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Nagaoka S, Abiru S, Komori A, et al. Hepatic flares promote rapid decline of serum hepatitis B surface antigen (HBsAg) in patients with HBsAg seroclearance: A long-term follow-up study. Hepatol Res. 2015;46(3):E89-99doi: 10.1111/hepr.12533.
Nagaoka, S., Abiru, S., Komori, A., Sasaki, R., Bekki, S., Hashimoto, S., Saeki, A., Yamasaki, K., Migita, K., Nakamura, M., Ezaki, H., & Yatsuhashi, H. (2016). Hepatic flares promote rapid decline of serum hepatitis B surface antigen (HBsAg) in patients with HBsAg seroclearance: A long-term follow-up study. Hepatology research : the official journal of the Japan Society of Hepatology, 46(3), E89-99. https://doi.org/10.1111/hepr.12533
Nagaoka, Shinya, et al. "Hepatic flares promote rapid decline of serum hepatitis B surface antigen (HBsAg) in patients with HBsAg seroclearance: A long-term follow-up study." Hepatology research : the official journal of the Japan Society of Hepatology vol. 46,3 (2016): E89-99. doi: https://doi.org/10.1111/hepr.12533
Nagaoka S, Abiru S, Komori A, Sasaki R, Bekki S, Hashimoto S, Saeki A, Yamasaki K, Migita K, Nakamura M, Ezaki H, Yatsuhashi H. Hepatic flares promote rapid decline of serum hepatitis B surface antigen (HBsAg) in patients with HBsAg seroclearance: A long-term follow-up study. Hepatol Res. 2016 Mar;46(3):E89-99. doi: 10.1111/hepr.12533. Epub 2015 May 25. PMID: 25951079.
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Hepatol Res. 2016 Mar;46(3):E89-99. doi: 10.1111/hepr.12533. Epub 2015 May 25.

Hepatic flares promote rapid decline of serum hepatitis B surface antigen (HBsAg) in patients with HBsAg seroclearance: A long-term follow-up study.

Hepatology research : the official journal of the Japan Society of Hepatology

Shinya Nagaoka, Seigo Abiru, Atsumasa Komori, Ryu Sasaki, Shigemune Bekki, Satoru Hashimoto, Akira Saeki, Kazumi Yamasaki, Kiyoshi Migita, Minoru Nakamura, Hironori Ezaki, Hiroshi Yatsuhashi

Affiliations

  1. Clinical Research Center, National Hospital Organization (NHO) Nagasaki Medical Center, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan.

PMID: 25951079 DOI: 10.1111/hepr.12533

Abstract

AIM: Serum hepatitis B surface antigen (HBsAg) seroclearance is one of the ultimate goals of management of chronic hepatitis B. We investigated the kinetics of serum HBsAg before HBsAg seroclearance in patients with chronic hepatitis B.

METHODS: We retrospectively analyzed 392 Japanese chronic hepatitis B patients who had been followed for 5 years or more between 1980 and 2000. Serum HBsAg levels were measured annually using chemiluminescent enzyme immunoassay.

RESULTS: During a median follow up of 14 years, 50 patients demonstrated HBsAg seroclearance (annual incidence rate, 0.91%). Multivariate analysis with baseline characteristics revealed that HBsAg of less than 3.3 log IU/mL (hazard ratio [HR], 2.22; P = 0.008) and treatment with nucleoside/nucleotide analog (HR, 0.12; P = 0.001) were independent predictive factors for seroclearance. The median HBsAg levels at 20, 10, 5, 3 and 1 year prior to seroclearance were 3.89, 2.84, 1.84, 0.78 and -1.10 log IU/mL, respectively. The rapid decline group, comprising patients who achieved HBsAg seroclearance within 5 years after confirmed HBsAg levels of 2 log IU/mL, demonstrated: (i) high alanine aminotransferase (ALT) levels; and (ii) a low frequency of liver cirrhosis progression. A significant reduction in annual HBsAg levels was found in years marked by at least one ALT flare (ALT ≥200 IU/L) (flare [+], n = 62) than in those without (flare [-], n = 323) (0.29 vs 0.17 log IU/mL/year, P = 0.003).

CONCLUSION: Hepatic flares promoted rapid declines and greater annual reductions of HBsAg levels in patients with HBsAg seroclearance.

© 2015 The Authors. Hepatology Research published by Wiley Publishing Asia Pty Ltd on behalf of The Japan Society of Hepatology.

Keywords: alanine aminotransferase flare; chronic hepatitis B; hepatitis B surface antigen quantification; hepatitis B surface antigen seroclearance

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