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Seroclearance rate of hepatitis B surface antigen in 2,112 patients with chronic hepatitis in Japan during long-term follow-up

  • Original Article—Liver, Pancreas, and Biliary Tract
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Abstract

Background

Rate of hepatitis B surface antigen (HBsAg) seroclearance was determined in 2,112 Japanese patients with chronic hepatitis B who were followed up for at least 15 years.

Methods

Patients had a median age of 37 years and included 1,431 (67.8 %) men. Median values were AST/ALT, 43/62 IU/L; platelet counts, 182 × 103/mm3; HBsAg, 3,400 IU/mL; and hepatitis B virus (HBV) DNA, 6.2 log copies/mL. Factors influencing HBsAg seroclearance were evaluated by the Cox proportional model and annual rate of HBsAg seroclearance by the Kaplan–Meier life table method.

Results

The overall annual rate of HBsAg seroclearance was 1.75 % in 2,112 patients; it was 1.65 % in 1,130 untreated and 2.05 % in 982 treated patients (p = 0.289). In untreated patients, seroclearance was influenced by age, no HBV infections in third-degree or closer relatives, and HBsAg levels in univariate analysis. Seroclearance was influenced by a median age ≥50 years [relative risk (RR) 1.61 (p = 0.018)] and HBsAg ≤2,000 IU/mL [RR 1.77 (p = 0.014)] in multivariate analysis. In treated patients, age, male gender, no HBV infections in third-degree or closer relatives, interferon therapy, chronic hepatitis, high AST and γ-GTP levels, low platelet counts, hepatitis B e antigen (HBeAg)-negative status, low HBsAg levels and the wild-type precore sequence significantly influenced HBsAg seroclearance. In multivariate analysis, no family history [RR 2.22 (p = 0.006)], interferon treatment [RR 3.15 (p < 0.001)], and HBeAg-negative status [RR 3.75 (p < 0.001)] significantly influenced HBsAg seroclearance.

Conclusions

In this retrospective cohort study, the annual rate of HBsAg seroclearance was 1.65 % in untreated patients and 2.05 % in treated patients.

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Abbreviations

ALT:

Alanine aminotransferase

AST:

Aspartate aminotransferase

ETV:

Entecavir

HBeAg:

Hepatitis B e antigen

HBcrAg:

Hepatitis B core-related antigen

HBV:

Hepatitis B virus

HBV DNA:

Hepatitis B virus DNA

HBsAg:

Hepatitis B surface antigen

IFN:

Interferon

LAM:

Lamivudine

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Acknowledgments

This work was supported in part by grants from the Ministry of Health, Labour and Welfare in Japan.

Conflict of interest

These authors disclose the following: Dr. Kumada reports having received investigator, lecture, and consulting fees from Dainippon Sumitomo Pharma Co., MSD KK, Bristol-Myers Squibb, Pharma International, Dentsu Sudler, and Hennessey Inc. Dr. Ikeda reports having received investigator, lecture, and consulting fees from Dainippon Sumitomo Pharma Co. No other potential conflicts of interest relevant to this article were reported.

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Authors and Affiliations

  1. Research Institute for Hepatology, Toranomon Hospital, 1-3-1 Kajigaya, Takatsu-ku, Kawasaki, 213-8587, Japan

    Mariko Kobayashi

  2. Department of Hepatology, Toranomon Hospital, 1-3-1 Kajigaya, Takatsu-ku, Kawasaki, 213-8587, Japan

    Tetsuya Hosaka, Fumitaka Suzuki, Norio Akuta, Hitomi Sezaki, Yoshiyuki Suzuki, Yusuke Kawamura, Masahiro Kobayashi, Satoshi Saitoh, Yasuji Arase, Kenji Ikeda & Hiromitsu Kumada

  3. Miyakawa Memorial Research Foundation, Tokyo, 107-0062, Japan

    Yuzo Miyakawa

Authors
  1. Mariko Kobayashi
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  2. Tetsuya Hosaka
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  3. Fumitaka Suzuki
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  4. Norio Akuta
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  5. Hitomi Sezaki
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  6. Yoshiyuki Suzuki
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  8. Masahiro Kobayashi
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  9. Satoshi Saitoh
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  10. Yasuji Arase
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  11. Kenji Ikeda
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  12. Yuzo Miyakawa
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  13. Hiromitsu Kumada
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Corresponding author

Correspondence to Mariko Kobayashi.

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Kobayashi, M., Hosaka, T., Suzuki, F. et al. Seroclearance rate of hepatitis B surface antigen in 2,112 patients with chronic hepatitis in Japan during long-term follow-up. J Gastroenterol 49, 538–546 (2014). https://doi.org/10.1007/s00535-013-0821-2

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  • DOI: https://doi.org/10.1007/s00535-013-0821-2

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