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https://tkuir.lib.tku.edu.tw/dspace/handle/987654321/122883
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| 题名: | Low Hepatitis B Core-Related Antigen Levels Correlate Higher Spontaneous Seroclearance of HBsAg in Chronic Hepatitis B Patients with High HBsAg Levels |
| 作者: | Tseng, Tai-Chung;Chiang, Chieh;Liu, Chun-Jen;Hong, Chun-Ming;Su, Tung-Hung;Yang, Hung-Chih;Yang, Wan-Ting;Liu, Chen-Hua;Chen, Pei-Jer;Kao, Jia-Horng |
| 关键词: | ERADICATE-B;HBV DNA;HBcrAg;HBsAg Loss |
| 日期: | 2023-01-13 |
| 上传时间: | 2023-04-28 16:22:57 (UTC+8) |
| 出版者: | Elsevier Inc. |
| 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. |
| 關聯: | Gastroenterology |
| DOI: | 10.1053/j.gastro.2023.01.005 |
| 显示于类别: | [數學學系暨研究所] 期刊論文
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