TOPLINE

In patients with chronic hepatitis B, older age, lower hepatitis B virus (HBV) DNA levels, and loss of hepatitis B e antigen (HBeAg) during follow-up were independently associated with clearance of hepatitis B surface antigen (HBsAg), which in turn was linked to better long-term liver outcomes.

METHODOLOGY

• Researchers conducted a prospective cohort study to identify baseline factors associated with HBsAg clearance and its effect on long-term liver outcomes in patients with chronic hepatitis B infection.
• They included 453 patients (286 men) at two Spanish hospitals between 1991 and 2022; mean ages were 46.2 years for men and 42.6 years for women.
• The clearance of HBsAg, defined as two consecutive negative tests at least 6 months apart, and associated factors were assessed over a mean follow-up duration of 11.34 years.
• The impact of HBsAg clearance on long-term prognosis was evaluated using a combined endpoint including portal hypertension complications, liver transplantation, liver cancer, or liver-related death.

TAKEAWAY

• During follow-up, 21.2% of patients achieved HBsAg clearance.
• Three independent factors associated with HBsAg clearance were identified: age > 40 years at first assessment (adjusted hazard ratio [aHR], 2.21), baseline HBV DNA levels < 3.3 log10 or < 2000 international units/mL (aHR, 3.44), and loss of HBeAg (among those positive at baseline) during follow-up (aHR, 7.23; P < .0001 for all).
• Patients who achieved HBsAg clearance demonstrated a significantly better long-term hepatic prognosis than those who did not clear the antigen.

IN PRACTICE

"Until more effective treatments for sterilizing the hepatitis B virus are available, the achievement of HBsAg loss represents a significant milestone in the natural history of chronic hepatitis," the authors of the study wrote.

SOURCE

The study was led by Paula Gavilán, Universidad de Málaga and Hospital Universitario Virgen de la Victoria in Málaga, Spain. It was published online on July 22 in Journal of Medical Virology.

LIMITATIONS

The authors did not explicitly mention any limitations but acknowledged the limited power of the study for certain analyses.

DISCLOSURES

No specific funding was reported for this study. The authors reported no relevant conflicts of interest.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.