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APHA Scientific Session and Event Listing

Bianca Malcolm, MPH¹, Longjian Liu, MD, PhD¹, Alison Evans, ScD², and Gang Chen². (1) Epidemiology and Biostatistics, Drexel University School of Public Health, 1505 Race Street, MS 660, Philadelphia, PA 19102, 215-553-7143, blm34@drexel.edu, (2) Fox Chase Cancer Center, 333 Cottoman Avenue, Philadelphia, PA 19111

Background: Spontaneous hepatitis B surface antigen (HBsAg) seroclearance is a rare event in patients with chronic hepatitis B virus infections.

Objectives: This study intends to identify determinants for HBsAg seroclearance in persons with chronic hepatitis B using a large cohort of Chinese patients with 11 years of follow-up.

Study Design and Methods: This analysis used the database of a prospective cohort study of 1863 patients who had returned 11 years after initial cohort entry (1992-93) to undergo further serum testing of viral markers and HBsAg-positivity. Of those 1863 patients, 341 (18.30%) had apparently cleared HBsAg by 2003. Spontaneous HBsAg seroclearance was investigated in terms of its relationship to age, HBeAg-status, gender, HBV DNA viral load, and history of clinical hepatitis B.

Results: Of the 997 persons who were 40 years and older, 206 (20.66%) underwent spontaneous HBsAg seroclearance. In contrast, only 135 (15.59%) of the 866 subjects younger than 40 years of age cleared HBsAg (p=.0047). The incidence of HBsAg seroclearance was also higher in persons who were HBeAg-negative compared to persons who were HBeAg-positive (21.52% vs. 13.17%; p <.0001).

Conclusions: The results suggest that the age of patients and HBeAg-status are determinants for HBsAg seroclearance. However, gender, HBV DNA viral load, and clinical hepatitis B history did not significantly influence the occurrence of spontaneous HBsAg seroclearance.

Learning Objectives: At the conclusion of the session, the participant (learner) in this session will be able to

• Describe the natural history of hepatitis B virus (HBV) infection.
• Recognize the significance of spontaneous HBsAg seroclearance in HBV infection and public health.
• List two indicators that may increase the incidence of spontaneous HBsAg seroclearance.
• Discuss the public health benefits of HBsAg seroclearance.

Keywords: Infectious Diseases, Asian and Pacific Islander

Presenting author's disclosure statement:

Not Answered

Handout (.ppt format, 342.0 kb)

Handout (.ppt format, 517.5 kb)