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Abstract Details
Prevalence and Clinical Features of Patients With Concurrent HBsAg and Anti-HBs: Evaluation of the Hepatitis B Research Network Cohort
J Viral Hepat. 2020 May 4.doi: 10.1111/jvh.13312. Online ahead of print.
William M Lee1, Wendy C King2, Kathleen B Schwarz3, Jody Rule1, Anna Sf Lok4, HBRN Investigators
Author information
1Division of Digestive and Liver Diseases, University of Texas Southwestern Medical Center, Dallas, TX, USA.
2Department of Epidemiology, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, PA, USA.
3Division of Pediatric Gastroenterology, Hepatology and Nutrition, Johns Hopkins University School of Medicine, Baltimore, MD, USA.
4Division of Gastroenterology and Hepatology, University of Michigan, Ann Arbor, MI, USA.
Abstract
The prevalence of concurrent HBsAg and anti-HBs in plasma of persons with chronic hepatitis B virus (HBV) infection is variable and its clinical significance enigmatic. We examined the prevalence,clinical and virological features of concurrent HBsAg and anti-HBs inchildren and adults with chronic HBV infection living in North America. A total of 1,462 HBsAg positive participants in the Hepatitis B Research Network pediatric and adult cohorts were included[median age 41 (range 4-80) years, 48% female, 11% white, 13% black, 73% Asians]. Only 18 (1.2%) were found to be anti-HBs positive (≥10 mIU/mL) at initial study evaluation.Distributions of sex, race, HBV genotype, and ALTwere similar between participants with and without concurrent anti-HBs. Those who were anti-HBs positive appeared to be older (median age 50 vs. 41 years,p=0.06), hadlower platelet counts (median 197 vs. 222 x 103/mm3 , p=0.07)and higher prevalence of HBeAg (44% vs. 26%, p=0.10). They also had lower HBsAg levels (median 2.0 vs. 3.5 log10 IU/mL, p=0.02).Testing of follow-up samples after a median of 4 years (range 1-6)in 12 of the 18 participants with initial concurrent anti-HBsshowed anti-HBs became undetectable in 6, decreased to <10 mIU/mL in 1and remained positive in 5 participants.Two patients lost HBsAg during follow-up. In conclusion, prevalenceof concurrent HBsAg and anti-HBs was low at 1.2%,with anti-HBs disappearing in some during follow-up, in this large cohort of racially diverse children and adults with chronic HBV infection living in North America. Presence of concurrent HBsAg and anti-HBs did not identify a specific phenotype of chronic hepatitis B, nor did it appear to affect clinical outcomes.