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Long-term outcome in Caucasian patients with chronic hepatitis B virus infection after HBsAg seroclearance

Eugenia Lauret1, María L González-Diéguez, Mercedes Rodríguez

  • 1Liver Unit, Division of Gastroenterology and Hepatology, Hospital Universitario Central de Asturias, Oviedo, Asturias, Spain.

Liver International : Official Journal of the International Association for the Study of the Liver
|January 8, 2014
PubMed

Insights

Hepatitis B surface antigen (HBsAg) loss significantly benefits Caucasian patients with HBV-related cirrhosis or on antiviral therapy. However, HBsAg reappearance can occur in some cases.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • The natural history of chronic hepatitis B virus (HBV) infection after hepatitis B surface antigen (HBsAg) seroclearance in Caucasian patients is not well-established.
  • Understanding the long-term outcomes is crucial for managing chronic HBV infection.

Purpose of the Study:

  • To investigate the clinical characteristics and outcomes of European Caucasian patients with chronic HBV infection based on HBsAg response over time.
  • To define the natural course following HBsAg seroclearance.

Main Methods:

  • Prospective follow-up of 612 patients with compensated chronic HBV infection.
  • Monitoring of clinical and virological parameters, including development of cirrhosis and liver-related complications over a mean of 9.9 years.
  • Stratification of patients based on HBsAg seroclearance (78 patients) versus persistent HBsAg positivity (534 patients).

Main Results:

  • HBsAg seroclearance was associated with undetectable HBV DNA in most tested patients, with a 2.6% rate of HBsAg reappearance.
  • At 15 years, the cumulative probability of liver-related complications was significantly lower in patients with HBsAg loss (1.8%) compared to HBsAg-positive patients (11.6%) (P=0.03).
  • This benefit was primarily observed in patients with HBV-related cirrhosis and those receiving antiviral therapy, but not in patients without cirrhosis or those not receiving therapy.

Conclusions:

  • Hepatitis B surface antigen loss provides a significant clinical benefit for Caucasian patients with HBV-related cirrhosis and those undergoing antiviral therapy.
  • The study highlights the importance of HBsAg seroclearance as a therapeutic goal in specific patient subgroups.
  • The possibility of HBsAg reappearance necessitates continued monitoring in certain cases.
Abstract

Keywords:
antiviral therapychronic hepatitis B complicationscirrhosishepatitis B reactivationhepatitis B resolved infectionhepatocellular carcinoma

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