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Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B

BACKGROUND/AIMS: Hepatitis B surface antigen (HBsAg) seroclearance remains uncommon in chronic hepatitis B (CHB) infection. During acute flares of CHB (AFOCHB), alanine aminotransferase elevation reflects a mounting immune response toward viral clearance. We hypothesized that severe AFOCHB is associ...

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Autores principales: Hui, Ka-Yin, Fung, James, Cheung, Ka-Shing, Mak, Lung-Yi, Seto, Wai-Kay, Yuen, Man-Fung
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Editorial Office of Gut and Liver 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10018308/
https://www.ncbi.nlm.nih.gov/pubmed/36317514
http://dx.doi.org/10.5009/gnl220122
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author Hui, Ka-Yin
Fung, James
Cheung, Ka-Shing
Mak, Lung-Yi
Seto, Wai-Kay
Yuen, Man-Fung
author_facet Hui, Ka-Yin
Fung, James
Cheung, Ka-Shing
Mak, Lung-Yi
Seto, Wai-Kay
Yuen, Man-Fung
author_sort Hui, Ka-Yin
collection PubMed
description BACKGROUND/AIMS: Hepatitis B surface antigen (HBsAg) seroclearance remains uncommon in chronic hepatitis B (CHB) infection. During acute flares of CHB (AFOCHB), alanine aminotransferase elevation reflects a mounting immune response toward viral clearance. We hypothesized that severe AFOCHB is associated with a greater quantitative HBsAg (qHBsAg) decline and HBsAg seroclearance rate. METHODS: A total of 75 patients with severe AFOCHB with alanine aminotransferase 10× the upper limit of normal were matched to a control group by age and sex in a 12 ratio. qHBsAg levels were measured at the time of flare and annually (for both cases and controls) until the last follow-up. RESULTS: The median follow-up times for patients with severe AFOCHB and controls were 8.8 and 10.5 years, respectively. The cumulative rate of HBsAg seroclearance was higher in the severe AFOCHB group than in the control group (11.8% vs 5.0%, p=0.04) despite the former group having a trend of a higher baseline median qHBsAg (3,127 IU/mL vs 1,178 IU/mL, p=0.076). Compared with the control group, the severe AFOCHB group had a greater annual qHBsAg reduction (–242.4 IU/mL/yr vs –47.3 IU/mL/yr, p=0.002). Increasing age (p=0.049), lower baseline qHBsAg (p=0.002), and severe AFOCHB (p=0.014) were independently associated with HBsAg seroclearance. However, the cumulative rate of hepatocellular carcinoma was significantly higher in the severe AFOCHB group than in the control group (15.8% vs 1.9%, p<0.001). CONCLUSIONS: Severe AFOCHB was associated with a greater incidence of HBsAg seroclearance and qHBsAg decline. However, it was associated with a higher incidence of hepatocellular carcinoma.
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spelling pubmed-100183082023-03-17 Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B Hui, Ka-Yin Fung, James Cheung, Ka-Shing Mak, Lung-Yi Seto, Wai-Kay Yuen, Man-Fung Gut Liver Original Article BACKGROUND/AIMS: Hepatitis B surface antigen (HBsAg) seroclearance remains uncommon in chronic hepatitis B (CHB) infection. During acute flares of CHB (AFOCHB), alanine aminotransferase elevation reflects a mounting immune response toward viral clearance. We hypothesized that severe AFOCHB is associated with a greater quantitative HBsAg (qHBsAg) decline and HBsAg seroclearance rate. METHODS: A total of 75 patients with severe AFOCHB with alanine aminotransferase 10× the upper limit of normal were matched to a control group by age and sex in a 12 ratio. qHBsAg levels were measured at the time of flare and annually (for both cases and controls) until the last follow-up. RESULTS: The median follow-up times for patients with severe AFOCHB and controls were 8.8 and 10.5 years, respectively. The cumulative rate of HBsAg seroclearance was higher in the severe AFOCHB group than in the control group (11.8% vs 5.0%, p=0.04) despite the former group having a trend of a higher baseline median qHBsAg (3,127 IU/mL vs 1,178 IU/mL, p=0.076). Compared with the control group, the severe AFOCHB group had a greater annual qHBsAg reduction (–242.4 IU/mL/yr vs –47.3 IU/mL/yr, p=0.002). Increasing age (p=0.049), lower baseline qHBsAg (p=0.002), and severe AFOCHB (p=0.014) were independently associated with HBsAg seroclearance. However, the cumulative rate of hepatocellular carcinoma was significantly higher in the severe AFOCHB group than in the control group (15.8% vs 1.9%, p<0.001). CONCLUSIONS: Severe AFOCHB was associated with a greater incidence of HBsAg seroclearance and qHBsAg decline. However, it was associated with a higher incidence of hepatocellular carcinoma. Editorial Office of Gut and Liver 2023-03-15 2022-11-01 /pmc/articles/PMC10018308/ /pubmed/36317514 http://dx.doi.org/10.5009/gnl220122 Text en Copyright © Gut and Liver. https://creativecommons.org/licenses/by-nc/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0 (https://creativecommons.org/licenses/by-nc/4.0/) ) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Article
Hui, Ka-Yin
Fung, James
Cheung, Ka-Shing
Mak, Lung-Yi
Seto, Wai-Kay
Yuen, Man-Fung
Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title_full Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title_fullStr Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title_full_unstemmed Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title_short Long-term Hepatitis B Surface Antigen Profile and Seroclearance after Severe Acute Flares of Chronic Hepatitis B
title_sort long-term hepatitis b surface antigen profile and seroclearance after severe acute flares of chronic hepatitis b
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10018308/
https://www.ncbi.nlm.nih.gov/pubmed/36317514
http://dx.doi.org/10.5009/gnl220122
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