Quantification of hepatitis B surface antigen can help predict spontaneous hepatitis B surface antigen seroclearance

Area of Science:

• Hepatology
• Virology
• Immunology

Background:

• Hepatitis B virus (HBV) infection affects millions globally.
• Hepatitis B surface antigen (HBsAg) seroclearance is associated with favorable clinical outcomes in HBV carriers.
• Understanding spontaneous HBsAg seroclearance is crucial for managing chronic HBV infection.

Purpose of the Study:

• To investigate the clinical course of spontaneous HBsAg seroclearance.
• To identify factors that predict spontaneous HBsAg seroclearance in HBV carriers.

Main Methods:

• Retrospective analysis of 423 HBsAg-positive patients referred to Chiba University Hospital (1985-2008).
• Analysis of clinical and laboratory parameters including age, sex, HBeAg status, ALT, HBV DNA, platelets, HBV genotype, prior interferon treatment, and HBsAg level.
• HBsAg seroclearance defined as <0.03 IU/ml using chemiluminescent enzyme immunoassay; follow-up ceased upon nucleotide analog treatment.

Main Results:

• Twenty-five patients (6% of cohort) achieved HBsAg seroclearance over the study period, with an incidence rate of 0.97% per year.
• Multivariate analysis identified baseline HBsAg titer as the sole significant predictor of HBsAg seroclearance (OR=0.45, 95% CI: 0.29-0.70).
• No association was found between HBsAg seroclearance and age, sex, HBeAg status, ALT, HBV DNA, platelet count, HBV genotype, or prior interferon treatment.

Conclusions:

• Spontaneous HBsAg seroclearance occurs at a low annual frequency (0.97%) in chronic HBV carriers not treated with nucleotide analogs.
• Baseline HBsAg level is the only identified predictor for achieving spontaneous HBsAg seroclearance.
• These findings highlight the importance of baseline HBsAg quantification in predicting HBV clearance.