Digestive Diseases and Sciences

, Volume 59, Issue 10, pp 2580–2587

High Risk of Hepatitis B Virus Reactivation in Nucleos(t)ide Analogue-Induced Hepatitis B e Antigen Seroconverters Older Than 40 Years

  • Li-Fu Kuo
  • Chuan-Mo Lee
  • Chao-Hung Hung
  • Jing-Houng Wang
  • Tsung-Hui Hu
  • Sheng-Nan Lu
  • Chi-Sin Changchien
  • Chien-Hung Chen
Original Article

DOI: 10.1007/s10620-014-3194-3

Cite this article as:
Kuo, LF., Lee, CM., Hung, CH. et al. Dig Dis Sci (2014) 59: 2580. doi:10.1007/s10620-014-3194-3

Abstract

Background

A recent study showed that chronic hepatitis B virus (HBV) carriers with nucleos(t)ide analogue (NA)-induced hepatitis B antigen (HBeAg) seroconversion occurring before the age of 30 years have a higher risk of HBV reactivation.

Aim

To compare the risk of HBV reactivation and HBeAg seroreversion between patients with spontaneous and NA-induced HBeAg seroconversion.

Methods

A total of 135 and 251 non-cirrhotic patients with NA-induced and spontaneous HBeAg seroconversion, respectively, were analyzed.

Results

NA-induced HBeAg seroconverters faced higher risks of HBV reactivation and HBeAg seroreversion than spontaneous HBeAg seroconverters (P < 0.001). In spontaneous HBeAg seroconverters, age at HBeAg seroconversion, sex, HBV DNA levels before HBeAg seroconversion, HBV genotype C, and pre-S deletions were independent predictors of HBV reactivation. In NA-induced HBeAg seroconverters, only age at baseline was an independent predictor of HBV reactivation. To determine whether the difference in the incidence of HBV reactivation or HBeAg seroreversion between two groups was age-specific, we analyzed these patients according to their age at HBeAg seroconversion (20–29, 30–39, and ≥40 years). Our data showed that NA-induced HBeAg seroconversion was an independent predictor of HBV reactivation and HBeAg seroreversion than spontaneous HBeAg seroconversion in patients older than 40 years at HBeAg seroconversion, but not in patients between 20–29 and 30–39 years of age.

Conclusions

NA-induced HBeAg seroconverters are associated with higher risks of HBV reactivation and HBeAg seroreversion compared to spontaneous HBeAg seroconverters, especially in patients who are older than 40 years at HBeAg seroconversion.

Keywords

Nucleos(t)ide analogueHepatitis B virusHBeAg seroconversionHBeAg seroreversionHBV reactivation

Abbreviations

ALT

Alanine aminotransferase

AFP

Alpha-fetoprotein

BCP

Basal core promoter

CHB

Chronic hepatitis B

HBeAg

Hepatitis B e antigen

HBV

Hepatitis B virus

HCC

Hepatocellular carcinoma

NAs

Nucleos(t)ide analogues

PCR

Polymerase chain reaction

ULN

Upper limit of normal

Copyright information

© Springer Science+Business Media New York 2014

Authors and Affiliations

  • Li-Fu Kuo
    • 1
  • Chuan-Mo Lee
    • 1
  • Chao-Hung Hung
    • 1
  • Jing-Houng Wang
    • 1
  • Tsung-Hui Hu
    • 1
  • Sheng-Nan Lu
    • 1
  • Chi-Sin Changchien
    • 1
  • Chien-Hung Chen
    • 1
  1. 1.Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung and School of Medicine, College of MedicineChang Gung University, TaoyuanKaohsiungTaiwan