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http://onlinelibrary.wiley.com/doi/10.1002/hep.21612/pdf
HBsAg Seroclearance in Asymptomatic Carriers of High Endemic Areas: Appreciably High Rates During a Long-Term Follow-Up
Chia-Ming Chu and Yun-Fan Liaw
Spontaneous hepatitis B surface antigen (HBsAg) seroclearance in chronic HBV infection
has long been suggested as a rare event in high endemic areas. The prevalence of HBsAg in
the general population of Taiwan, however, decreased remarkably from 15%-20% before
age 40 to 5%-10% after age 60 or 70. This study aimed to reexamine the rates of HBsAg
seroclearance by a long-term follow-up of 1965 hepatitis B e antibody–positive symptomatic
adult carriers. Of these, 1076 (55%) were males, the mean (+- SD) age was 35.6 +- 9.2
years and the mean follow-up was 10.8 +-5.4 years. Hepatitis relapsed in 314 patients, 0.5
to 18 (mean +- SD +- 5.8 +- 4.4) years after the entry. The probability of hepatitis relapse
correlated positively with male sex (P < 0.0001) and age at entry (P < 0.0001). Serum
HBsAg cleared in 245 patients at the mean age of 47.8 +- 9.6 years. The cumulative probabilities of HBsAg seroclearance were 8.1% after 10 years, but increased disproportionally to 24.9% and 44.7%, respectively, after 20 and 25 years. In multivariate analysis, the probability of HBsAg seroclearance correlated positively with age at entry (P < 0.0001) and sustained remission of hepatitis (P < 0.0001) and marginally significantly with male sex (P = 0.053).
Conclusion: Cumulative rate of HBsAg seroclearance in asymptomatic adult
carriers from high endemic areas was approximately 40% after 25 years of follow-up. The
low HBsAg seroclearance rates in previous studies might be due to the relative short period
of follow-up. (HEPATOLOGY 2007;45:1187-1192.)
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发表于 2012-1-5 13:01
