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1555
Prevalence and serological features of chronic hepatitis
B patients with concurrent HBsAg and anti-HBs in the
Hepatitis B Research Network (HBRN).
William M. Lee1, Yona K. Cloonan2, Kathleen B. Schwarz3, Doan
Y. Dao1, Anna S. Lok4; 1Division of Digestive and Liver Diseases,
University of Texas Southwestern Medical Center at Dallas, Dallas,
TX; 2Epidemiology, University of Pittsburgh, Pittsburgh, PA; 3Pediatrics,
Johns Hopkins University School of Medicine, Baltimore, MD;
4Gastroenterology, University of Michigan, Ann Arbor, MI
Background: Some patients with chronic HBV infection have
concurrent HBsAg and anti-HBs. We examined the HBRN
cohort to determine the prevalence of anti-HBs in participants
with chronic HBV infection, and compared demographic and
clinical factors between participants with and without anti-HBs.
Methods: Data from 1402 (1115 adults and 287 pediatric)
participants with chronic HBV infection enrolled in the HBRN,
who had been tested for both HBsAg and anti-HBs within 1
year of enrollment were included. 139 participants belonging
to specifically targeted groups (e.g., pregnant women) were
excluded from prevalence estimates. Characteristics of anti-HBs
positive and anti-HBs negative participants were compared.
Results: 93 participants were anti-HBs positive, overall prevalence
of concurrent HBsAg and anti-HBs was 6.6% (7.7%
pediatric and 6.3% adult). Age, sex, race and birthplace did
not differ significantly between anti-HBs positive and anti-HBs
negative participants. Similarly, there were no significant differences
in mode of transmission, estimated years of infection,
past HBV treatment, prevalence of HBeAg, HBV genotypes,
AST, ALT or other biochemical markers of liver injury[SB1] in
the 2 groups. HBsAg levels were significantly lower in anti-HBs
positive participants: median 3.0 vs. 3.6 log10 IU/mL (p<0.01)
while HBV DNA levels were similar: median 4.9 vs. 4.5 log10
IU/mL. Similar patterns for HBsAg and HBV DNA levels were
noted in pediatric and adult groups. Conclusion: Concurrent
HBsAg and anti-HBs is not uncommon in persons with chronic
HBV infection. The prevalence of anti-HBs is similar for adults
and children, and is not associated with markers of disease
activity or a specific clinical phenotype. Anti-HBs positive participants
had lower HBsAg titers but similar HBV DNA levels
suggesting a role for anti-HBs in decreasing sub-virion particles
or in immune control of HBV infection. Further studies are
planned to examine surface gene variants and anti-HBs titers in
this [SB2] population.
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