Spontaneous Hepatitis B Surface Antigen Seroclearance.

StephenW

Gastroenterology. 2010 Apr 28. [Epub ahead of print]

Incidence and Determinants of Spontaneous Hepatitis B Surface Antigen
Seroclearance: A Community-based Follow-up Study.

Liu J, Yang HI, Lee MH, Lu SN, Jen CL, Wang LY, You SL, Iloeje UH, Chen CJ;
R.E.V.E.A.L.-HBV Study Group.

Rollins School of Public Health, Emory University, Atlanta, GA, USA; Genomics
Research Center, Academia Sinica, Taipei.

Abstract
BACKGROUND AND AIMS:: Seroclearance of hepatitis B surface antigen (HBsAg) is
one of the most important clinical outcomes for chronic hepatitis B treatment
trials. Few studies have explored the incidence and determinants of
spontaneous HBsAg seroclearance using a long-term follow-up study. This study
aims to examine the natural history and predictors of HBsAg seroclearance.
METHODS:: A total of 3087 individuals with chronic hepatitis B virus infection
were enrolled between 1991-1992 in this community-based study. Serum samples
collected at baseline and follow-up examinations were tested for HBsAg,
hepatitis B e antigen (HBeAg), serum HBV DNA levels and anti-HCV serostatus.
Cox proportional hazards models were used to estimate HBsAg seroclearance rate
ratios associated with various determinants. RESULTS:: HBsAg seroclearance
occurred in 562 participants during 24,829 person-years of follow-up, giving a
2.26% annual seroclearance rate. HBV DNA levels at baseline and follow-up were
the most significant predictor of seroclearance. Higher HBV viral loads
conferred lower HBsAg seroclearance rates (p<0.001). A spontaneous decrease in
follow-up HBV DNA level (>/=3 log) was significantly associated with HBsAg
seroclearance, showing an adjusted odds ratio (95% CI) of 4.17 (2.55-6.82).
Among those with seroclearance, 95.8% had undetectable HBV DNA prior to
seroclearance. Cumulative incidence of HBsAg seroclearance at 60 and 100
months after serum HBV DNA decreased to undetectable levels was 25.8% and
51.3%, respectively. CONCLUSIONS:: This study reveals various determinants of
HBsAg seroclearance, and suggests that a low viral load is an important factor
affecting the natural seroclearance of HBsAg, indicating significant clinical
implications for the treatment of chronic HBV. Copyright © 2010 AGA
Institute. Published by Elsevier Inc. All rights reserved.

小民百姓

低表面抗原定量是表面抗原血清自然转换的重要因素？

StephenW

回复 小民百姓 的帖子

是的.
通常低血清HBsAg（<1,000 IU/ ml）意味低HBVDNA和更好的免疫控制.
血清HBsAg <100 IU/ ml, 表面抗原血清自然转换率高.

小民百姓

谢谢！

zgct

好！谢谢