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Yang SC, Lu SN, Lee CM, et al. Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes in patients with spontaneous HBeAg seroconversion. Hepatol Int. 2012;7(2):489-99doi: 10.1007/s12072-012-9382-3.
Yang, S. C., Lu, S. N., Lee, C. M., Hu, T. H., Wang, J. H., Hung, C. H., Changchien, C. S., & Chen, C. H. (2013). Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes in patients with spontaneous HBeAg seroconversion. Hepatology international, 7(2), 489-99. https://doi.org/10.1007/s12072-012-9382-3
Yang, Shih-Cheng, et al. "Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes in patients with spontaneous HBeAg seroconversion." Hepatology international vol. 7,2 (2013): 489-99. doi: https://doi.org/10.1007/s12072-012-9382-3
Yang SC, Lu SN, Lee CM, Hu TH, Wang JH, Hung CH, Changchien CS, Chen CH. Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes in patients with spontaneous HBeAg seroconversion. Hepatol Int. 2013 Jun;7(2):489-99. doi: 10.1007/s12072-012-9382-3. Epub 2012 Jun 22. PMID: 26201781.
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Hepatol Int. 2013 Jun;7(2):489-99. doi: 10.1007/s12072-012-9382-3. Epub 2012 Jun 22.

Combining the HBsAg decline and HBV DNA levels predicts clinical outcomes in patients with spontaneous HBeAg seroconversion.

Hepatology international

Shih-Cheng Yang, Sheng-Nan Lu, Chuan-Mo Lee, Tsung-Hui Hu, Jing-Houng Wang, Chao-Hung Hung, Chi-Sin Changchien, Chien-Hung Chen

Affiliations

  1. Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan.
  2. Division of Hepato-Gastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, 123 Ta Pei Road, Kaohsiung, Taiwan. [email protected].

PMID: 26201781 DOI: 10.1007/s12072-012-9382-3

Abstract

PURPOSE: The aim was to investigate whether the quantitation of the hepatitis B surface antigen (HBsAg) and hepatitis B virus (HBV) DNA levels can predict HBV reactivation and advanced liver disease after spontaneous hepatitis B e antigen (HBeAg) seroconversion.

METHODS: A total of 121 patients who experienced spontaneous HBeAg seroconversion were included in this longitudinal study. Serial HBsAg and HBV DNA levels were measured before and after HBeAg seroconversion.

RESULTS: Of the 121 patients, 32 experienced HBV reactivation and six achieved an HBsAg loss after HBeAg seroconversion during the follow-up period. The decline in the HBsAg level was considerably more pronounced in patients without HBV reactivation when compared to those with HBV reactivation (p = 0.016). Multivariate analysis revealed that the age of >40 years at HBeAg seroconversion, male sex, and HBsAg decline, and HBV DNA levels at month 12 after HBeAg seroconversion were independent factors for the development of HBeAg-negative hepatitis. All the six patients who achieved HBsAg loss had HBsAg level of <1,000 IU/mL at month 12 after HBeAg seroconversion (p < 0.001). The risk of HBeAg-negative hepatitis, cirrhosis, and HCC was substantially increased in patients who had a combination of both, i.e., no decline in the HBsAg level and HBV DNA level of >10(4) copies/mL at month 12 after HBeAg seroconversion.

CONCLUSIONS: Combining HBsAg reduction and HBV DNA levels at month 12 after HBeAg seroconversion was a useful marker to predict clinical outcomes in spontaneous HBeAg seroconverters. HBsAg level of <1,000 IU/mL at month 12 after HBeAg seroconversion could predict the HBsAg loss after HBeAg seroconversion.

Keywords: Cirrhosis; HBeAg seroconversion; Hepatitis B surface antigen; Hepatitis B virus; Hepatocellular carcinoma

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