Clinical—Liver, Pancreas, and Biliary TractIncidence and Determinants of Spontaneous Hepatitis B Surface Antigen Seroclearance: A Community-Based Follow-Up Study
Section snippets
Study Cohort
From 1991 to 1992, all 89,293 inhabitants aged 30 to 65 years, who were residing in 7 townships (Sanchi, Chutung, Potzu, Kaoshu, Makung, Hushi, and Paisha) in Taiwan, were invited to participate in a cancer screening program as a part of the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) study.10, 27 Recruitment was performed by mailed letters, and follow-up telephone calls were made to those who did not respond to the initial
Study Cohort
Figure 1 shows the flow of study participants through the study. A total of 3087 participants with no previous history of treatment for HBV who were seropositive for HBsAg, anti-HCV seronegative, and free of cirrhosis at study entry were included in this analysis. Among the 3087 participants in this study, 65% were men, the median age was 45 years old, and most were HBeAg seronegative (84%), had ALT levels less than 45 U/L (94%), and had no previous history of diabetes at baseline (98%).
HBsAg Seroclearance Rates and Cumulative Probability of Seroclearance
There
Discussion
This was a large community-based sample of HBsAg carriers who were followed up. Previous studies of the determinants of HBsAg seroclearance have been either clinic-based, or have had smaller numbers of participants.21, 22, 24, 26 In this study, 562 of 3087 chronic HBV carriers spontaneously cleared HBsAg, showing a seroclearance rate of 2.26 per 100 person-years. This rate is substantially higher than previously reported rates of HBsAg seroclearance in high-endemic areas, which ranged from 0.5%
Acknowledgments
J.L. and H.-I.Y. contributed equally to this article.
Other members of the Risk Evaluation of Viral Load Elevation and Associated Liver Disease/Cancer-Hepatitis B Virus (REVEAL-HBV) Study Group are as follows: National Taiwan University Hospital: C. Y. Hsieh, H. S. Lee, P. M. Yang, C. H. Chen, J. D. Chen, S. P. Huang, and C. F. Jan; National Taiwan University: T.H.H. Chen; National Defense Medical Center: C. A. Sun; Taipei City Psychiatric Center: M. H. Wu; Tzu Chi University: S. Y. Chen; Shin
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Conflicts of interest These authors disclose the following: Dr Iloeje is an employee of and holds stock in Bristol-Myers Squibb Company. The remaining authors disclose no conflicts.
Funding This study was supported by research grants from the Department of Health, Executive Yuan, Taipei, Taiwan; Academia Sinica, Taipei, Taiwan; National Health Research Institutes, Chunan, Taiwan; and the Bristol-Myers Squibb Company, Wallingford, CT, to conduct the laboratory tests for this study.
The funding sources of this study had no role in the design or conduct of the study, nor did they have any role in the collection, management, analysis, and interpretation of the data as well as the preparation, review, or approval of the manuscript. All data handling and statistical analyses were performed by staff at the National Taiwan University and Academia Sinica. At no time did the funding sources have access to the data.