Low Hepatitis B Core-Related Antigen Levels Correlate Higher Spontaneous Seroclearance of HBsAg in Chronic Hepatitis B Patients with High HBsAg Levels
學年 111
學期 1
出版（發表）日期 2023-01-13
作品名稱 Low Hepatitis B Core-Related Antigen Levels Correlate Higher Spontaneous Seroclearance of HBsAg in Chronic Hepatitis B Patients with High HBsAg Levels
作品名稱（其他語言）
著者 Tai-Chung Tseng; Chieh Chiang; Chun-Jen Liu; Chun-Ming Hong; Tung-Hung Su; Hung-Chih Yang; Wan-Ting Yang; Chen-Hua Liu; Pei-Jer Chen; Jia-Horng Kao
單位
出版者
著錄名稱、卷期、頁數 Gastroenterology 164(4), pp.669-679
摘要 Background & aims: Seroclearance of hepatitis B surface antigen (HBsAg) indicates functional cure for hepatitis B virus (HBV) infection. Low HBsAg levels can predict HBsAg seroclearance over time. However, little is known about the association between hepatitis B core-related antigen (HBcrAg) levels and spontaneous seroclearance of HBsAg. Methods: We conducted a retrospective cohort study including 2614 treatment-naïve patients with chronic HBV infection who received long-term follow-up at the National Taiwan University Hospital. The primary end point was spontaneous HBsAg seroclearance. We aimed to explore whether HBcrAg levels could predict HBsAg seroclearance, especially for patients with HBsAg levels >1000 IU/mL. Results: There were 465 patients who cleared HBsAg with 32,414.72 person-years of follow-up, with a mean clearance rate of 1.43% per year. We found that lower HBcrAg levels at baseline were associated with an increased likelihood of HBsAg seroclearance (log rank P < .001). When restricting the study population to 1539 patients with HBsAg levels >1000 IU/mL, only HBcrAg <10,000 U/mL (vs ≥100,000 U/mL) served as an independent viral predictor for HBsAg seroclearance, with adjusted hazard ratio of 1.95 (95% CI, 1.16-3.27). In contrast to the late decline of HBsAg levels (5-9 years before HBsAg seroclearance), HBcrAg levels became undetectable 10-14 years before HBsAg seroclearance. This finding was confirmed by the different annual HBsAg seroclearance rates in the first and second decades of follow-up (0.97% vs 3.75%; P < .001) in patients achieving undetectable HBcrAg levels. Conclusions: Lower serum HBcrAg levels were associated with increased probability of HBsAg seroclearance over time. In patients with HBsAg levels >1000 IU/mL, clearing HBcrAg may serve as an early biomarker for HBsAg seroclearance.
關鍵字 ERADICATE-B;HBV DNA;HBcrAg; HBsAg Loss
語言 en
ISSN
期刊性質 國外
收錄於 SCI
產學合作
通訊作者
審稿制度 否
國別 NLD
公開徵稿
出版型式 ,電子版
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機構典藏連結 ( http://tkuir.lib.tku.edu.tw:8080/dspace/handle/987654321/122883 )