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Spontaneous Seroclearance Is Associated with Lower Liver Fibrosis in Treatment-Naïve Chronic Hepatitis B Patients

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Abstract

Background

Chronic hepatitis B virus (HBV) is a major public health concern. Transient elastrography (TE) is a reliable method in assessing hepatic fibrosis in patients with liver disease. We assess the potential clinical associations between HBsAg seroclearance and the severity of liver fibrosis.

Methods

We retrospectively performed a matched analysis of 23 consecutive HBsAg seroclearance patients who underwent TE between March 2008 and August 2021 from a community practice at a 1:3 ratio based on clinic visit date. Baseline laboratory and clinical data were collected. Fisher’s exact test and Chi-square test for proportions, and Wilcoxon rank-sum test for median were performed.

Results

Twenty-three cases and 69 controls were identified. Median follow up (interquartile range) for the cases and controls was 24,314 (1402) and 2332 (1587) days (p  =  0.15), respectively. All patients were Asian. Median age of cases was higher than controls (64 vs 52, p < 0.01, respectively). While most comorbidities were similar, diabetes and hyperlipidemia were more prevalent in cases. Baseline HBV DNA was detectable in 78% of cases and 97% of controls (p < 0.01). More cases had baseline HBsAg titers below 1000 IU/mL than controls (81% vs 8.7%, p < 0.01). Other baseline laboratory values were similar. Few cases had a fibrosis score greater than 1, while control had over a quarter of patients with a fibrosis score of 2 or 3.

Conclusion

Spontaneous HBsAg seroclearance remains rare in patients with chronic HBV infection. It is associated with low baseline HBsAg, and lower level of liver fibrosis as detected by TE.

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Authors and Affiliations

  1. Departments of Medicine, University of California at Los Angeles, Los Angeles, CA, USA

    Sammy Saab

  2. Departments of Surgery, University of California at Los Angeles, Los Angeles, CA, USA

    Sammy Saab, Nguyen Pham, William Wu, Long Dang, An Dang, Jung Yum & Kisub Shim

  3. Private Practice, Hacienda Heights, CA, 91745, USA

    William Wu & Steven Wu

Authors
  1. Sammy Saab
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  2. Nguyen Pham
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  3. William Wu
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  4. Long Dang
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  5. An Dang
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Contributions

Study concept and design (SS, SW); acquisition of data (WW); analysis and interpretation of data (all); drafting of the manuscript (SS, NP, LD, AD); critical revision of the manuscript for important intellectual content (SS, NP, SW); statistical analysis (SK); obtained funding (not applicable); administrative, technical, or material support (SS, JY); study supervision (SS, SW, JY).

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Correspondence to Sammy Saab.

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Saab, S., Pham, N., Wu, W. et al. Spontaneous Seroclearance Is Associated with Lower Liver Fibrosis in Treatment-Naïve Chronic Hepatitis B Patients. Dig Dis Sci 67, 5309–5314 (2022). https://doi.org/10.1007/s10620-022-07402-1

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  • DOI: https://doi.org/10.1007/s10620-022-07402-1

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