Department of Medicine and Clinical Oncology, Graduate School of Medicine, Chiba University, Chiba, Japan.
Eur J Gastroenterol Hepatol. 2012 Apr;24(4):414-8. doi: 10.1097/MEG.0b013e328350594d.
The clinical outcomes of hepatitis B virus (HBV) carriers are favorable following hepatitis B surface antigen (HBsAg) seroclearance. The aim of this study was to investigate the clinical course of spontaneous HBsAg seroclearance and the factors predicting it.
A total of 423 patients who tested positive for HBsAg and were referred to Chiba University Hospital between January 1985 and April 2008 were included in the study and the following characteristics were analyzed: age, sex, status of hepatitis B e antigen, alanine aminotransferase level, HBV DNA level, number of platelets, HBV genotype, past treatment with interferon, and HBsAg level. When a nucleotide analog was used for treatment, we stopped follow-up. Measurement of HBsAg was performed using the chemiluminescent enzyme immunoassay method and less than 0.03 IU/ml of HBsAg was designated as HBsAg seroclearance.
The study group included 239 men and 184 women and their average age was 40.5 ± 13.8 years. Twenty-five patients achieved HBsAg seroclearance during the follow-up period with an incidence rate of 0.97% per year. Multivariate analysis revealed that HBsAg titer (compared with patients with a low HBsAg level: odds ratio=0.45, 95% confidence interval: 0.29-0.70) at baseline was the only predictive factor for HBsAg seroclearance.
HBsAg seroclearance occurred at a frequency of 0.97% per year without the use of a nucleotide analog. HBsAg titer at baseline was the only predictive factor for HBsAg seroclearance.
乙肝表面抗原（HBsAg）清除后，乙肝病毒（HBV）携带者的临床结局良好。本研究旨在探讨 HBsAg 自发性清除的临床过程及其预测因素。
本研究纳入了 1985 年 1 月至 2008 年 4 月期间在千叶大学医院就诊的 423 例 HBsAg 阳性患者，并分析了以下特征：年龄、性别、乙型肝炎 e 抗原状态、丙氨酸氨基转移酶水平、HBV DNA 水平、血小板计数、HBV 基因型、既往干扰素治疗情况和 HBsAg 水平。当使用核苷酸类似物进行治疗时，我们停止随访。HBsAg 检测采用化学发光酶免疫分析法，HBsAg<0.03IU/ml 定义为 HBsAg 清除。
研究组包括 239 名男性和 184 名女性，平均年龄为 40.5±13.8 岁。25 例患者在随访期间实现了 HBsAg 清除，年发生率为 0.97%。多因素分析显示，HBsAg 滴度（与低 HBsAg 水平患者相比：比值比=0.45，95%置信区间：0.29-0.70）是 HBsAg 清除的唯一预测因素。
未使用核苷酸类似物时，HBsAg 清除的年发生率为 0.97%。HBsAg 滴度是 HBsAg 清除的唯一预测因素。
