ArticleVirus research2025
HBsAg and anti-HBs coexistence in patients with HBV in acute and chronic phases.
Article in Virus research, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.
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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.
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Who cites it
3 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Global epidemiology of hepatitis B virus infection in dialysis patients: a systematic review and meta-analysis of prevalence, immunity, risk factors, and beyond.International urology and nephrology · 2026Pooled it
- Breaking the serologic rule: chronic hepatitis B with simultaneous HBsAg and anti-HBs positivity-a case report.Journal of medical case reports · 2026Article
- Unusual Concurrent HBsAg and Anti-HBs Positivity in Chronic Hepatitis B with Compensated Cirrhosis.European journal of case reports in internal medicine · 2025Article
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Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
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.
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