Yu-Chun Chiu1, Shu-Fen Liao2, Jia-Feng Wu3, Chun-Yin Lin4, Wen-Chung Lee2, Huey-Ling Chen5, Yen-Hsuan Ni6, Hong-Yuan Hsu3, Mei-Hwei Chang7. 1. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Medical Education, National Taiwan University Hospital, Taipei, Taiwan. 2. Research Center for Genes, Environment, and Human Health, and Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan. 3. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan. 4. Department of Laboratory Medicine, National Taiwan University Hospital, Taipei, Taiwan. 5. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. 6. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Genetics, National Taiwan University Hospital, Taipei, Taiwan. 7. Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Hepatitis Research Center, National Taiwan University Hospital, Taipei, Taiwan. Electronic address: changmh@ntu.edu.tw.
Abstract
OBJECTIVE: To investigate the factors predicting spontaneous clearance of hepatitis B surface antigen (HBsAg) in a long-term, prospectively followed cohort from childhood into adult life. STUDY DESIGN: Children with chronic hepatitis B virus (HBV) infection without treatment were followed longitudinally every 6 months. At each visit, liver profiles and HBV markers were assessed. Hepatitis B vaccination history and the maternal HBV markers also were studied. RESULTS: A total of 349 children (205 male) were followed for 20.6 ± 4.4 years with initial ages of 8.4 ± 3.9 years; 42 (12.0%) cleared HBsAg spontaneously. The HBsAg titers decayed with age, with an average annual clearance rate of 0.58%. Children had a lower annual HBsAg decay rate if their mothers are HBsAg carriers (P < .001). Hepatitis B e antigen-seroconversion is a favorable predictor for spontaneous HBsAg clearance (P = .04). Those with HBsAg titer ≤1000 IU/mL at enrollment during childhood have a higher rate of HBsAg clearance (hazard ratio = 5.23; P < .001). Using HBsAg titer ≤1000 IU/mL to predict HBsAg clearance, the sensitivity is 38.1%, specificity is 90.6%, positive predictive value is 35.6%, and negative predictive value is 91.4%. CONCLUSIONS: During long-term follow-up, spontaneous HBsAg clearance is most likely to occur in a patient born to a non-HBsAg-carrier mother, is a hepatitis B e antigen-seroconverter, and had an initial HBsAg level ≤1000 IU/mL.
OBJECTIVE: To investigate the factors predicting spontaneous clearance of hepatitis B surface antigen (HBsAg) in a long-term, prospectively followed cohort from childhood into adult life. STUDY DESIGN:Children with chronic hepatitis B virus (HBV) infection without treatment were followed longitudinally every 6 months. At each visit, liver profiles and HBV markers were assessed. Hepatitis B vaccination history and the maternal HBV markers also were studied. RESULTS: A total of 349 children (205 male) were followed for 20.6 ± 4.4 years with initial ages of 8.4 ± 3.9 years; 42 (12.0%) cleared HBsAg spontaneously. The HBsAg titers decayed with age, with an average annual clearance rate of 0.58%. Children had a lower annual HBsAg decay rate if their mothers are HBsAg carriers (P < .001). Hepatitis B e antigen-seroconversion is a favorable predictor for spontaneous HBsAg clearance (P = .04). Those with HBsAg titer ≤1000 IU/mL at enrollment during childhood have a higher rate of HBsAg clearance (hazard ratio = 5.23; P < .001). Using HBsAg titer ≤1000 IU/mL to predict HBsAg clearance, the sensitivity is 38.1%, specificity is 90.6%, positive predictive value is 35.6%, and negative predictive value is 91.4%. CONCLUSIONS: During long-term follow-up, spontaneous HBsAg clearance is most likely to occur in a patient born to a non-HBsAg-carrier mother, is a hepatitis B e antigen-seroconverter, and had an initial HBsAg level ≤1000 IU/mL.
Authors: Carla S Coffin; Scott K Fung; Fernando Alvarez; Curtis L Cooper; Karen E Doucette; Claire Fournier; Erin Kelly; Hin Hin Ko; Mang M Ma; Steven R Martin; Carla Osiowy; Alnoor Ramji; Edward Tam; Jean Pierre Villeneuve Journal: Can Liver J Date: 2018-12-25
Authors: Kathleen B Schwarz; Yona Keich Cloonan; Simon C Ling; Karen F Murray; Norberto Rodriguez-Baez; Sarah Jane Schwarzenberg; Jeffrey Teckman; Lilia Ganova-Raeva; Philip Rosenthal Journal: J Pediatr Date: 2015-09-10 Impact factor: 4.406
Authors: Simon C Ling; Hsing-Hua S Lin; Karen F Murray; Philip Rosenthal; Douglas Mogul; Norberto Rodriguez-Baez; Sarah Jane Schwarzenberg; Jeffrey Teckman; Kathleen B Schwarz Journal: J Pediatr Date: 2021-05-20 Impact factor: 6.314