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

Authors

  • Man-Fung Yuen,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • Danny Ka-Ho Wong,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • Erwin Sablon,

    1. Innogenetics NV, Ghent, Belgium
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    • All authors contributed equally to this study.

  • Eric Tse,

    1. Division of Hematology & Oncology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • Irene Oi-Lin Ng,

    1. Department of Pathology, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • He-Jun Yuan,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • Chung-Wah Siu,

    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
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    • All authors contributed equally to this study.

  • Tamara J. Sander,

    1. Third Wave Technologies, Madison, WI
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  • Eric J. Bourne,

    1. GlaxoSmithKline, Discovery Medicine, International Clinical Virology, Research Triangle Park, NC
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  • Jeff G. Hall,

    1. Third Wave Technologies, Madison, WI
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  • Lynn D. Condreay,

    1. GlaxoSmithKline, Discovery Medicine, International Clinical Virology, Research Triangle Park, NC
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  • Ching-Lung Lai

    Corresponding author
    1. Division of Gastroenterology and Hepatology, Department of Medicine, University of Hong Kong, Queen Mary Hospital, Hong Kong, China
    • Department of Medicine, University of Hong Kong, Queen Mary Hospital, Pokfulam Road, Hong Kong, China
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    • fax: (852) 28162863


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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