Higher lifetime chance of spontaneous surface antigen loss in hepatitis B carriers with genotype C infection

作者：Tseng T C; Liu C J; Chen C L; Yang W T; Yang H C; Su T H; Wang C C; Kuo S F T; Liu C H; Chen P J; Chen D S; Kao J H^*

来源：Alimentary Pharmacology and Therapeutics, 2015, 41(10): 949-960.

DOI：10.1111/apt.13170

BackgroundClearance of hepatitis B surface antigen (HBsAg) indicates clinical control of hepatitis B virus (HBV) infection. However, little is known about the impact of viral genomic variations on HBsAg loss.
MethodsWe explored the association between viral genomic factors and HBsAg loss in 2121HBeAg-negative patients. HBV pre-core stop codon (1896) and basal core promoter (BCP) (1762/1764) sequences were determined in patients with HBV DNA 200IU/mL (N=1693). The effect of HBV genotype on HBsAg loss was further validated in the whole cohort of 3445 HBsAg carriers.
ResultsThe cumulative lifetime (age 28-75years) incidence of HBsAg loss was 50.4% in 2121 HBeAg-negative patients. We found that genotype C, but not pre-core stop codon or BCP mutants, was associated with HBsAg loss. Compared to genotype B patients, genotype C patients had higher lifetime chance of HBsAg loss, with hazard ratio of 1.8 (95% confidence interval: 1.4-2.4). Multivariable analysis showed that male sex, elevated ALT levels, lower serum HBV DNA and HBsAg levels, and genotype C infection were associated with higher chance of HBsAg loss independently. We then performed sensitivity analysis, which re-included HBeAg-positive, cirrhotic and treatment-experienced patients, and confirmed the robustness of our results in 3445 HBsAg carriers.
ConclusionGenotype C infection, compared to genotype B, is associated with a higher lifetime chance of HBsAg loss in Asian HBV carriers.

• 出版日期2015-5