Viral Hepatitis

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HBsAg seroclearance in chronic hepatitis B in the Chinese: Virological, histological, and clinical aspects

  1. Man-Fung Yuen1,†,
  2. Danny Ka-Ho Wong1,†,
  3. Erwin Sablon2,†,
  4. Eric Tse3,†,
  5. Irene Oi-Lin Ng4,†,
  6. He-Jun Yuan1,†,
  7. Chung-Wah Siu1,†,
  8. Tamara J. Sander5,†,
  9. Eric J. Bourne6,†,
  10. Jeff G. Hall5,†,
  11. Lynn D. Condreay6,†,
  12. Ching-Lung Lai1,†,‡,*

Article first published online: 27 MAY 2004

DOI: 10.1002/hep.20240

Issue

Hepatology

Hepatology

Volume 39, Issue 6, pages 1694–1701, June 2004

Additional Information

How to Cite

Yuen, M.-F., Wong, D. K.-H., Sablon, E., Tse, E., Ng, I. O.-L., Yuan, H.-J., Siu, C.-W., Sander, T. J., Bourne, E. J., Hall, J. G., Condreay, L. D. and Lai, C.-L. (2004), HBsAg seroclearance in chronic hepatitis B in the Chinese: Virological, histological, and clinical aspects. Hepatology, 39: 1694–1701. doi: 10.1002/hep.20240

Author Information

  1. 1

    Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

  2. 2

    Innogenetics NV, Ghent, Belgium

  3. 3

    Division of Hematology & Oncology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

  4. 4

    Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China

  5. 5

    Third Wave Technologies, Madison, WI

  6. 6

    GlaxoSmithKline, Discovery Medicine, International Clinical Virology, Research Triangle Park, NC

  1. †

    All authors contributed equally to this study.

  2. ‡

    fax: (852) 28162863

*Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China

  1. †

    All authors contributed equally to this study.

  2. ‡

    fax: (852) 28162863

Publication History

  1. Issue published online: 27 MAY 2004
  2. Article first published online: 27 MAY 2004
  3. Manuscript Accepted: 5 MAR 2004
  4. Manuscript Received: 8 OCT 2003

Funded by

  • University of Hong Kong, Department of Medicine

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Abstract

Few studies have examined Chinese patients with chronic hepatitis B who exhibit hepatitis B surface antigen (HBsAg) seroclearance. We comprehensively studied the biochemical, virological, histological, and clinical aspects of 92 patients with HBsAg seroclearance (median follow-up, 126 months). Ninety-two HBsAg-positive controls matched for age, sex, and duration of follow-up were also recruited. Liver biochemistry, serum hepatitis B virus (HBV) DNA levels, and development of clinical complications were monitored. Intrahepatic total and covalently closed circular (ccc) HBV DNA were measured quantitatively in 16 patients. HBV genotype was determined in 30 patients. The mean age at HBsAg seroclearance was 48.8 (+ 13.81) years. There was a significant improvement in serum alanine aminotransferase levels after HBsAg seroclearance (p<0.0001). Patients with genotype B had a higher chance of HBsAg seroclearance than those with genotype C (P = .014). Ninety-eight percent of patients had undetectable serum HBV DNA. Thirty-seven percent of patients had low titer of intrahepatic HBV DNA, mainly in the form of cccDNA (71%-100%). All 14 patients with liver biopsies had near normal histology. There was no difference in the risk of development of hepatocellular carcinoma (HCC) between patients with and without HBsAg seroclearance. However, the mean age of HBsAg seroclearance was significantly older in patients with HCC than in patients without HCC (P = .016). In conclusion, patients with HBsAg seroclearance had favorable biochemical, virological, and histological parameters. Intrahepatic HBV DNA level was low and predominantly in the form of cccDNA. However, HCC could still develop, particularly in patients with cirrhosis who had HBsAg seroclearance at an older age. (HEPATOLOGY 2004;39:1694–1701.)

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