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Clinical Trial
. 2015 Jan;35(1):130-9.
doi: 10.1111/liv.12661. Epub 2014 Sep 15.

Loss of hepatitis B surface antigen in a real-life clinical cohort of patients with chronic hepatitis B virus infection

François Habersetzer  1 , Rémy Moenne-Loccoz, Nicolas Meyer, Evelyne Schvoerer, Pauline Simo-Noumbissie, Stavros Dritsas, Thomas F Baumert, Michel Doffoël
Affiliations
Clinical Trial

Loss of hepatitis B surface antigen in a real-life clinical cohort of patients with chronic hepatitis B virus infection

François Habersetzer et al. Liver Int. 2015 Jan.

Abstract

Background & aims: Hepatitis B surface antigen (HBsAg) clearance is the main indicator of viral cure in patients infected with the hepatitis B virus (HBV). We sought to identify the parameters associated with HBsAg loss in a well-characterized real-life clinical cohort of chronically HBV-infected patients.

Methods: Patients with chronic HBV infection were prospectively included, classified according to the disease stage, and followed up to determine parameters associated with HBsAg clearance.

Results: In total, 315 patients were followed up for a mean of almost 6 years. At study entry, 109 (34.6%) were inactive HBsAg carriers, 204 (64.8%) had chronic active hepatitis (CAH), and two (0.6%) were immune-tolerant carriers. During follow-up, 128 (62.7%) of the 204 patients with CAH received antiviral therapy. Sixty-nine had HBeAg-positive CAH: 55 (79.7%) were treated and 14 (20.3%) untreated. One hundred thirty-five had HBeAg-negative CAH: 73 (54.1%) were treated and 62 (45.9%) untreated. Inactive carriers showed an annual HBsAg clearance incidence rate of 23.4 cases per 1000 persons-years, which was higher than that of CAH groups. The clearance incidence rates (in cases per 1000 persons-years) of CAH groups were: treated HBeAg-positive (20.7), untreated HBeAg-positive (19.1), treated HBeAg-negative (10.1), and untreated HBeAg-negative (8.1). Older age (P = 0.001) and inactive carrier status (P = 0.019) were independent predictors of HBsAg clearance.

Conclusion: In a well-characterized real-life clinical cohort of chronically HBV-infected patients in various disease phases, older age, and inactive HBsAg carrier status were the only predictors of HBsAg clearance, whereas anti-HBV therapy only marginally increased annual incidence of HBsAg loss.

Keywords: antiviral therapy; chronic HBV infection; chronic active hepatitis; inactive carrier state; incidence and predictive factors of HBsAg loss; real-life clinical cohort.

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