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Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and
Yee Hui Yeo1, Hsiu J Ho2, Hwai-I Yang3
1Division of Gastroenterology and Hepatology, Stanford University Medical Center, Palo Alto, California.
Gastroenterology
|October 21, 2018
Summary
Hepatitis B surface antigen (HBsAg) seroclearance, a marker of chronic hepatitis B virus (HBV) infection clearance, occurs at a low annual rate of approximately 1%. This finding highlights the need for lifelong treatment and new curative therapies for chronic HBV.
Area of Science:
- Hepatology
- Virology
- Public Health
Background:
- Chronic hepatitis B virus (HBV) infection affects millions globally.
- Seroclearance of hepatitis B surface antigen (HBsAg) signifies viral clearance but incidence rates vary.
- Precise estimates of HBsAg seroclearance are crucial for patient management and treatment strategies.
Purpose of the Study:
- To conduct a systematic review and meta-analysis to determine HBsAg seroclearance rates.
- To provide precise estimates of HBsAg seroclearance across different subgroups and populations.
- To identify factors associated with HBsAg seroclearance in chronic HBV infection.
Main Methods:
- Systematic review and meta-analysis of published cohort studies.
- Inclusion criteria: adults with chronic HBV, >1 year follow-up, and repeat HBsAg testing.
- Pooled annual and cumulative incidence rates using a random effects model.
Main Results:
- Pooled annual HBsAg seroclearance rate was 1.02%. Cumulative rates at 15 years were 17.99%.
- Seroclearance was higher in patients negative for HBeAg at baseline and with lower baseline HBV DNA and HBsAg levels.
- No significant differences were observed based on sex, HBV genotype, or treatment history.
Conclusions:
- The rate of HBsAg seroclearance in chronic HBV infection is low, approximately 1% annually.
- Seroclearance is more common in patients with less active disease.
- Lifelong treatment counseling is recommended, and curative therapies are needed for chronic HBV.
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