Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA)
Background: Hepatitis B surface antigen (HBsAg) loss is associated with improved clinical outcomes for individuals with chronic hepatitis B (CHB); however, the effects of varying HBsAg levels on clinical outcomes in diverse cohorts are understudied. Methods: In this cross-sectional, multicentre, ret...
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MDPI AG
2022-11-01
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| Series: | Viruses |
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| Online Access: | https://www.mdpi.com/1999-4915/14/12/2668 |
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| author | Carla S. Coffin Sarah Haylock-Jacobs Karen Doucette Alnoor Ramji Hin Hin Ko David K. Wong Magdy Elkhashab Robert Bailey Julia Uhanova Gerald Minuk Keith Tsoi Alexander Wong Mang M. Ma Edward Tam Mayur Brahmania Carmine Nudo Julie Zhu Christopher F. Lowe Carla Osiowy B. Cord Lethebe Stephen E. Congly Eric K. H. Chan Angelina Villasis-Keever Urbano Sbarigia Curtis L. Cooper Scott Fung |
| author_facet | Carla S. Coffin Sarah Haylock-Jacobs Karen Doucette Alnoor Ramji Hin Hin Ko David K. Wong Magdy Elkhashab Robert Bailey Julia Uhanova Gerald Minuk Keith Tsoi Alexander Wong Mang M. Ma Edward Tam Mayur Brahmania Carmine Nudo Julie Zhu Christopher F. Lowe Carla Osiowy B. Cord Lethebe Stephen E. Congly Eric K. H. Chan Angelina Villasis-Keever Urbano Sbarigia Curtis L. Cooper Scott Fung |
| author_sort | Carla S. Coffin |
| collection | DOAJ |
| description | Background: Hepatitis B surface antigen (HBsAg) loss is associated with improved clinical outcomes for individuals with chronic hepatitis B (CHB); however, the effects of varying HBsAg levels on clinical outcomes in diverse cohorts are understudied. Methods: In this cross-sectional, multicentre, retrospective study, the data on adult subjects enrolled in the Canadian HBV Network with CHB seen from 1 January 2012 to 30 January 2021 with the treatment and virologic data within 1 year of HBsAg testing were analyzed. Patients were tested for HBsAg using qualitative (for HBsAg-negative samples) and/or commercial quantitative assays. Fibrosis or hepatic necroinflammation was determined by the liver stiffness measurement (LSM). The baseline data were summarized using descriptive statistics and compared by using univariable/multivariable analyses. Results: This study included 844 CHB patients, with a median age of 49.6 years (IQR 40.1–60.5), and 37% were female. In total, 751 patients (78.6%) had known ethnicity data, and 76.7% self-reported as Asian, 11.4% as Black, 6.8% as White, and 4.8% as other. Among the 844 patients, 237 (28.0%) were HBsAg (−) (<LLOQ), 190 (22.5%) had qHBsAg 1–100, 91 (10.8%) had qHBsAg 100–500, 54 (6.4%) had qHBsAg 500–1000, and 272 (32.2%) had qHBsAg >1000 IU/mL. Overall, 80% (682) had known HBeAg status at the last follow-up, and the majority (87.0%) were HBeAg-negative. In addition, 54% (461/844) had prior antiviral therapy, 19.7% of which (16.3, 23.7, <i>n</i> = 91) were HBsAg (−). The treated patients had a lower risk of cirrhosis (16.46, 95% CI 1.89–143.39, <i>p</i> = 0.01) or HCC (8.23, 95% CI 1.01–67.39, <i>p</i> = 0.05) than the untreated patients. A lower proportion of the HBsAg-loss group had cirrhosis (5.7% vs. 10.9%, <i>p</i> = 0.021) and HCC (0.9% vs. 6.2%, <i>p</i> = 0.001). Conclusion: In this retrospective, ethnically diverse cohort study, CHB patients who received antiviral therapy and/or had HBsAg loss were less likely to develop cirrhosis and HCC, confirming the results of the studies in less diverse cohorts. No association was found between the qHBsAg level and fibrosis determined with LSM. Individuals who achieved HBsAg loss had low-level qHBsAg within 1 year of seroclearance. |
| first_indexed | 2024-03-09T15:44:46Z |
| format | Article |
| id | doaj.art-6989dedfa34b460aaecea1e961657d56 |
| institution | Directory Open Access Journal |
| issn | 1999-4915 |
| language | English |
| last_indexed | 2024-03-09T15:44:46Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Viruses |
| spelling | doaj.art-6989dedfa34b460aaecea1e961657d562023-11-24T18:37:31ZengMDPI AGViruses1999-49152022-11-011412266810.3390/v14122668Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA)Carla S. Coffin0Sarah Haylock-Jacobs1Karen Doucette2Alnoor Ramji3Hin Hin Ko4David K. Wong5Magdy Elkhashab6Robert Bailey7Julia Uhanova8Gerald Minuk9Keith Tsoi10Alexander Wong11Mang M. Ma12Edward Tam13Mayur Brahmania14Carmine Nudo15Julie Zhu16Christopher F. Lowe17Carla Osiowy18B. Cord Lethebe19Stephen E. Congly20Eric K. H. Chan21Angelina Villasis-Keever22Urbano Sbarigia23Curtis L. Cooper24Scott Fung25Cumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaCumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaDepartment of Medicine, University of Alberta, Edmonton, AB T6G 2R3, CanadaDepartment of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, CanadaDepartment of Medicine, University of British Columbia, Vancouver, BC V6T 1Z4, CanadaDepartment of Medicine, University of Toronto, Toronto, ON M5G 2CV, CanadaToronto Liver Centre, Toronto, ON M6H 3M1, CanadaBailey Health Clinic, Edmonton, AB T5H 4B9, CanadaDepartment of Internal Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, CanadaDepartment of Internal Medicine, University of Manitoba, Winnipeg, MB R3T 2N2, CanadaDepartment of Medicine, McMaster University, Hamilton, ON L8S 4L8, CanadaDepartment of Medicine, University of Saskatchewan, Regina, SK S7N 5A2, CanadaDepartment of Medicine, University of Alberta, Edmonton, AB T6G 2R3, CanadaPacific Gastroenterology Associates, Vancouver, BC V6Z 2K5, CanadaMulti Organ Transplant Unit, Department of Medicine, Division of Gastroenterology, Western University, London, ON N6A 3K7, CanadaCité-de-la-Santé de Laval, Laval, QC H7M 3L9, CanadaFaculty of Medicine, Dalhousie University, Halifax, NS B3H 4R2, CanadaDivision of Medical Microbiology, Providence Health Care, Vancouver, BC V6Z 1Y6, CanadaNational Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB R3E 3R2, CanadaCumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaCumming School of Medicine, University of Calgary, Calgary, AB T2N 1N4, CanadaJanssen Global Services LC, Raritan, NJ 08869, USAJanssen Global Services LC, Raritan, NJ 08869, USAJanssen Pharmaceuticals NV, 2340 Beerse, BelgiumDepartment of Medicine, Division of infectious Diseases, University of Ottawa, Ottawa, ON K1N 6N5, CanadaDepartment of Medicine, University of Toronto, Toronto, ON M5G 2CV, CanadaBackground: Hepatitis B surface antigen (HBsAg) loss is associated with improved clinical outcomes for individuals with chronic hepatitis B (CHB); however, the effects of varying HBsAg levels on clinical outcomes in diverse cohorts are understudied. Methods: In this cross-sectional, multicentre, retrospective study, the data on adult subjects enrolled in the Canadian HBV Network with CHB seen from 1 January 2012 to 30 January 2021 with the treatment and virologic data within 1 year of HBsAg testing were analyzed. Patients were tested for HBsAg using qualitative (for HBsAg-negative samples) and/or commercial quantitative assays. Fibrosis or hepatic necroinflammation was determined by the liver stiffness measurement (LSM). The baseline data were summarized using descriptive statistics and compared by using univariable/multivariable analyses. Results: This study included 844 CHB patients, with a median age of 49.6 years (IQR 40.1–60.5), and 37% were female. In total, 751 patients (78.6%) had known ethnicity data, and 76.7% self-reported as Asian, 11.4% as Black, 6.8% as White, and 4.8% as other. Among the 844 patients, 237 (28.0%) were HBsAg (−) (<LLOQ), 190 (22.5%) had qHBsAg 1–100, 91 (10.8%) had qHBsAg 100–500, 54 (6.4%) had qHBsAg 500–1000, and 272 (32.2%) had qHBsAg >1000 IU/mL. Overall, 80% (682) had known HBeAg status at the last follow-up, and the majority (87.0%) were HBeAg-negative. In addition, 54% (461/844) had prior antiviral therapy, 19.7% of which (16.3, 23.7, <i>n</i> = 91) were HBsAg (−). The treated patients had a lower risk of cirrhosis (16.46, 95% CI 1.89–143.39, <i>p</i> = 0.01) or HCC (8.23, 95% CI 1.01–67.39, <i>p</i> = 0.05) than the untreated patients. A lower proportion of the HBsAg-loss group had cirrhosis (5.7% vs. 10.9%, <i>p</i> = 0.021) and HCC (0.9% vs. 6.2%, <i>p</i> = 0.001). Conclusion: In this retrospective, ethnically diverse cohort study, CHB patients who received antiviral therapy and/or had HBsAg loss were less likely to develop cirrhosis and HCC, confirming the results of the studies in less diverse cohorts. No association was found between the qHBsAg level and fibrosis determined with LSM. Individuals who achieved HBsAg loss had low-level qHBsAg within 1 year of seroclearance.https://www.mdpi.com/1999-4915/14/12/2668functional cureHBsAg lossquantitative HBsAgCanadamultiethnic |
| spellingShingle | Carla S. Coffin Sarah Haylock-Jacobs Karen Doucette Alnoor Ramji Hin Hin Ko David K. Wong Magdy Elkhashab Robert Bailey Julia Uhanova Gerald Minuk Keith Tsoi Alexander Wong Mang M. Ma Edward Tam Mayur Brahmania Carmine Nudo Julie Zhu Christopher F. Lowe Carla Osiowy B. Cord Lethebe Stephen E. Congly Eric K. H. Chan Angelina Villasis-Keever Urbano Sbarigia Curtis L. Cooper Scott Fung Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) Viruses functional cure HBsAg loss quantitative HBsAg Canada multiethnic |
| title | Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) |
| title_full | Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) |
| title_fullStr | Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) |
| title_full_unstemmed | Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) |
| title_short | Clinical Outcomes and Quantitative HBV Surface Antigen Levels in Diverse Chronic Hepatitis B Patients in Canada: A Retrospective Real-World Study of CHB in Canada (REVEAL-CANADA) |
| title_sort | clinical outcomes and quantitative hbv surface antigen levels in diverse chronic hepatitis b patients in canada a retrospective real world study of chb in canada reveal canada |
| topic | functional cure HBsAg loss quantitative HBsAg Canada multiethnic |
| url | https://www.mdpi.com/1999-4915/14/12/2668 |
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