Metabolic syndrome delays HBeAg seroclearance in Chinese patients with hepatitis B

Aliment Pharmacol Ther. 2014 Sep;40(6):716-26. doi: 10.1111/apt.12874. Epub 2014 Jul 13.

Abstract

Background: Delayed hepatitis B e antigen (HBeAg) seroclearance increases the risk of cirrhosis and hepatocellular carcinoma (HCC). The effect of metabolic syndrome (MetS) on HBeAg seroclearance in chronic hepatitis B (CHB) patients remains unclear.

Aims: To examine the effect of MetS on HBeAg seroclearance.

Methods: A prospective cohort of 413 treatment-naïve HBeAg-positive CHB patients from 2005 to 2012 was studied. Clinical, virological and histological parameters were evaluated. The patients were classified into three groups according to the metabolic characteristics; normal, pre-MetS and MetS based on the International Diabetes Federation criteria. The primary outcome was age at HBeAg seroclearance.

Results: The overall HBeAg seroclearance rate was 11.4% per annum during 19 351 patient-months of follow-up with no difference in HBeAg seroclearance rates between 162 treatment-free and 251 patients receiving nucleos(t)ide analogues. Patients with pre-MetS and MetS were older when HBeAg seroclearance occurred (44 ± 12 and 53 ± 7 years, respectively) than the normal patients (37 ± 9 years, all P < 0.01). Patients with pre-MetS and MetS had more advanced liver fibrosis (33.0% and 53.1%, respectively) than the normal patients (18.4%, all P < 0.05). By the age of 50, 59.3% of the metabolic normal patients, 42.1% of the pre-MetS and 18.7% of the MetS patients had achieved HBeAg seroclearance (all P < 0.05, except P = 0.07 for pre-MetS vs. MetS). In multivariate analysis, MetS and type II diabetes at baseline were predictors of delayed HBeAg seroclearance after adjusting for viral load, anti-viral therapy and necroinflammatiom.

Conclusion: Chinese patients with chronic hepatitis B and with pre-metabolic syndrome or metabolic syndrome have delayed HBeAg seroclearance.

MeSH terms

  • Adult
  • Asian People
  • Comorbidity
  • Female
  • Hepatitis B / immunology
  • Hepatitis B e Antigens / blood*
  • Hepatitis B, Chronic / blood*
  • Hepatitis B, Chronic / epidemiology
  • Hepatitis B, Chronic / immunology
  • Humans
  • Male
  • Metabolic Syndrome / blood*
  • Metabolic Syndrome / epidemiology
  • Metabolic Syndrome / immunology
  • Middle Aged
  • Prospective Studies

Substances

  • Hepatitis B e Antigens