Effect of seasonal variation on the clinical course of chronic hepatitis B

Zhang, Shijun; Chen, Zexiong; Jiang, Kaiping; Wu, Weikang; Zhang, Cui-Yi; Gu, Yanli

doi:10.1007/s00535-006-1903-1

Cited by 7 publications

(4 citation statements)

References 47 publications

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“…Ten studies included treated patients (although less than 10% of the cohort per inclusion criteria) and treatment status was unclear in 17 studies. In studies with treated patients, 4 included oral antivirals (35,56,62,81), 3 interferon therapy (20,35,38) and 4 either did not specify (26,65,72) or included older non-standard drugs (77). Co-infected patients were not excluded in 17 studies and either not reported or not tested in 7 studies.…”

Section: Resultsmentioning

confidence: 99%

Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses

Zhou

Contag

Whitaker

et al. 2019

The Lancet Gastroenterology & Hepatology

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Background-Spontaneous loss of hepatitis B surface antigen (HBsAg), or functional cure, in patients with chronic hepatitis B (CHB) significantly reduces liver-related complications. Differential rates have been suggested by individual studies performed in non-endemic and endemic regions, potentially related to likelihood of spontaneous clearance if CHB was acquired as an adult versus child. We systematically determined a pooled annual rate of HBsAg loss in untreated CHB-infected adults and examined impact of regional endemicity. Methods-Pubmed/EMBASE were searched for observational cohort studies and non-treatment arms of randomized controlled trials (RCTs) reporting proportion of patients with CHB achieving spontaneous HBsAg loss. RCTs were excluded from meta-analyses due to substantial cohort differences. Results were stratified on whether the underlying cohort primarily arose from an endemic, defined as CHB prevalence >2%, or non-endemic region. We explored sources of heterogeneity through univariate meta-regression. Results-Of 4771 screened, 66 studies (11 RCTs, 38 prospective and 17 retrospective cohort studies) met inclusion criteria and 55 were included in meta-analyses with exclusion of RCTs. Spontaneous HBsAg loss occurred in 3489 (7.6%) of 45,975 patients with 341,862 person-years of follow-up. The pooled annual incidence rate of HBsAg loss was 1.13% (0.92-1.36%, I 2 =96%). Rates did not differ by endemicity: 1.13% (0.85-1.45%) in endemic vs 1.29% (0.99-1.62%) in non-endemic cohorts. Meta-regression showed proportion of cohort HBeAg-negative and cohort age were primary contributors to substantial heterogeneity. Conclusion-Globally, spontaneous HBsAg loss occurs infrequently (~1% per year) in treatment-naïve adults with CHB infection. The low and homogeneous rate of HBsAg loss

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Section: Resultsmentioning

confidence: 99%

Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses

Zhou

Contag

Whitaker

et al. 2019

The Lancet Gastroenterology & Hepatology

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“…Seasonal variation in immunity has been found in healthy individuals and in association with some diseases [14]. There is paucity of data on effect of seasonal variation on prevalence of HBV and HCV infection.…”

Section: Discussionmentioning

confidence: 99%

Seasonal variation of hepatitis B and C virus infection among HIV- and non-HIV-infected patients in Benin City, Nigeria

Oladeinde¹,

Ekejindu²,

Omoregie³

2018

HIV & AIDS Review

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“…Seasonal reactivation of HBV might induce damage to hepatocytes and increase R249S release into the bloodstream in the weeks that follow reactivation. Seasonal hepatitis flare was described by Zhang et al (2006) in a longitudinal study of 2,238 subjects from the area of Guangzhou, China. In that study, acute exacerbation of hepatitis peaked during spring (March–May), and HBeAg seroconversion peaked during summer (June–August).…”

Section: Discussionmentioning

confidence: 99%

Seasonal Variation in TP53 R249S -Mutated Serum DNA with Aflatoxin Exposure and Hepatitis B Virus Infection

Villar

Roux-Goglin

Gouas

et al. 2011

Environ Health Perspect

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Background: Chronic hepatitis B virus (HBV) infection and dietary aflatoxin B1 (AFB1) exposure are etiological factors for hepatocellular carcinoma (HCC) in countries with hot, humid climates. HCC often harbors a TP53 (tumor protein p53) mutation at codon 249 (R249S). In chronic carriers, 1762T/1764A mutations in the HBV X gene are associated with increased HCC risk. Both mutations have been detected in circulating cell-free DNA (CFDNA) from asymptomatic HBV carriers.Objective: We evaluated seasonal variation in R249S and HBV in relation to AFB1 exposure.Methods: R249S was quantitated by mass spectrometry in CFDNA in a cross-sectional survey of 473 asymptomatic subjects (237 HBV carriers and 236 noncarriers) recruited in three villages in the Gambia over a 10-month period. 1762T/1764A HBV mutations were detected by quantitative polymerase chain reaction. In addition, the HBV S gene was sequenced in 99 subjects positive for HBV surface antigen (HBsAg).Results: We observed a seasonal variation of serum R249S levels. Positivity for R249S and average concentration were significantly higher in HBsAg-positive subjects surveyed during April–July (61%; 5,690 ± 11,300 R249S copies/mL serum) than in those surveyed October–March [32% and 480 ± 1,030 copies/mL serum (odds ratio = 3.59; 95% confidence interval: 2.05, 6.30; p < 0.001)]. Positivity for HBV e antigen (HBeAg) (a marker of HBV replication) and viral DNA load also varied seasonally, with 15–30% of subjects surveyed between April and June HBeAg positive, compared with < 10% surveyed during other months. We detected 1762T/1764A mutations in 8% of carriers, half of whom were positive for R249S. We found HBV genotype E in 95 of 99 HBsAg-positive subjects.Conclusion: R249S is detectable in CFDNA of asymptomatic subjects. Evidence of temporal and quantitative variations suggests an interaction among AFB1 exposure, HBV positivity, and replication on TP53 mutation formation or persistence.

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Effect of seasonal variation on the clinical course of chronic hepatitis B

Abstract: Seasonal variation might affect the clinical course of chronic hepatitis B. The role of seasonal triggering factors should be further investigated.

Cited by 7 publications

References 47 publications

Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses

Spontaneous loss of surface antigen among adults living with chronic hepatitis B virus infection: a systematic review and pooled meta-analyses

Seasonal variation of hepatitis B and C virus infection among HIV- and non-HIV-infected patients in Benin City, Nigeria

Seasonal Variation in TP53 R249S -Mutated Serum DNA with Aflatoxin Exposure and Hepatitis B Virus Infection

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