Incidence and prediction of HBsAg seroclearance in a prospective multi-ethnic HBeAg-negative chronic hepatitis B cohort.
Adult
Age Factors
Child
Ethnicity
/ statistics & numerical data
Female
Follow-Up Studies
Hepatitis B Antibodies
/ analysis
Hepatitis B Surface Antigens
/ analysis
Hepatitis B virus
/ genetics
Hepatitis B, Chronic
/ diagnosis
Humans
Incidence
Male
Predictive Value of Tests
Prognosis
Serologic Tests
/ methods
Sustained Virologic Response
Journal
Hepatology (Baltimore, Md.)
ISSN: 1527-3350
Titre abrégé: Hepatology
Pays: United States
ID NLM: 8302946
Informations de publication
Date de publication:
03 2022
03 2022
Historique:
revised:
20
10
2021
received:
20
06
2021
accepted:
24
10
2021
pubmed:
8
11
2021
medline:
4
3
2022
entrez:
7
11
2021
Statut:
ppublish
Résumé
Achieving HBsAg loss is an important landmark in the natural history of chronic hepatitis B (CHB). A more personalized approach to prediction of HBsAg loss is relevant in counseling patients. This study sought to develop and validate a prediction model for HBsAg loss based on quantitative HBsAg levels (qHBsAg) and other baseline characteristics. The Hepatitis B Research Network (HBRN) is a prospective cohort including 1240 untreated HBeAg-negative patients (1150 adults, 90 children) with median follow-up of 5.5 years. Incidence rates of HBsAg loss and hepatitis B surface antibody (anti-HBs) acquisition were determined, and a predictor score of HBsAg loss using readily available variables was developed and externally validated. Crude incidence rates of HBsAg loss and anti-HBs acquisition were 1.6 and 1.1 per 100 person-years (PY); 67 achieved sustained HBsAg loss for an incidence rate of 1.2 per 100 PY. Increased HBsAg loss was significantly associated with older age, non-Asian race, HBV phenotype (inactive CHB vs. others), HBV genotype A, lower HBV-DNA levels, and lower and greater change in qHBsAg. The HBRN-SQuARe (sex,∆quantHBsAg, age, race) score predicted HBsAg loss over time with area under the receiver operating characteristic curve (AUROC) (95% CIs) at 1 and 3 years of 0.99 (95% CI: 0.987-1.00) and 0.95 (95% CI 0.91-1.00), respectively. In validation in another cohort of 1253 HBeAg-negative patients with median follow-up of 3.1 years, HBRN SQuARe predicted HBsAg loss at 1 and 3 years with AUROC values of 0.99 (0.98-1.00) and 0.88 (0.77-0.99), respectively. HBsAg loss in predominantly untreated patients with HBeAg-negative CHB can be accurately predicted over a 3-year horizon using a simple validated score (HBRN SQuARe). This prognostication tool can be used to support patient care and counseling.
Sections du résumé
BACKGROUND AND AIMS
Achieving HBsAg loss is an important landmark in the natural history of chronic hepatitis B (CHB). A more personalized approach to prediction of HBsAg loss is relevant in counseling patients. This study sought to develop and validate a prediction model for HBsAg loss based on quantitative HBsAg levels (qHBsAg) and other baseline characteristics.
METHODS
The Hepatitis B Research Network (HBRN) is a prospective cohort including 1240 untreated HBeAg-negative patients (1150 adults, 90 children) with median follow-up of 5.5 years. Incidence rates of HBsAg loss and hepatitis B surface antibody (anti-HBs) acquisition were determined, and a predictor score of HBsAg loss using readily available variables was developed and externally validated.
RESULTS
Crude incidence rates of HBsAg loss and anti-HBs acquisition were 1.6 and 1.1 per 100 person-years (PY); 67 achieved sustained HBsAg loss for an incidence rate of 1.2 per 100 PY. Increased HBsAg loss was significantly associated with older age, non-Asian race, HBV phenotype (inactive CHB vs. others), HBV genotype A, lower HBV-DNA levels, and lower and greater change in qHBsAg. The HBRN-SQuARe (sex,∆quantHBsAg, age, race) score predicted HBsAg loss over time with area under the receiver operating characteristic curve (AUROC) (95% CIs) at 1 and 3 years of 0.99 (95% CI: 0.987-1.00) and 0.95 (95% CI 0.91-1.00), respectively. In validation in another cohort of 1253 HBeAg-negative patients with median follow-up of 3.1 years, HBRN SQuARe predicted HBsAg loss at 1 and 3 years with AUROC values of 0.99 (0.98-1.00) and 0.88 (0.77-0.99), respectively.
CONCLUSION
HBsAg loss in predominantly untreated patients with HBeAg-negative CHB can be accurately predicted over a 3-year horizon using a simple validated score (HBRN SQuARe). This prognostication tool can be used to support patient care and counseling.
Identifiants
pubmed: 34743343
doi: 10.1002/hep.32231
pmc: PMC8943823
mid: NIHMS1754715
doi:
Substances chimiques
Hepatitis B Antibodies
0
Hepatitis B Surface Antigens
0
Types de publication
Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
709-723Subventions
Organisme : NIAAA NIH HHS
ID : K24 AA022523
Pays : United States
Organisme : NCRR NIH HHS
ID : M01 RR000040
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082923
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000058
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082863
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082874
Pays : United States
Organisme : NCATS NIH HHS
ID : UL1 TR000004
Pays : United States
Organisme : NCRR NIH HHS
ID : UL1 RR024986
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082919
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082872
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082871
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082944
Pays : United States
Organisme : NIDDK NIH HHS
ID : U01 DK082864
Pays : United States
Informations de copyright
© 2021 American Association for the Study of Liver Diseases.
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