Why Do Some People Clear HBsAg After Years of Chronic Infection?
Every year, about 1.75% of chronic hepatitis B patients are able to spontaneously eradicate the HBsAg in their bodies. Why are they able to clear the virus while others remain chronically infected?
To find out, Japanese researchers followed 2,112 hepatitis B patients over 15 years to see what common factors led to this spontaneous clearance of HBsAg.
The study group included a mix of treated and untreated patients, their average age was 37 and 68% were male. Their ALT levels were only moderately elevated and their HBV DNA levels were on average around 1 million copies per milliliter.
The annual HBsAg clearance rates in these two groups were:
1.65% in 1,130 untreated patients
And 2.05% in 982 previously treated patients.
In the untreated patients, HBsAg clearance was more common in:
Older patients (over 50)
Patients with no immediate family history of HBV infections
And those with HBsAg levels less than 2,000 international units per milliliter.
In treated patients, older age, male gender, no family history of HBV infection, HBeAg-negative status, no viral mutations, and past interferon treatment increased their chance of clearing HBsAg, according to the report published in the June issue of the Journal of Gastroenterology.
Source: "Seroclearance rate of hepatitis B surface antigen in 2,112 patients with chronic hepatitis in Japan during long-term follow-up," bt Kobayashi M, Hosaka T, Suzuki F, et al. J Gastroenterol. 2013 Jun 20.
This study supports steff's view that people with low HBSAg more likely to clear the surface antigen. But i know several people with low HBSAG i.e. 20 or <100 iu/ml are unable to clear their surface antigen by PEG. Steff also know some people like this. However, if what study for hope says about people with 0.05 iu/ml still have miilions of HBSag in one ml of blood then it is not surprising.
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