Delayed clearance of serum HBsAg in compensated cirrhosis B: relation to interferon alpha therapy and disease prognosis. European Concerted Action on Viral Hepatitis (EUROHEP)

Am J Gastroenterol. 1998 Jun;93(6):896-900. doi: 10.1111/j.1572-0241.1998.00272.x.


Objective: The aim of this study was to evaluate the incidence, prognostic factors and clinical significance of delayed clearance of serum HBsAg in compensated cirrhosis B.

Methods: This was a retrospective cohort study of 309 consecutive white patients with biopsy-proved compensated cirrhosis type B.

Results: During a mean follow-up of 68 months, HBsAg loss occurred in 32 patients, including 16 (8%) of 196 untreated patients (mean annual incidence 0.8%), 8 (10%) of 82 interferon (IFN) alpha-treated patients and eight patients who had been treated with other antivirals or steroids. The 5-yr probability of HBsAg loss was 4% and 16% for untreated and IFN-treated patients, respectively (p = 0.0001). Cox's regression analysis identified hepatitis B e antigen-positivity at entry as the sole independent prognostic factor for HBsAg loss. Of the 32 patients who lost HBsAg, one (3%) subsequently developed hepatocellular carcinoma (HCC) and died, whereas, among the patients who remained HBsAg-positive, 11% developed HCC and 20% had died. The probability of HCC appearance was lower (p = 0.0137) and survival was longer (p = 0.0006) in patients who cleared HBsAg compared with patients with HBsAg persistence.

Conclusion: The incidence of HBsAg loss is about 0.8% in cirrhosis type B. Prognostic factors for clearance of HBsAg are initial HBeAg positivity and therapy with alpha interferon. Patients with cirrhosis type B, who lose HBsAg, have a low risk for liver cancer or liver-related death.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Carcinoma, Hepatocellular / etiology
  • Cohort Studies
  • Disease Progression
  • Follow-Up Studies
  • Hepatitis B / complications
  • Hepatitis B / diagnosis*
  • Hepatitis B / mortality
  • Hepatitis B / therapy
  • Hepatitis B Surface Antigens / blood*
  • Humans
  • Interferon-alpha / therapeutic use*
  • Liver Cirrhosis / diagnosis*
  • Liver Cirrhosis / mortality
  • Liver Cirrhosis / therapy
  • Liver Cirrhosis / virology
  • Liver Neoplasms / etiology
  • Prognosis
  • Regression Analysis
  • Retrospective Studies
  • Treatment Outcome


  • Hepatitis B Surface Antigens
  • Interferon-alpha