Evidence map›Paper›PMID 29221441›Full record

ArticleBMC gastroenterology2017

Time-varying serum gradient of hepatitis B surface antigen predicts risk of relapses after off-NA therapy.

Nai-Hsuan Chien, Yen-Tsung Huang, Chun-Ying Wu, Chi-Yang Chang, Ming-Shiang Wu, Jia-Horng Kao, Lein-Ray Mo, Chi-Ming Tai, Chih-Wen Lin, Tzeng-Huey Yang and 2 more

Abstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in BMC gastroenterology, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed.

  1. [Controversy and consensus on antiviral treatment strategies for low-level hepatitis B surface antigens].Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology · 2025
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Nai-Hsuan ChienCathay General Hospital, Taipei, Taiwan.
Yen-Tsung HuangInstitute of Statistical Science, Academia Sinica, Taipei, Taiwan.
Chun-Ying WuDivision of Gastroenterology, Taichung Veterans General Hospital, Taichung, Taiwan.
Chi-Yang ChangSchool of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
Ming-Shiang WuDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Jia-Horng KaoDepartment of Internal Medicine, National Taiwan University Hospital, Taipei, Taiwan.
Lein-Ray MoDepartment of Internal Medicine, Tainan Municipal Hospital, Tainan, Taiwan.
Chi-Ming TaiDivision of Gastroenterology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Chih-Wen LinDivision of Gastroenterology, E-Da Hospital/I-Shou University, Kaohsiung, Taiwan.
Tzeng-Huey YangDepartment of Internal Medicine, Lotung Poh-Ai Hospital, Yilan Country, Taiwan.
Jaw-Town LinSchool of Medicine, Fu Jen Catholic University, New Taipei, Taiwan.
Yao-Chun HsuSchool of Medicine, Fu Jen Catholic University, New Taipei, Taiwan. gatsbyhsu@yahoo.com.tw.

Funding

Cathay General Hospital and Fu-Jen University 104-GGH-FJU-11E-Da Hospital EDAHP105019Taipei Pathology Institutes TIP104-2
6 · The paper itself

Abstract

backgroundThe serum gradient of hepatitis B surface antigen (HBsAg) varies over time after cessation of nucleos(t)ide analog (NA) treatment in patients with chronic hepatitis B (CHB). The association between the time-varying HBsAg serum gradient and risk of relapse has not been elucidated.

methodsThis multicenter cohort study prospectively enrolled CHB patients who discontinued 3 year-NA treatment. Eligible patients were serologically negative for HBeAg and viral DNA at NA cessation. The participants (n = 140) were followed every 3 months through HBsAg quantification. Virological and clinical relapses were defined as viral DNA levels >2000 IU/mL and alanine aminotransferase (ALT) levels >80 U/mL, respectively. The association of time-varying HBsAg levels with relapses was assessed through a time-dependent Cox analysis.

resultsDuring a median follow-up of 19.9 (interquartile range [IQR], 10.6-25.3) months, virological and clinical relapses occurred in 94 and 49 patients, with a 2-year cumulative incidence of 79.2% (95% confidence interval [CI], 70.9%-86.4%) and 42.9% (95% CI, 34.1%-52.8%), respectively. The serum level of HBsAg was associated with virological (P < 0.001) and clinical (P = 0.01) relapses in a dose-response manner, with adjusted hazard ratios of 2.10 (95% CI, 1.45-3.04) and 2.32 (95% CI, 1.28-4.21). Among the patients (n = 19) whose HBsAg levels ever dropped below 10 IU/mL, only one and three patients subsequently developed clinical and virological relapses.

conclusionThe serum gradient of HBsAg measured throughout the off-therapy observation is associated with the subsequent occurrence of virological and clinical relapses in CHB patients who discontinue NA treatment.

Indexed as

AdultAlanine TransaminaseAntiviral AgentsCohort StudiesDNA, ViralDose-Response Relationship, DrugFemaleHepatitis B, ChronicHepatitis B Surface AntigensHumansMaleMiddle AgedProspective StudiesRecurrenceRisk FactorsWithholding TreatmentAlanine TransaminaseAntiviral AgentsDNA, ViralHepatitis B Surface AntigensChronic hepatitis BHepatitis B surface antigen quantificationNucleos(t)ide analogsTime-dependent Cox proportion hazards model

Identifiers

PMID29221441
PMCPMC5723064

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.