Clinical Features For Spontaneous HBsAg Loss Of The Chronic HBV Infected Individuals

ObjectiveTo investigate the clinical characteristics of chronic HBV infected individuals with spontaneous HBsAg loss.To identify the relationship between the quantitative values of HBsAg and spontaneous HBsAg loss,to identify whether there is statistical significance for different age,gender patients in the process of spontaneous HBsAg seroclearance,to identify the influencing factors of this process at the same time,including the contributing and resistance factors,whether the factors such as family history,alcohol history,gender,age will produce positive or negative effects,and spontaneous HBsAg loss individuals were followed up to assess the prognosis.MethodsEighty-five chronic HBV infected individuals with HBsAg spontaneous loss(HBsAg<0.05IU/ml)were enrolled,they are from inpatient units and outpatient clinics in Infectious department of Yan'an University Affiliated Hospital during Sep 2014 to Feb 2017.Diagnosis of chronic HBV infection was according to 2015 Chinese Practice Guidelines of Chronic Hepatitis B.Excluded HBsAg seroclearance individuals by the use of antiviral drugs such as interferon,nucleoside or nucleotide analogue.And set up the control group(eighty cases)without HBsAg spontaneous loss,these cases had the similar quantitative values of HBsAg.Age,gender,family history,alcohol history,HBV M(HBsAg,HBsAb,HBe Ag,HBeAb,HBcAb),HBV viral load,abdomen B ultrasound,liver function,AFP,liver fibrosis,Liver stiffness measurement(LSM)were collected,to collected Magnetic Resonance Imaging(MRI)of HCC patients.And follow-up,follow-up content included changes in the above indicators of patients.Follow-up ends: initiation of antiviral therapy,the patient died due to disease progression and follow-up time as of February 2017.Apply the statistical method for analysis and processing according type of data.Results1.Follow-up time was 2-42 years,mean follow-up time(17.5±9.5)years.The process of HBsAg spontaneuos loss takes(14.6±9.6)years,3 cases are C genotype and 3 patients started antiviral therapy in the 85 cases.2.In the eighty-five chronic HBV infected individuals with HBsAg loss,57 cases of male(67.1%),28 cases of female(32.9%).Aged 21-73 years,mean age(47.7±12.1)years old.3.There are 3 cases whose HBsAg appear again after HBsAg loss(3.5%).During the follow-up period,1 case(1.2%)of HBsAg appear again did not appear HBsAg loss,2 cases(2.3%)of HBsAg appear again keep HBsAg negative.Fisher Exact probabilities for male recurrence and female recurrence rate in 2×2 table,P > 0.05.4.In the eighty-five chronic HBV infected individuals with HBsAg loss,6 cases(7.0%)are initial HBeAg positive individuals,65 cases(76.5%)HBeAg negative,14 cases(16.5%)were unknown.5.HBVDNA quantitative when HBsAg spontaneuos loss: 0-197 IU / ml.6.Pearson Linear correlation coefficient between HBsAb andALT,AST are r =-0.013(P=0.894),r=-0.075(P=0.712).7.Pearson Linear correlation coefficient between HBcAb and ALT,AST are r=0(P=0.072),r=-0.008(P=0.955).8.Pearson Linear correlation coefficient between HBcAb and HBsAg is r=-0.559(P=0.000).9.HBsAg loss age ? 50 years old,a total of 56 cases: 49 cases of normal abdominal B ultrasound and liver function,7 cases of liver cirrhosis,0 cases of HCC.HBsAg loss age> 50 years old,a total of 29 cases: 9 cases of normal abdominal B ultrasound,liver function,16 cases of liver cirrhosis,4 cases of HCC.The ?2 for Age when HBsAg turn(age 50 or less and > 50 years old)and the cases of different condition patients is ?2 =29.509,P=0.000.Mean liver stiffness measurement(?50years,>50)are 6.3KPa and 9.9KPa,By t test,P = 0.003,the difference was statistically significant.10.In the control group,80 cases of chronic HBV infection with no HBsAg loss,sex,family history,drinking history age,multivariate logistic regression analysis,the P values were: 0.645,0.514,0.440,0.002.11.The mean value of hepatitis B surface antigen at first:(75.93±12.40)IU / ml,95% confidence interval(50.98,100.98)IU / ml.HBcAb mean:(173.8±22.6)S / CO,95% confidence interval(128.94,218.72)IU / ml.12.The Pearson correlation coefficient between laminin and AFP was r=0.787 and P = 0.000.Conclusions1.In individuals with spontaneous HBsAg loss,the proportion of men is more.2.There will still be some patients with HBsAg reproduction after HBsAg seroclearance,There is no correlation between HBsAg reproduction and gender.3.HBeAg negative chronic HBV infected individuals increased chances for HBsAg seroclearance than HBeAg positive.4.HBsAg negative,the serum can still be measured hepatitis B virus,HBsAg negative,can not rule out hepatitis B virus infection.5.The value of HBsAb was not correlated with ALT and AST,suggesting that increased HBsAb will not predict liver injury.The value of HBcAb had no correlation with ALT and AST,suggesting that increased HBcAb will not predict liver function damage.6.HBcAb rise,HBsAg drops,HBcAb and HBsAg were negatively correlated,HBcAb increased,suggesting that the possibility of HBsAg seroclearance.7.HBsAg loss before the age of 50 years in patients will face small risk of liver cirrhosis and HCC.8.Gender,family history,drinking history are not contribution factors to spontaneous HBsAg loss,and for the CHB patients whose HBsAg are less than 100 IU / ml,With age,the possibility of HBsAg negative increases.9.AFP and laminin are related,AFP increased,laminin rise,the two have a correlation.