ABSTRACT FINAL ID: 1827
TITLE: Clinical outcomes after spontaneous and nucleos(t)ide analogues (NUCs)-treated hepatitis B surface antigen(HBsAg) seroclearance in chronic HBV infection are favourable
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12th Five-Year science and technology major projects，NO.2012ZX10004-902
Objects To investigate the long-term clinical outcomes and durability of HBsAg seroclearance following nucleos(t)ide analogue (NUC) therapy or without antiviral treatment in patients with chronic HBV infection.
Methods we retrospectively analyzed 9335 patients with chronic HBV infection who was treated with nucleos(t)ide analogues or without antiviral treatment during a median follow-up period of 6.3 years, and a total of 158 patients achieved HBsAg seroclearance.
Results During follow-up for 2620 CHB patients who didn’t receive antiviral treatment, 54 patients acquired HBsAg seroclearance. The average time for acquiring HBsAg seroclearance was 5.5 (0～20) years. 16 cases of whom acquired HBsAg/HBsAb seroconversion, one patient returned HBsAg positive. HBeAg seroclearance in HBeAg-postive patients occured in 9 patients, and the rate of HBeAg/HBeAb seroconversion was 57.1% (8/14). The virological breakthrough was occurred in one patient (1.9%). None developed into liver cirrhosis, liver carcinoma or died. During follow-up for 6715 CHB patients who received NUC treatment, 104 patients acquired HBsAg seroclearance. The average time for acquiring HBsAg seroclearance was 6.6 (0.5～14) years. HBsAg seroconversion occured in 29 patients, and one patients returned HBsAg positive. The rate of HBeAg seroclearance was 88.2%（30/34）, and HBeAg/HBeAb seroconversion occured in 27 patients. No patient developed virological breakthrough. There were 28 cases discontinued the NUCs treatment. 3 cases of 104 patients with HBsAg seroclearance got disease progression, 1 case developed into compensated cirrhosis from the initial imaging diagnosis of CHB, and 2 cases developed into liver carcinoma from the initial diagnosis of decompensated liver cirrhosis; no death occurred among the patients.
Conclusion HBsAg seroclearance in chronic HBV infection with or without antiviral treatment was associated with favourable clinical outcomes in most cases during long-term follow-up.