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Published in: Journal of Gastroenterology 9/2012

01-09-2012 | Original Article—Liver, Pancreas, and Biliary Tract

Changes in the serum level of hepatitis B virus (HBV) surface antigen over the natural course of HBV infection

Authors: Akihiro Matsumoto, Eiji Tanaka, Susumu Morita, Kaname Yoshizawa, Takeji Umemura, Satoru Joshita

Published in: Journal of Gastroenterology | Issue 9/2012

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Abstract

Background

Despite its status as a potential biomarker of hepatitis B virus (HBV) response to interferon treatment, the changes in hepatitis B surface antigen (HBsAg) levels over the natural course of HBV carriers have not been analyzed sufficiently.

Methods

A total of 101 HBV carriers were followed prospectively from 1999 to 2009. HBsAg level was measured yearly during the followed period.

Results

HBsAg levels at baseline ranged from −1.4 to 5.32 log IU/ml, with a median value of 3.2 log IU/ml. Lower HBsAg levels were significantly associated with higher age and lower HBV replication status. The rate of change of HBsAg levels showed two peaks, with a cut-off value of −0.4 log IU/year. Based on this, patients were tentatively classified into rapid decrease (rate of change <−0.4 log IU/year) and non-rapid decrease groups. All baseline levels of HBsAg, HB core-related Ag, and HBV DNA were lower in the rapid decrease group than in the non-rapid decrease group. Patients with persistently positive HBeAg were all classified into the non-rapid decrease group. In patients with persistently negative HBeAg, HBV DNA levels were significantly (P = 0.028) lower in the rapid decrease group than in the non-rapid decrease group.

Conclusions

Lower baseline HBsAg levels were significantly associated with older age and lower viral activity. Both a loss of HBeAg detection as well as inactive replication of HBV are suggested to be fundamental factors contributing to a rapid decrease in HBsAg over the natural course of HBV infection.
Literature
1.
go back to reference Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004;11:97–107.PubMedCrossRef Lavanchy D. Hepatitis B virus epidemiology, disease burden, treatment, and current and emerging prevention and control measures. J Viral Hepat. 2004;11:97–107.PubMedCrossRef
2.
go back to reference Hoofnagle JH, Doo E, Liang TJ, Fleischer R, Lok AS. Management of hepatitis B: summary of a clinical research workshop. Hepatology. 2007;45:1056–75.PubMedCrossRef Hoofnagle JH, Doo E, Liang TJ, Fleischer R, Lok AS. Management of hepatitis B: summary of a clinical research workshop. Hepatology. 2007;45:1056–75.PubMedCrossRef
4.
go back to reference Brunetto MR, Moriconi F, Bonino F, Lau GK, Farci P, Yurdaydin C, et al. Hepatitis B virus surface antigen levels: a guide to sustained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B. Hepatology. 2009;49:1141–50.PubMedCrossRef Brunetto MR, Moriconi F, Bonino F, Lau GK, Farci P, Yurdaydin C, et al. Hepatitis B virus surface antigen levels: a guide to sustained response to peginterferon alfa-2a in HBeAg-negative chronic hepatitis B. Hepatology. 2009;49:1141–50.PubMedCrossRef
5.
go back to reference Moucari R, Mackiewicz V, Lada O, Ripault MP, Castelnau C, Martinot-Peignoux M, et al. Early serum HBsAg drop: a strong predictor of sustained virological response to pegylated interferon alfa-2a in HBeAg-negative patients. Hepatology. 2009;49:1151–7.PubMedCrossRef Moucari R, Mackiewicz V, Lada O, Ripault MP, Castelnau C, Martinot-Peignoux M, et al. Early serum HBsAg drop: a strong predictor of sustained virological response to pegylated interferon alfa-2a in HBeAg-negative patients. Hepatology. 2009;49:1151–7.PubMedCrossRef
6.
go back to reference Simonetti J, Bulkow L, McMahon BJ, Homan C, Snowball M, Negus S, et al. Clearance of hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort chronically infected with hepatitis B virus. Hepatology. 2010;51:1531–7.PubMedCrossRef Simonetti J, Bulkow L, McMahon BJ, Homan C, Snowball M, Negus S, et al. Clearance of hepatitis B surface antigen and risk of hepatocellular carcinoma in a cohort chronically infected with hepatitis B virus. Hepatology. 2010;51:1531–7.PubMedCrossRef
7.
go back to reference Yuen MF, Wong DK, Fung J, Ip P, But D, Hung I, et al. HBsAg Seroclearance in chronic hepatitis B in Asian patients: replicative level and risk of hepatocellular carcinoma. Gastroenterology. 2008;135:1192–9.PubMedCrossRef Yuen MF, Wong DK, Fung J, Ip P, But D, Hung I, et al. HBsAg Seroclearance in chronic hepatitis B in Asian patients: replicative level and risk of hepatocellular carcinoma. Gastroenterology. 2008;135:1192–9.PubMedCrossRef
8.
go back to reference Tseng TC, Kao JH. HBsAg seroclearance: the more and earlier, the better. Gastroenterology. 2009;136:1842–3. author reply 3–4. Tseng TC, Kao JH. HBsAg seroclearance: the more and earlier, the better. Gastroenterology. 2009;136:1842–3. author reply 3–4.
9.
go back to reference Chu CM, Liaw YF. HBsAg seroclearance in asymptomatic carriers of high endemic areas: appreciably high rates during a long-term follow-up. Hepatology. 2007;45:1187–92.PubMedCrossRef Chu CM, Liaw YF. HBsAg seroclearance in asymptomatic carriers of high endemic areas: appreciably high rates during a long-term follow-up. Hepatology. 2007;45:1187–92.PubMedCrossRef
10.
go back to reference Chan HL, Wong VW, Wong GL, Tse CH, Chan HY, Sung JJ. A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B. Hepatology. 2010;52:1232–41.PubMedCrossRef Chan HL, Wong VW, Wong GL, Tse CH, Chan HY, Sung JJ. A longitudinal study on the natural history of serum hepatitis B surface antigen changes in chronic hepatitis B. Hepatology. 2010;52:1232–41.PubMedCrossRef
11.
go back to reference Suzuki F, Miyakoshi H, Kobayashi M, Kumada H. Correlation between serum hepatitis B virus core-related antigen and intrahepatic covalently closed circular DNA in chronic hepatitis B patients. J Med Virol. 2009;81:27–33.PubMedCrossRef Suzuki F, Miyakoshi H, Kobayashi M, Kumada H. Correlation between serum hepatitis B virus core-related antigen and intrahepatic covalently closed circular DNA in chronic hepatitis B patients. J Med Virol. 2009;81:27–33.PubMedCrossRef
12.
go back to reference Kimura T, Ohno N, Terada N, Rokuhara A, Matsumoto A, Yagi S, et al. Hepatitis B virus DNA-negative dane particles lack core protein but contain a 22-kDa precore protein without C-terminal arginine-rich domain. J Biol Chem. 2005;280:21713–9.PubMedCrossRef Kimura T, Ohno N, Terada N, Rokuhara A, Matsumoto A, Yagi S, et al. Hepatitis B virus DNA-negative dane particles lack core protein but contain a 22-kDa precore protein without C-terminal arginine-rich domain. J Biol Chem. 2005;280:21713–9.PubMedCrossRef
13.
go back to reference Mizokami M, Nakano T, Orito E, Tanaka Y, Sakugawa H, Mukaide M, et al. Hepatitis B virus genotype assignment using restriction fragment length polymorphism patterns. FEBS Lett. 1999;450:66–71.PubMedCrossRef Mizokami M, Nakano T, Orito E, Tanaka Y, Sakugawa H, Mukaide M, et al. Hepatitis B virus genotype assignment using restriction fragment length polymorphism patterns. FEBS Lett. 1999;450:66–71.PubMedCrossRef
14.
go back to reference Tanaka E, Matsumoto A, Yoshizawa K, Maki N. Hepatitis B core-related antigen assay is useful for monitoring the antiviral effects of nucleoside analogue therapy. Intervirology. 2008;51(Suppl 1):3–6.PubMedCrossRef Tanaka E, Matsumoto A, Yoshizawa K, Maki N. Hepatitis B core-related antigen assay is useful for monitoring the antiviral effects of nucleoside analogue therapy. Intervirology. 2008;51(Suppl 1):3–6.PubMedCrossRef
16.
go back to reference Chan HL, Wong VW, Tse AM, Tse CH, Chim AM, Chan HY, et al. Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response. Clin Gastroenterol Hepatol. 2007;5:1462–8.PubMedCrossRef Chan HL, Wong VW, Tse AM, Tse CH, Chim AM, Chan HY, et al. Serum hepatitis B surface antigen quantitation can reflect hepatitis B virus in the liver and predict treatment response. Clin Gastroenterol Hepatol. 2007;5:1462–8.PubMedCrossRef
17.
go back to reference Hosaka T, Suzuki F, Kobayashi M, Hirakawa M, Kawamura Y, Yatsuji H, et al. HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy. Liver Int. 2010;30:1461–70.PubMedCrossRef Hosaka T, Suzuki F, Kobayashi M, Hirakawa M, Kawamura Y, Yatsuji H, et al. HBcrAg is a predictor of post-treatment recurrence of hepatocellular carcinoma during antiviral therapy. Liver Int. 2010;30:1461–70.PubMedCrossRef
18.
go back to reference Wong DK, Tanaka Y, Lai CL, Mizokami M, Fung J, Yuen MF. Hepatitis B virus core-related antigens as markers for monitoring chronic hepatitis B infection. J Clin Microbiol. 2007;45:3942–7.PubMedCrossRef Wong DK, Tanaka Y, Lai CL, Mizokami M, Fung J, Yuen MF. Hepatitis B virus core-related antigens as markers for monitoring chronic hepatitis B infection. J Clin Microbiol. 2007;45:3942–7.PubMedCrossRef
19.
go back to reference Matsumoto A, Tanaka E, Minami M, Okanoue T, Yatsuhashi H, Nagaoka S, et al. Low serum level of hepatitis B core-related antigen indicates unlikely reactivation of hepatitis after cessation of lamivudine therapy. Hepatol Res. 2007;37:661–6.PubMedCrossRef Matsumoto A, Tanaka E, Minami M, Okanoue T, Yatsuhashi H, Nagaoka S, et al. Low serum level of hepatitis B core-related antigen indicates unlikely reactivation of hepatitis after cessation of lamivudine therapy. Hepatol Res. 2007;37:661–6.PubMedCrossRef
20.
go back to reference Shinkai N, Tanaka Y, Orito E, Ito K, Ohno T, Hirashima N, et al. Measurement of hepatitis B virus core-related antigen as predicting factor for relapse after cessation of lamivudine therapy for chronic hepatitis B virus infection. Hepatol Res. 2006;36:272–6.PubMedCrossRef Shinkai N, Tanaka Y, Orito E, Ito K, Ohno T, Hirashima N, et al. Measurement of hepatitis B virus core-related antigen as predicting factor for relapse after cessation of lamivudine therapy for chronic hepatitis B virus infection. Hepatol Res. 2006;36:272–6.PubMedCrossRef
21.
go back to reference Matsumoto A, Tanaka E, Suzuki Y, Kobayashi M, Tanaka Y, Shinkai N, et al. Combination of hepatitis B viral antigens and DNA for prediction of relapse after discontinuation of nucleos(t)ide analogues in patients with chronic hepatitis B. Hepatol Res. 2012;42:139–49.PubMedCrossRef Matsumoto A, Tanaka E, Suzuki Y, Kobayashi M, Tanaka Y, Shinkai N, et al. Combination of hepatitis B viral antigens and DNA for prediction of relapse after discontinuation of nucleos(t)ide analogues in patients with chronic hepatitis B. Hepatol Res. 2012;42:139–49.PubMedCrossRef
Metadata
Title
Changes in the serum level of hepatitis B virus (HBV) surface antigen over the natural course of HBV infection
Authors
Akihiro Matsumoto
Eiji Tanaka
Susumu Morita
Kaname Yoshizawa
Takeji Umemura
Satoru Joshita
Publication date
01-09-2012
Publisher
Springer Japan
Published in
Journal of Gastroenterology / Issue 9/2012
Print ISSN: 0944-1174
Electronic ISSN: 1435-5922
DOI
https://doi.org/10.1007/s00535-012-0559-2

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