HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases
HBsAg and anti-HBs coexistence represents an unusual serological pattern in hepatitis B virus (HBV) infection. However, its natural course remains unclear. This study investigated the occurrence of this serological pattern in patients with HBV in acute and chronic phases and estimated the associated...
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Elsevier
2025-05-01
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| Series: | Virus Research |
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| author | Zhongshu Pu Zhaohua Ji Haixia Su Ting Fu Zhongjun Shao Yongping Yan |
| author_facet | Zhongshu Pu Zhaohua Ji Haixia Su Ting Fu Zhongjun Shao Yongping Yan |
| author_sort | Zhongshu Pu |
| collection | DOAJ |
| description | HBsAg and anti-HBs coexistence represents an unusual serological pattern in hepatitis B virus (HBV) infection. However, its natural course remains unclear. This study investigated the occurrence of this serological pattern in patients with HBV in acute and chronic phases and estimated the associated risks. Of the 215 adult patients diagnosed with acute-phase HBV, 19 (8.84 %) cases demonstrated HBsAg and anti-HBs coexistence. In the chronic phase, 54 new cases of HBsAg and anti-HBs coexistence were identified during a median follow-up of 14 months (interquartile range: 14–28) among 4593 HBsAg-positive patients. The average annual incidence of coexistence was 1.41 % ± 0.28 %. The cumulative risk of HBsAg and anti-HBs coexistence in chronic phase patients was higher in those aged ≥ 50 years (risk ratio [RR]: 1.79, 95 % confidence interval [CI]: 1.04–3.09, P = 0.035), with positive HBeAg (RR: 3.43, 95 % CI: 1.91–6.19, P < 0.001), baseline alanine transaminase abnormalities (RR: 3.62, 95 % CI: 1.93–6.79, P < 0.001), and higher HBV DNA levels (RR: 1.97, 95 % CI: 1.12–3.49, P = 0.017). The quasispecies heterogeneity of the “a” determinant mutation demonstrated no significant change during the occurrence of coexistence with HBsAg and anti-HBs in HBV infection. Therefore, HBsAg and anti-HBs coexistence may be the intermediate process in the natural history of HBV infection, unrelated to “a'' determinant mutation but associated with the disease phase. |
| format | Article |
| id | doaj-art-07deece8d5114349a77fbb675657e733 |
| institution | DOAJ |
| issn | 1872-7492 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Elsevier |
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| series | Virus Research |
| spelling | doaj-art-07deece8d5114349a77fbb675657e7332025-08-20T03:10:29ZengElsevierVirus Research1872-74922025-05-0135519956710.1016/j.virusres.2025.199567HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phasesZhongshu Pu0Zhaohua Ji1Haixia Su2Ting Fu3Zhongjun Shao4Yongping Yan5Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR ChinaDepartment of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR China; Corresponding author at: Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, No.169 Changle West Road, Xincheng District, Xi'an, Shaanxi 710032, PR China.Department of Epidemiology, School of Public Health, Air Force Medical University, Xi'an, PR China; Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, Xi'an, PR China; Corresponding author at: Department of Epidemiology, Ministry of Education Key Lab of Hazard Assessment and Control in Special Operational Environment, School of Public Health, Air Force Medical University, No.169 Changle West Road, Xincheng District, Xi'an, Shaanxi 710032, PR China.HBsAg and anti-HBs coexistence represents an unusual serological pattern in hepatitis B virus (HBV) infection. However, its natural course remains unclear. This study investigated the occurrence of this serological pattern in patients with HBV in acute and chronic phases and estimated the associated risks. Of the 215 adult patients diagnosed with acute-phase HBV, 19 (8.84 %) cases demonstrated HBsAg and anti-HBs coexistence. In the chronic phase, 54 new cases of HBsAg and anti-HBs coexistence were identified during a median follow-up of 14 months (interquartile range: 14–28) among 4593 HBsAg-positive patients. The average annual incidence of coexistence was 1.41 % ± 0.28 %. The cumulative risk of HBsAg and anti-HBs coexistence in chronic phase patients was higher in those aged ≥ 50 years (risk ratio [RR]: 1.79, 95 % confidence interval [CI]: 1.04–3.09, P = 0.035), with positive HBeAg (RR: 3.43, 95 % CI: 1.91–6.19, P < 0.001), baseline alanine transaminase abnormalities (RR: 3.62, 95 % CI: 1.93–6.79, P < 0.001), and higher HBV DNA levels (RR: 1.97, 95 % CI: 1.12–3.49, P = 0.017). The quasispecies heterogeneity of the “a” determinant mutation demonstrated no significant change during the occurrence of coexistence with HBsAg and anti-HBs in HBV infection. Therefore, HBsAg and anti-HBs coexistence may be the intermediate process in the natural history of HBV infection, unrelated to “a'' determinant mutation but associated with the disease phase.http://www.sciencedirect.com/science/article/pii/S0168170225000449HBsAg and anti-HBs coexistenceOccurrenceRisk factorsNatural history |
| spellingShingle | Zhongshu Pu Zhaohua Ji Haixia Su Ting Fu Zhongjun Shao Yongping Yan HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases Virus Research HBsAg and anti-HBs coexistence Occurrence Risk factors Natural history |
| title | HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases |
| title_full | HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases |
| title_fullStr | HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases |
| title_full_unstemmed | HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases |
| title_short | HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases |
| title_sort | hbsag and anti hbs coexistence in patients with hbv in acute and chronic phases |
| topic | HBsAg and anti-HBs coexistence Occurrence Risk factors Natural history |
| url | http://www.sciencedirect.com/science/article/pii/S0168170225000449 |
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