Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis
| العنوان: | Factors Associated With Rates of HBsAg Seroclearance in Adults With Chronic HBV Infection: A Systematic Review and Meta-analysis |
|---|---|
| المؤلفون: | Leslie Y. Kam, Yutian Chong, Hwai I. Yang, Tetsuya Hosaka, James Fung, Biyao Zou, Xiangyong Li, Min Sun Kwak, Tassanee Sriprayoon, Chiao-Chin Lee, Anna S. Lok, Carmen Monica Preda, Yee Hui Yeo, Young Min Park, Tawesak Tanwandee, Michael H. Le, Nicholas Chien, Hyo Suk Lee, Jia-Horng Kao, Jian Zhang, Mindie H. Nguyen, Jiayi Li, Fumitaka Suzuki, Tai-Chung Tseng, Mariko Kobayashi, Donghak Jeong, Manuel J. Rodriguez, Sombat Treeprasertsuk, Teerapat Ungtrakul, Phunchai Charatcharoenwitthaya, Huy N. Trinh, Maria Buti, An Le, Mar Riveiro-Barciela, Chun Ying Wu, Hsiu J. Ho, Bin Wei, Man-Fung Yuen, Doina Istratescu |
| المصدر: | Gastroenterology. 156:635-646.e9 |
| بيانات النشر: | Elsevier BV, 2019. |
| سنة النشر: | 2019 |
| مصطلحات موضوعية: | Adult, Male, 0301 basic medicine, Hepatitis B virus, medicine.medical_specialty, HBsAg, Cochrane Library, medicine.disease_cause, 03 medical and health sciences, Hepatitis B, Chronic, 0302 clinical medicine, Reference Values, Risk Factors, Seroepidemiologic Studies, Internal medicine, Humans, Medicine, Serologic Tests, Cumulative incidence, Hepatitis B Surface Antigens, Hepatology, business.industry, Gastroenterology, virus diseases, Middle Aged, Prognosis, digestive system diseases, Confidence interval, 030104 developmental biology, HBeAg, Meta-analysis, DNA, Viral, Female, 030211 gastroenterology & hepatology, business, Biomarkers, Cohort study |
| الوصف: | Seroclearance of hepatitis B surface antigen (HBsAg) is a marker for clearance of chronic hepatitis B virus (HBV) infection, but reported annual incidence rates of HBsAg seroclearance vary. We performed a systematic review and meta-analysis to provide more precise estimates of HBsAg seroclearance rates among subgroups and populations.We searched PubMed, Embase, and the Cochrane library for cohort studies that reported HBsAg seroclearance in adults with chronic HBV infection with more than 1 year of follow-up and at least 1 repeat test for HBsAg. Annual and 5-, 10-, and 15-year cumulative incidence rates were pooled using a random effects model.We analyzed 34 published studies (with 42,588 patients, 303,754 person-years of follow-up, and 3194 HBsAg seroclearance events), including additional and updated aggregated data from 19 studies. The pooled annual rate of HBsAg seroclearance was 1.02% (95% CI, 0.79-1.27). Cumulative incidence rates were 4.03% at 5 years (95% CI, 2.49-5.93), 8.16% at 10 years (95% CI, 5.24-11.72), and 17.99% at 15 years (95% CI, 6.18-23.24). There were no significant differences between the sexes. A higher proportion of patients who tested negative for HBeAg at baseline had seroclearance (1.33%; 95% CI, 0.76-2.05) than those who tested positive for HBeAg (0.40%; 95% CI, 0.25-0.59) (P.01). Having HBsAg seroclearance was also associated with a lower baseline HBV DNA level (6.61 logIn a systematic review and meta-analysis, we found a low rate of HBsAg seroclearance in untreated and treated patients (pooled annual rate, approximately 1%). Seroclearance occurred mainly in patients with less active disease. Patients with chronic HBV infection should therefore be counseled on the need for lifelong treatment, and curative therapies are needed. |
| تدمد: | 0016-5085 |
| DOI: | 10.1053/j.gastro.2018.10.027 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::7221f87094dc59f81fb15f7fe6037225 https://doi.org/10.1053/j.gastro.2018.10.027 |
| Rights: | OPEN |
| رقم الانضمام: | edsair.doi.dedup.....7221f87094dc59f81fb15f7fe6037225 |
| قاعدة البيانات: | OpenAIRE |
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