Journal of Gastroenterology

, Volume 49, Issue 3, pp 538–546

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

Authors

    • Research Institute for HepatologyToranomon Hospital
  • Tetsuya Hosaka
    • Department of HepatologyToranomon Hospital
  • Fumitaka Suzuki
    • Department of HepatologyToranomon Hospital
  • Norio Akuta
    • Department of HepatologyToranomon Hospital
  • Hitomi Sezaki
    • Department of HepatologyToranomon Hospital
  • Yoshiyuki Suzuki
    • Department of HepatologyToranomon Hospital
  • Yusuke Kawamura
    • Department of HepatologyToranomon Hospital
  • Masahiro Kobayashi
    • Department of HepatologyToranomon Hospital
  • Satoshi Saitoh
    • Department of HepatologyToranomon Hospital
  • Yasuji Arase
    • Department of HepatologyToranomon Hospital
  • Kenji Ikeda
    • Department of HepatologyToranomon Hospital
  • Yuzo Miyakawa
    • Miyakawa Memorial Research Foundation
  • Hiromitsu Kumada
    • Department of HepatologyToranomon Hospital
Original Article—Liver, Pancreas, and Biliary Tract

DOI: 10.1007/s00535-013-0821-2

Cite this article as:
Kobayashi, M., Hosaka, T., Suzuki, F. et al. J Gastroenterol (2014) 49: 538. doi:10.1007/s00535-013-0821-2

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.

Keywords

SeroclearanceHepatitis B surface antigenHepatitis B virusChronic hepatitis B

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

Copyright information

© Springer Japan 2013