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© 2019 Gastroenterology & Hepatology Advanced Practice Providers

Long-Term Follow-up and Quantitative Hepatitis B Surface Antigen Monitoring in North American Chronic HBV Carriers

Abstract

INTRODUCTION: 
Quantitative hepatitis B surface antigen (qHBsAg) combined with HBV DNA may be useful for predicting chronic hepatitis B (CHB) activity and nucleoside analogue (NA) response.
MATERIAL AND METHODS: 
In this retrospective cohort study we evaluated qHBsAg levels according to CHB disease phase and among patients on treatment. Random effect logistic regression analysis was used to analyze qHBsAg change with time in the NA-treated cohort.
RESULTS: 
545 CHB carriers [56% M, median age 48 y (IQR 38-59), 73% Asian] had qHBsAg testing. In the untreated group (44%), 8% were classified as immune tolerant, 10% immune clearance, 40% inactive, and 43% had HBeAg- CHB and the median HBsAg levels were 4.6 (IQR 3.4-4.9), 4.0 (IQR 3.4-4.5), 2.9 (IQR 1.4-3.8), and 3.2 log IU/mL (IQR 2.6-4.0), respectively; p < 0.001. In the NA-treated group (28% entecavir, 68% tenofovir, 4% lamivudine), no significant change in qHBsAg levels occured with time. However, 19% of patients on long-term NA had sustained qHBsAg < 2 log10 IU/mL.
CONCLUSION: 
qHBsAg titers were associated with CHB phase and remained stable in those on long-term NA. A significant number of treated patients had low-level qHBsAg, of which some may be eligible for treatment discontinuation without risk of flare.

Authors

O'Neil CR1, Congly SE2, Rose MS3, Lee SS2, Borman MA2, Charlton CL4, Osiowy C5, Swain MG2, Burak KW2, Coffin CS6. Ann Hepatol. 2018 Mar - Apr;17(2):232-241. doi: 10.5604/01.3001.0010.8640.

Author Information

1.  Division of Infectious Disease, Faculty of Medicine & Dentistry, University of Alberta, Edmonton, Alberta, Canada; Department of Internal Medicine, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

2.  Calgary Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada.

3.  Research Facilitation, Alberta Health Services, Calgary, Alberta, Canada.

4.  Department of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, Canada, Provincial Laboratory for Public Health, Edmonton, Alberta, Canada.

5.  National Microbiology Laboratory, Winnipeg, Manitoba, Canada.

6.  Calgary Liver Unit, Division of Gastroenterology and Hepatology, University of Calgary Cumming School of Medicine, Calgary, Alberta, Canada; Department of Microbiology, Immunology and Infectious Diseases, University of Calgary Cumming School of Medicine, Calgary, Canada. Electronic address: cscoffin@ucalgary.ca.