Hepatitis B surface antigen disappearance and hepatitis B surface antigen subtype

A prospective, long-term, follow-up study of Japanese residents of Okinawa, Japan with chronic hepatitis B virus infection

Norihiro Furusyo, Jun Hayashi, Yasunori Sawayama, Yasuhiro Kishihara, Seizaburo Kashiwagi

Research output: Contribution to journalArticle

30 Citations (Scopus)

Abstract

To determine the natural course of hepatitis B surface antigen (HBsAg) disappearance in chronic hepatitis B virus (HBV) infection and the factors related to its disappearance, 946 HBsAg carriers in Okinawa, Japan were prospectively followed for up to 19 years (mean = 9.2 years). The disappearance of HBsAg, as determined by radioimmunoassay (RIA), was observed in 62 (6.6%) and the overall annual disappearance rate was 0.79%/year. Its disappearance was more frequent in 60 (7.4%) of 815 serum samples negative for hepatitis B e antigen (HBeAg) by RIA at entry compared with only two (1.5%) of 131 serum samples that were HBeAg positive by RIA at entry (P < 0.05). Stepwise logistic regression analysis showed that age and HBsAg subtype were significantly associated with HBsAg disappearance (both P < 0.05), and that carriers with subtype adr (odds ratio = 2.87) had an increased probability of clearing HBsAg compared with carriers with subtype adw. Conversely, HBeAg disappearance was earlier in those with the adw subtype than in those with adr. Hepatitis B virus DNA was not detected by the polymerase chain reaction after HBsAg disappearance in any of the 62 from whom it had disappeared. The HBsAg titer, as measured by reverse passive hemagglutination, was related to the time to its disappearance; the higher the titer, the longer the time to disappearance. These findings suggest that HBeAg negativity, a more advanced age, and low titers of HBsAg are favorable factors for HBsAg disappearance in the natural course of chronic HBV infection. Moreover, HBsAg subtype adr was a predictive factor for HBsAg disappearance, whereas subtype adw was predictive of early HBeAg disappearance.

Original languageEnglish
Pages (from-to)616-622
Number of pages7
JournalAmerican Journal of Tropical Medicine and Hygiene
Volume60
Issue number4
DOIs
Publication statusPublished - Jan 1 1999

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Chronic Hepatitis B
Virus Diseases
Hepatitis B Surface Antigens
Hepatitis B virus
Japan
Hepatitis B e Antigens
Radioimmunoassay
Hemagglutination
Serum
Logistic Models
Odds Ratio
Regression Analysis

All Science Journal Classification (ASJC) codes

  • Parasitology
  • Infectious Diseases
  • Virology

Cite this

Hepatitis B surface antigen disappearance and hepatitis B surface antigen subtype : A prospective, long-term, follow-up study of Japanese residents of Okinawa, Japan with chronic hepatitis B virus infection. / Furusyo, Norihiro; Hayashi, Jun; Sawayama, Yasunori; Kishihara, Yasuhiro; Kashiwagi, Seizaburo.

In: American Journal of Tropical Medicine and Hygiene, Vol. 60, No. 4, 01.01.1999, p. 616-622.

Research output: Contribution to journalArticle

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abstract = "To determine the natural course of hepatitis B surface antigen (HBsAg) disappearance in chronic hepatitis B virus (HBV) infection and the factors related to its disappearance, 946 HBsAg carriers in Okinawa, Japan were prospectively followed for up to 19 years (mean = 9.2 years). The disappearance of HBsAg, as determined by radioimmunoassay (RIA), was observed in 62 (6.6{\%}) and the overall annual disappearance rate was 0.79{\%}/year. Its disappearance was more frequent in 60 (7.4{\%}) of 815 serum samples negative for hepatitis B e antigen (HBeAg) by RIA at entry compared with only two (1.5{\%}) of 131 serum samples that were HBeAg positive by RIA at entry (P < 0.05). Stepwise logistic regression analysis showed that age and HBsAg subtype were significantly associated with HBsAg disappearance (both P < 0.05), and that carriers with subtype adr (odds ratio = 2.87) had an increased probability of clearing HBsAg compared with carriers with subtype adw. Conversely, HBeAg disappearance was earlier in those with the adw subtype than in those with adr. Hepatitis B virus DNA was not detected by the polymerase chain reaction after HBsAg disappearance in any of the 62 from whom it had disappeared. The HBsAg titer, as measured by reverse passive hemagglutination, was related to the time to its disappearance; the higher the titer, the longer the time to disappearance. These findings suggest that HBeAg negativity, a more advanced age, and low titers of HBsAg are favorable factors for HBsAg disappearance in the natural course of chronic HBV infection. Moreover, HBsAg subtype adr was a predictive factor for HBsAg disappearance, whereas subtype adw was predictive of early HBeAg disappearance.",
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