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easl2015 PREDICTIVE MODEL OF HBsAg NEGATIVIZATION IN INACTIVE HBsAg
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easl2015 PREDICTIVE MODEL OF HBsAg NEGATIVIZATION IN INACTIVE HBsAg

P0593
PREDICTIVE MODEL OF HBsAg NEGATIVIZATION IN INACTIVE
HBsAg CHRONIC CARRIERS, MAINLY CAUCASIAN
M.L. Gonza´ lez-Die´guez1, C.A. Navascue´ s1, G. Albines1,
Mercedes Rodr´ıguez2, V. Cadah´ıa1, M. Varela1, R. P´erez1,
Manuel Rodr´ıguez1. 1Liver Unit, 2Microbiology Department, Hospital
Universitario Central de Asturias, Oviedo, Spain
E-mail: ***@****
Background and Aims: HBsAg negativization is the last phase of
HBV chronic infection and represents its resolution. The aim of this
study was to analyze the frequency of HBsAg negativization in HBV
inactive carriers (HBV-IC) and to develop a predictive model of it.
Methods: 297 HBV-IC were studied, 51% males, 86% Caucasians,
42% genotype A and 35% genotype D, 67% with liver elastography
<6.2 kPa and with a mean age of 45±13 years. HBV-IC diagnosis was
based on HBeAg negativity and HBV-DNA <20000 IU/ml, confirmed
in several controls. HCV, HDV and HIV coinfection were excluded

However, area under the ROC curve was greater in the model using
HBsAg and HBV-DNA (0.88 [0.83–0.92]) than in the one based only
in HBsAg (0.84 [0.78–0.89]).
Conclusions: In a series of HBV-IC, mainly Caucasians, the
combination of HBsAg cuantification and the presence or absence of
HBV-DNA is useful to predict the probability of infection resolution
at 5 years.
in all. Basal determinations of HBV-DNA (RT-PCR, Cobas TaqMan
VHB) and quantitative HBsAg (Architect HBsAg; Abbott), with
lower limit of detection of 0.05 IU/ml, were performed. Patients
were prospectively followed annually or biannually, with a mean
follow-up of 52±28 months.
Results: 57/297 (19%) were initially HBV-DNA negative. Mean
HBsAg level was 8.852±17.700 IU/ml. During the follow-up, 49
patients (16.5%) became HBsAg-negative. In univariate analysis
(Kaplan–Meier), HBsAg negativization was not associated with sex
(p = 0.18), ALT normal or high values (p = 0.8), liver elastography
30 years
(p = 0.02), HBV-DNA-negative (p < 0.001) and with initial HBsAg
<1000 UI (p < 0.001). In multivariate analysis, initial HBV-DNA
absence (HR 2.37 [95% CI 1.34–4.19], p = 0.03) and basal HBsAg
<1000 IU/ml (HR 49.4 [95% CI 6.76–361.02], p < 0.001) were
independently associated with the probability of HBsAg clearance.
The presence or absence of these factors allowed to establish three
groups of patients with a significant different probability of HBsAg
negativization at 5 years: In those without any favorable factor
(n = 151) such probability was 0%, in those with one factor (n = 101)
27.2%, and in patients with both of them (n = 45) 53.5% (p 1000 UI/ml, 15.2% if HBsAg was
between 100 and 1000 IU/ml and 53% when it was <100 IU/ml.
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