Characteristics and outcomes of HBV-infected patients with HBsAg and anti- HBs coexistence

Background

The coexistence of HBsAg and anti-HBs is a unique detection in chronic HBV-infected patients. This serological status has not been reported in Vietnamese cases.

Objectives

description of HBV viral markers, activity of hepatitis, and progression of HBV-infected patients with HBsAg and anti-HBs coexistence over a six-month follow-up period and define related factors to HBsAg seroclearance.

Method

cross-sectional descriptive study with a six-month follow-up on patients who tested positive for HBsAg and anti-HBs simultaneously at the Liver Clinic nit, Hospital for Tropical Diseases, Vietnam, from 12/2018 to 12/2019.

Result

122 patients with coexistence of HBsAg and anti-HBs were included. 50.8 % were male, with median age of 42 (30-53). The median of ALT was 34 (24-66) U/L, 24.6 % had chronic hepatitis, 32 % had positive HBeAg, median of HBsAg was 1.76 ((-0.25) – (2.87)) log IU/mL, median of anti-HBs was 50 (24-99) mIU/mL, median of HBVDNA was 3.45 (1.46-6.55) log copies/mL. Eighty-four patients were confirmed chronic HBV infection with anti-HBs coexistence (68.9 %), 26.2 % loss HBsAg, and 6 cases (4.9 %) loss anti-HBs, as chronic HBV infection. Without chronic hepatitis, HBsAg <100 S/CO, high anti-HBs, low HBsAg quantification lower 3 log IU/mL, HBeAg negative, HBV DNA lower 1.7 log copies/mL related to HBsAg seroclearance.

Conclusion

The coexistence of HBsAg and anti-HBs occurs in both HBeAg-negative and HBeAg-positive patients. Most cases had high viral load, and one-fourth of cases had chronic liver diseases. HBsAg loss occurred in 26.2 % of cases and related to chronic liver disease, low HBsAg, high anti-HBs, and low HBV DNA.