scholarly journals Incidence and predictors of hepatitis B surface antigen clearance in HIV patients: a retrospective multi-site study

2021 ◽  
Author(s):  
Mamta K Jain ◽  
Karen J Vigil ◽  
Paul Parisot ◽  
Gabriella Go ◽  
Trung Vu ◽  
...  
Keyword(s):  
Drug Use ◽  
Hepatitis B ◽  
Injection Drug Use ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Injection Drug ◽  
People Living With Hiv ◽  
Hiv Patients ◽  
Hbsag Loss ◽  
Hbsag Clearance

Abstract Background New therapies to achieve hepatitis B surface antigen (HBsAg) clearance are under development. However, gaps in knowledge exist in understanding the incidence and predictors of HBsAg clearance in a racially diverse HIV population. Methods We examined the incidence and risk of HBsAg clearance in a retrospective cohort of people living with HIV/HBV. Included patients had sufficient data to establish chronic infection based on CDC guidelines. We examined the incident rate for HBsAg loss and hazard rate ratios to evaluate predictors for HBsAg clearance in a multivariable model. Results Among the 571 HIV/HBV, 87% were male, 61% Black, 45% had AIDS, 48% HBeAg-positive, and median follow-up was 88 months. Incident HBsAg clearance was 1.5 per 100 person-years. In multivariate model, AIDS at baseline [adjusted hazard ratio [(aHR) 2.43, 95% CI:1.37,4.32 ], Hispanics (aHR 3.57, 95% CI: 1.33, 9.58), and those with injection drug use as an HIV risk factor (aHR, 3.35, 95% CI: 1.26, 8.89) were more likely to lose HBsAg whereas those who were HBeAg-positive (aHR 0.34, 0.19, 0.63) were less likely to lose HBsAg. Median change in CD4 cell count during the observation period was 231 cells/mm 3 in those with HBsAg loss vs. 112 cells/mm 3 in those with HBsAg persistence (p=0.004). Conclusion HBsAg loss occurs in about 10% of those with chronic HBV-infection. Hispanics, AIDS at baseline, injection drug use history, and HBeAg-negative status at baseline predicted the likelihood of HBsAg loss. Immune restoration may be a mechanism through which HBsAg loss occurs in HIV patients.

scholarly journals Time to seroconversion of HBsAg to anti-HBs in individuals who lost HBsAg during follow-up

2016 ◽  
Vol 144 (12) ◽  
pp. 2648-2653 ◽  
Author(s):  
M. R. H. ROUSHAN ◽  
M. MOHAMMADPOUR ◽  
M. BAIANY ◽  
S. SOLEIMANI ◽  
A. BIJANI
Keyword(s):  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Liver Function Tests ◽  
Hbsag Clearance ◽  
Positive Antibody ◽  
B Virus ◽  
The Mean ◽  
Cumulative Probabilities

SUMMARYTo determine the time to appearance of antibody against hepatitis B surface antigen (anti-HBs) after clearance of hepatitis B surface antigen (HBsAg) in chronically infected individuals, we followed up 3963 cases with positive antibody against hepatitis B e antigen (anti-HBe) from 1991 to 2014. Of these, 101 (67 males, 34 females) lost HBsAg. These serocleared cases were checked every 6-month interval regarding HBsAg, anti-HBs, liver function tests, and liver sonography. Hepatitis B virus DNA was assessed at the time of seroclearance or the appearance of anti-HBs. The mean age of these patients at entry to this study was 34·4 ± 13 years. The mean follow-up duration until seroclearance of HBsAg was 6·6 ± 4·3 years. After the mean follow-up of 43·7 ± 45 months, anti-HBs appeared in 64 (63·4%) cases. The cumulative probabilities of anti-HBs appearance for 2, 5 and 10 years were 24·3%, 58% and 78·2%, respectively. The appearance of anti-HBs was associated with age ⩾35 years and seroclearance of HBsAg (hazard ratio 1·96, 95% confidence interval 1·32–3·38,P= 0·016) but not with sex. The results show that anti-HBs may develop in 78·2% of cases within 10 years of HBsAg clearance. Age ⩾35 years at HBsAg loss was associated with earlier development of anti-HBs.

scholarly journals Usefulness of a Hepatitis B Surface Antigen-Based Model for the Prediction of Functional Cure in Patients with Chronic Hepatitis B Virus Infection Treated with Nucleos(t)ide Analogues: A Real-World Study

2021 ◽  
Vol 10 (15) ◽  
pp. 3308
Author(s):  
Gian Paolo Caviglia ◽  
Yulia Troshina ◽  
Enrico Garro ◽  
Marcantonio Gesualdo ◽  
Serena Aneli ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Functional Cure ◽  
Hbsag Loss ◽  
Chronic Hepatitis B Virus ◽  
Long Term Treatment ◽  
Hbsag Seroclearance

In patients with chronic hepatitis B (CHB) under long-term treatment with nucleso(t)ide analogues (NAs), the loss of hepatitis B surface antigen (HBsAg) is a rare event. A growing body of evidence supports the use of quantitative HBsAg for the prediction of functional cure, although these results are mainly derived from studies performed on Asian patients with hepatitis B e antigen (HBeAg)-positive CHB. Here, we investigated the clinical role of quantitative HBsAg in a real-life cohort of CHB patients under treatment with NAs in a tertiary care center from North-West Italy. A total of 101 CHB patients (HBeAg-negative, n = 86) undergoing NAs treatment were retrospectively enrolled. HBsAg was measured at baseline (T0), 6 months (T1), 12 months (T2) and at the last follow-up (FU). Median FU was 5.5 (3.2–8.3) years; at the end of FU, 11 patients lost the HBsAg (annual incidence rate = 1.8%). Baseline HBsAg levels were significantly different between patients with no HBsAg loss and those achieving a functional cure (3.46, 2.91–3.97 vs. 1.11, 0.45–1.98 Log IU/mL, p < 0.001). Similarly, the HBsAg decline (Δ) from T0 to T2 was significantly different between the two groups of patients (0.05, −0.04–0.13, vs. 0.38, 0.11–0.80 Log IU/mL, p = 0.002). By stratified cross-validation analysis, the combination of baseline HBsAg and ΔHBsAg T0–T2 showed an excellent accuracy for the prediction of HBsAg loss (C statistic = 0.966). These results corroborate the usefulness of quantitative HBsAg in Caucasian CHB patients treated with antivirals for the prediction of HBsAg seroclearance.

Highly significant differences in HBsAg kinetics among patients with two types of hepatitis B flare, with and without retreatment

2021 ◽  
Author(s):  
Wen-Juei Jeng ◽  
Yen-Chun Liu ◽  
Chien-Wei Peng ◽  
Rong-Nan Chien ◽  
Yun-Fan Liaw
Keyword(s):  
Hepatitis B ◽  
Surface Antigen ◽  
Loss Rate ◽  
Hepatitis B Surface Antigen ◽  
Rapid Decline ◽  
Hepatitis B E Antigen ◽  
Hbsag Level ◽  
Hbsag Loss ◽  
Hepatitis Flare

Abstract Background Off-therapy hepatitis flare may be detrimental or, conversely, facilitate hepatitis B surface antigen (HBsAg) decline. Retreatment decisions are crucial. Methods HBsAg was quantified before and during flares, at peak/retreatment start and at Months 6 and 12 in 336 entecavir/tenofovir-retreated and 105 non-retreated hepatitis B e antigen (HBeAg)-negative patients. Increasing HBsAg during ALT flare defined a ‘virus-dominating flare’ and decreasing HBsAg a ‘host-dominating flare’. Results Two hundred and eighty-eight retreated patients with a virus-dominating flare showed greater 1 year HBsAg decline (−1.0 versus −0.01 log10 IU/mL; P &lt; 0.0001), more frequent rapid decline (69.8% versus 8.3%; P &lt; 0001) and higher 3 year incidence of HBsAg &lt; 100 IU/mL (32% versus 12%; P = 0.026) than 48 patients with a host-dominating flare, of whom 16 (33.3%) showed 3.8-fold (2 to 52-fold) HBsAg rebound on retreatment (versus 2/288; P &lt; 0.0001). Compared with non-retreated controls, 1 year HBsAg decline was greater (−1.0 versus −0.47 log10 IU/mL; P &lt; 0.0001) and faster (69.8% versus 42.5%; P &lt; 0.0001) in patients with a virus-dominating flare, whereas 1 year HBsAg decline (−0.01 versus −0.16 log10 IU/mL) and 3 year HBsAg loss rate (0% versus 21%; P = 0.009) were lower in patients with a host-dominating flare. Conclusions Entecavir/tenofovir retreatment effectively decreases HBsAg level in patients with a virus-dominating flare but is ineffective/worse in patients with a host-dominating flare. These results support the use of combined HBsAg/ALT kinetics for the decision to retreat patients with a virus-dominating flare and withhold retreatment for patients with a host-dominating flare.

scholarly journals Association of Human Leukocyte Antigen Class I Polymorphism with Spontaneous Clearance of Hepatitis B Surface Antigen in Qidong Han Population

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Fengqin Miao ◽  
Hang Sun ◽  
Ning Pan ◽  
Jinhuan Xu ◽  
Jie Qiu ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Human Leukocyte ◽  
Hla Class I ◽  
Hbv Infection ◽  
Class I ◽  
Spontaneous Clearance ◽  
Han Population ◽  
Hbsag Clearance

Aim. To investigate whether HLA class I polymorphisms could influence the clearance of hepatitis B surface antigen (HBsAg) in Qidong Han population.Methods. We genotyped HLA-A, -B, and -C loci of 448 individuals with HBV persistent infection and 140 persons with spontaneous clearance of HBsAg by polymerase chain reaction with sequencing based typing (PCR/SBT). All the individuals were unrelated males enrolled from Qidong Han population and were followed up for 10 years.Results. The frequency ofHLA-A*33:03:01Gwas increased in persistent HBV infection group (Pvalue is 0.028), while frequency ofHLA-B*13:01:01Gwas increased in HBsAg clearance group (Pvalue is 0.0004).Conclusion. These findings suggested that the host HLA class I polymorphism is an important factor in determining the outcomes of HBV infection.

Baseline hepatitis B surface antigen (HBsAg) as predictor of sustained HBsAg loss in chronic hepatitis B patients treated with peginterferon alfa-2a and adefovir

2013 ◽  
Vol 18 (7) ◽  
pp. 895-904 ◽  
Author(s):  
R Bart Takkenberg ◽  
Louis Jansen ◽  
Annikki de Niet ◽  
Hans L Zaaijer ◽  
Christine J Weegink ◽  
...  
Keyword(s):  
Chronic Hepatitis ◽  
Hepatitis B ◽  
Chronic Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
Hbsag Loss ◽  
Peginterferon Alfa

Incidence and predictors of hepatitis B surface antigen clearance among people living with HIV and hepatitis B

2020 ◽  
Vol 73 ◽  
pp. S591
Author(s):  
Mamta Jain ◽  
Karen Vigil ◽  
Xilong Li ◽  
Paul Parisot ◽  
Gabriella Go ◽  
...  
Keyword(s):  
Hepatitis B ◽  
Surface Antigen ◽  
Hepatitis B Surface Antigen ◽  
People Living With Hiv ◽  
Living With Hiv
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