Publication:
Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis

Issued Date

2019-02-01

Resource Type

Article

ISSN

15280012
00165085

DOI

10.1053/j.gastro.2018.10.027

Other identifier(s)

2-s2.0-85060987197

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

Gastroenterology. Vol.156, No.3 (2019), 635-646.e9

Suggested Citation

Yee Hui Yeo, Hsiu J. Ho, Hwai I. Yang, Tai Chung Tseng, Tetsuya Hosaka, Huy N. Trinh, Min Sun Kwak, Young Min Park, James Yan Yue Fung, Maria Buti, Manuel Rodríguez, Sombat Treeprasertsuk, Carmen Monica Preda, Teerapat Ungtrakul, Phunchai Charatcharoenwitthaya, Xiangyong Li, Jiayi Li, Jian Zhang, Michael Huan Le, Bin Wei, Biyao Zou, An Le, Donghak Jeong, Nicholas Chien, Leslie Kam, Chiao Chin Lee, Mar Riveiro-Barciela, Doina Istratescu, Tassanee Sriprayoon, Yutian Chong, Tawesak Tanwandee, Mariko Kobayashi, Fumitaka Suzuki, Man Fung Yuen, Hyo Suk Lee, Jia Horng Kao, Anna S. Lok, Chun Ying Wu, Mindie H. Nguyen Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis. Gastroenterology. Vol.156, No.3 (2019), 635-646.e9. doi:10.1053/j.gastro.2018.10.027 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/51942

Research Projects

Organizational Units

Authors

Journal Issue

Thesis

Title

Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis

Author(s)

Yee Hui Yeo
 Hsiu J. Ho
 Hwai I. Yang
 Tai Chung Tseng
 Tetsuya Hosaka
 Huy N. Trinh
 Min Sun Kwak
 Young Min Park
 James Yan Yue Fung
 Maria Buti
 Manuel Rodríguez
 Sombat Treeprasertsuk
 Carmen Monica Preda
 Teerapat Ungtrakul
 Phunchai Charatcharoenwitthaya
 Xiangyong Li
 Jiayi Li
 Jian Zhang
 Michael Huan Le
 Bin Wei
 Biyao Zou
 An Le
 Donghak Jeong
 Nicholas Chien
 Leslie Kam
 Chiao Chin Lee
 Mar Riveiro-Barciela
 Doina Istratescu
 Tassanee Sriprayoon
 Yutian Chong
 Tawesak Tanwandee
 Mariko Kobayashi
 Fumitaka Suzuki
 Man Fung Yuen
 Hyo Suk Lee
 Jia Horng Kao
 Anna S. Lok
 Chun Ying Wu
 Mindie H. Nguyen

Other Contributor(s)

Academia Sinica, Genomics Research Center
 Daejin Medical Center
 Centro de Investigación Biomédica en Red de Enfermedades Hepáticas y Digestivas
 National Taiwan University Hospital
 Palo Alto Medical Foundation
 Chulalongkorn University
 University of Michigan, Ann Arbor
 National Taiwan University College of Medicine
 University of California, San Francisco
 Sun Yat-Sen University
 Seoul National University Hospital
 Hospital Universitario Central de Asturias
 Toranomon Hospital
 Stanford University Medical Center
 Veterans General Hospital-Taipei
 Institutul Clinic Fundeni
 Hospital Universitari Vall d'Hebron
 Kaohsiung Medical University
 Triservice General Hospital Taiwan
 Faculty of Medicine, Siriraj Hospital, Mahidol University
 China Medical University Taichung
 The University of Hong Kong
 Chulabhorn Royal Academy
 Chinese Hospital
 San Jose Gastroenterology

Abstract

© 2019 AGA Institute Background & Aims: Seroclearance of hepatitis B surface antigen (HBsAg) is a marker for clearance of chronic hepatitis B virus (HBV) infection, but reported annual incidence rates of HBsAg seroclearance vary. We performed a systematic review and meta-analysis to provide more precise estimates of HBsAg seroclearance rates among subgroups and populations. Methods: We searched PubMed, Embase, and the Cochrane library for cohort studies that reported HBsAg seroclearance in adults with chronic HBV infection with more than 1 year of follow-up and at least 1 repeat test for HBsAg. Annual and 5-, 10-, and 15-year cumulative incidence rates were pooled using a random effects model. Results: We analyzed 34 published studies (with 42,588 patients, 303,754 person-years of follow-up, and 3194 HBsAg seroclearance events), including additional and updated aggregated data from 19 studies. The pooled annual rate of HBsAg seroclearance was 1.02% (95% CI, 0.79–1.27). Cumulative incidence rates were 4.03% at 5 years (95% CI, 2.49–5.93), 8.16% at 10 years (95% CI, 5.24–11.72), and 17.99% at 15 years (95% CI, 6.18–23.24). There were no significant differences between the sexes. A higher proportion of patients who tested negative for HBeAg at baseline had seroclearance (1.33%; 95% CI, 0.76–2.05) than those who tested positive for HBeAg (0.40%; 95% CI, 0.25–0.59) (P <.01). Having HBsAg seroclearance was also associated with a lower baseline HBV DNA level (6.61 log 10 IU/mL; 95% CI, 5.94–7.27) vs not having HBsAg seroclearance (7.71 log 10 IU/mL; 95% CI, 7.41–8.02) (P <.01) and with a lower level of HBsAg at baseline (2.74 log 10 IU/mL; 95% CI, 1.88–3.60) vs not having HBsAg seroclearance (3.90 log 10 IU/mL, 95% CI, 3.73–4.06) (P <.01). HBsAg seroclearance was not associated with HBV genotype or treatment history. Heterogeneity was substantial across the studies (I 2 = 97.49%). Conclusion: In a systematic review and meta-analysis, we found a low rate of HBsAg seroclearance in untreated and treated patients (pooled annual rate, approximately 1%). Seroclearance occurred mainly in patients with less active disease. Patients with chronic HBV infection should therefore be counseled on the need for lifelong treatment, and curative therapies are needed.

Keyword(s)

Medicine

Availability

URI

https://repository.li.mahidol.ac.th/handle/20.500.14594/51942

Collections

Scopus 2019