Background: Spontaneous hepatitis B surface antigen (HBsAg) seroclearance is a ... Hepatitis B surface antigen disappearance and hepatitis B surface antigen ...
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By Bianca Malcolm
Candidate for the Master of Public Health Degree
Community-Based Master’s Project Oral Defense
May 8, 2006
Faculty Chair: Longjian Liu, M.D., Ph.D., MSc
Community Preceptor: Alison Evans, Sc.D.
I would like to take this opportunity to thank Alison Evans, my community preceptor, and Gang Chen of Fox Chase Cancer Center for providing me with the data for my analysis and assisting me with my analysis. I also thank Dr. Longjian Liu, my faculty advisor, of the Department of Epidemiology and Biostatistics at Drexel University School of Public Health who provided me innumerable support and guidance during my Community Based Master’s Project. Finally, I would like to thank all participants in the original study for making this secondary data analyses possible.
Background: Spontaneous hepatitis B surface antigen (HBsAg) seroclearance is a rare event in patients with chronic hepatitis B virus (HBV) infections and there is little available literature on it.
Objective: This study intended to identify determinants for HBsAg seroclearance in persons with chronic HBV using a large cohort of Chinese patients with 11 years of follow-up.
Design/Methods: This secondary data analysis used the database of a prospective cohort study of 1863 subjects who had returned 11 years after initial cohort entry (1992-93) to undergo further testing of viral markers and HBsAg-status. Of those 1863 subjects, 341 (18.30%) had apparently cleared HBsAg by 2003. Spontaneous HBsAg seroclearance was investigated in terms of its relationship to age, HBeAg-status, gender, HBV-DNA viral load, and history of clinical hepatitis.
Results: Of the 365 persons who were 50 years and older, 93 (25.47%) spontaneously cleared HBsAg. In contrast, only 248 (16.56%) of the 1498 subjects younger than 50 years of age cleared HBsAg (p<.0001). The incidence of HBsAg seroclearance was also significantly higher in persons who were HBeAg-negative compared to persons who were HBeAg-positive (21.52% vs. 13.17%; p <.0001). And HBsAg seroclearance incidence was higher in persons with a low-positive (21.37%) HBV-DNA viral load than in persons with either a negative (16.77%) or a high-positive (14.13%) viral load (p=.0009).
Conclusions: Results suggest that theage of patients, HBeAg-status, and HBV-DNA viral load are determinants for spontaneous HBsAg seroclearance. However, gender and history of clinical hepatitis did not significantly influence the occurrence of HBsAg seroclearance.
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