patients

Cited by 13 publications

References 49 publications

Artificial Neural Network Accurately Predicts Hepatitis B Surface Antigen Seroclearance

Artificial Neural Network Accurately Predicts Hepatitis B Surface Antigen Seroclearance

Occult Hepatitis Infection in Transfusion Medicine: Screening Policy and Assessment of Current Use of Anti-HBc Testing

Factors Predicting HBsAg Seroclearance and Alanine Transaminase Elevation in HBeAg-Negative Hepatitis B Virus-Infected Patients with Persistently Normal Liver Function

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