Rate and durability of the clearance of HBsAg in Alaska Native persons with long-term HBV infection: 1982-2019

Hepatology. 2024 Jun 1;79(6):1412-1420. doi: 10.1097/HEP.0000000000000658. Epub 2023 Nov 7.


Background and aims: A functional cure and therapeutic end point of chronic HBV infection is defined as the clearance of HBsAg from serum. Little is known about the long-term durability of HBsAg loss in the Alaskan Native population.

Approach and results: We performed a retrospective cohort study of Alaska Native patients with chronic HBV-monoinfection from January 1982 through December 2019. The original group in this cohort was identified during a 1982 to 1987 population-based screening for 3 HBV serologic markers in 53,000 Alaska Native persons. With close to 32,000 years of follow-up, we assessed the frequency and duration of HBsAg seroclearance (HBsAg-negative for > 6 mo). We examined factors associated with HBsAg clearance and followed persons for a median of 13.1 years afterward to assess the durability of HBsAg clearance. Among 1079 persons with an average length of follow-up of 33 years, 260 (24%) cleared HBsAg at a constant rate of 0.82% per person/per year. Of the 260 persons who cleared, 249 (96%) remained HBsAg-negative, while 11 persons had ≥ 2 transient HBsAg-positive results in subsequent follow-up.

Conclusions: Of the patients with chronic HBV monoinfection, 0.82% of people per year achieved a functional cure. HBsAg seroclearance was durable for treated and nontreated patients and lasted, on average, over 13 years without seroreversion.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Alaska / epidemiology
  • Alaska Natives* / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Hepatitis B Surface Antigens* / blood
  • Hepatitis B virus / immunology
  • Hepatitis B, Chronic* / blood
  • Hepatitis B, Chronic* / epidemiology
  • Hepatitis B, Chronic* / immunology
  • Humans
  • Male
  • Middle Aged
  • Retrospective Studies
  • Time Factors
  • Young Adult