— Christine M. Kukka, Project Manager, HBV Advocate
Patients age 40 and older who lose the hepatitis B "e" antigen
(HBeAg) as a result of antiviral treatment face a high risk of its
return, compared to people who lose it spontaneously (without
treatment), or who lose it during treatment when they're younger.
Researchers, writing in a report published in the May journal of Digestive Diseases and Sciences,
compared 135 patients with antiviral-induced HBeAg seroconversion
(loss of HBeAg and development of "e" antibodies) with 251 patients who
experienced HBeAg seroconversion spontaneously.
When patients spontaneously seroconverted,
various factors played roles in whether they relapsed, such as age at
HBeAg seroconversion, male gender, HBV DNA levels before HBeAg
seroconversion, HBV genotype C, and the presence of mutations in HBsAg
(pre-S deletions).
However, in patients with antiviral-induced HBeAg
seroconversion, the only risk factor for a return of HBeAg was older
age at time of seroconversion. These researchers found that
antiviral-treated patients who seroconverted after age 40 had higher
rates of HBeAg returning than treated patients who seroconverted in
their 20s and 30s. (1)
An unrelated study published in the May issue of Liver International
followed 228 patients after they spontaneously cleared HBeAg and found
that those who continued to have elevated viral loads were most at
risk of relapse (including liver damage and increased viral load.)
Hepatitis B flares occurred in 76 (33.3%)
patients over the five-year study period, and the patients who
experienced a resurgence of infection were older, had higher HBV DNA
levels at the time they lost HBeAg, and were male (42.7% vs 23.4%
female). (2)
Source 1: www.ncbi.nlm.nih.gov/pubmed/24846794
Source 2: www.ncbi.nlm.nih.gov/pubmed/24840542
HBV Journal Review — June 1, 2014, Vol 11, no 6 Labels: age, HBeAg seroconversion
