부산대학교 도서관

Background Both spontaneous and nucleos(t)ide analogue (Nuc)-treated hepatitis B surface antigen ( HBsAg) seroclearance are associated with excellent clinical outcomes. Aim To conduct a case-control study to explore whether there is difference of clinical outcomes between these two groups. Methods A total of 312 chronic hepatitis B patients with spontaneous HBsAg seroclearance and 110 patients with Nuc-treated HBsAg seroclearance were recruited retrospectively. Propensity score ( PS) matching method produced 98 patients in each group for comparison. The development of hepatocellular carcinoma ( HCC), hepatic complications and cumulative incidence of antibody to HBsAg (anti- HBs) was compared. Results During a mean follow-up period of 107 months after HBsAg seroclearance, five patients developed HCC after a mean period of 75.3 months (four and one patients with spontaneous and Nuc-treated HBsAg seroclearance, respectively) in overall population. One died of pneumonia with sepsis and one experienced variceal bleeding in Nuc-treated patients but none in spontaneous group. The incidence of anti- HBs seroconversion was comparable between spontaneous and Nuc-treated HBsAg seroclearance (69.6% vs. 66.4%, respectively, P = 0.617). There were no significant differences in HCC development (2% vs. 1.1%), overall mortality (0% vs. 1%), variceal bleeding (0% vs. 4.2%) and 6-year cumulative incidence of anti- HBs seroconversion (62.3% vs. 61.5%) among PS-matched patients with spontaneous and Nuc-treated HBsAg seroclearance. Conclusions The clinical outcomes between patients with spontaneous and Nuc-treated HBsAg seroclearance are comparable. HCC can develop at a low rate during long-term follow-up and periodic surveillance after HBsAg seroclearance is still mandatory. [ABSTRACT FROM AUTHOR]