caa a22 4500 606158014 CHVBK 20210128100617.0 cr unu---uuuuu 210128e20151101xx s 000 0 eng 10.1007/s10096-015-2467-x doi (NATIONALLICENCE)springer-10.1007/s10096-015-2467-x Low serum hyaluronic acid levels associated with spontaneous HBsAg clearance [Elektronische Daten] [S. Harkisoen, J. Arends, A. van den Hoek, K. van Erpecum, G. Boland, A. Hoepelman] Purpose: The pathophysiological underlying mechanism of spontaneous HBsAg clearance in hepatitis B virus (HBV) infected patients is largely unknown. However, serum hyaluronic acid (sHA) plays a role in liver fibrosis progression and reversely could serve as a potential biomarker for HBsAg clearance. This study investigates whether low sHA is associated with HBsAg loss in non-Asian HBV patients. Methods: Non-Asian women living in Amsterdam with known chronic HBV infection between 1990-2003 were invited for a single follow-up visit at the Municipal Health Service Amsterdam between September 2011 to May 2012. Serum hyaluronic acid and liver stiffness measurement together with clinical evaluation, biochemical and virologic blood tests were performed. Results: Of the 160 women, HBsAg loss occurred in 38 (23%) patients between diagnosis and follow-up. sHA levels were lower in HBsAg negative patients compared to HBsAg positive patients (14.5 [9.4-27.2] ng/mL vs 25.0 [12.3-42.5] ng/mL, p <0.01). A similar distinction in sHA between low and high HBV DNA was noted. sHA had a significant discriminatory ability to differentiate between HBsAg positive and HBsAg negative patients, (AUC 0.65 [95% CI 0.55-0.75], p < 0.01). In multivariable analysis only sHA level was associated with HBsAg loss (OR 0.4 [0.2-0.9]). Finally, F3-F4 fibrosis (cut-off >8.1 kPa) was diagnosed in 3% in HBsAg negative patients compared to 10% in HBsAg positive patients (p = 0.15). Conclusion: Serum HA levels are lower in patients who experience spontaneous HBsAg loss compared to HBsAg positive patients. The Author(s), 2015 Harkisoen S. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut Arends J. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut van den Hoek A. Department of Infectious diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands aut van Erpecum K. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands aut Boland G. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands aut Hoepelman A. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/11(2015-11-01), 2183-2189 0934-9723 34:11<2183 2015 34 10096 https://doi.org/10.1007/s10096-015-2467-x text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2467-x text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Harkisoen S. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut NATIONALLICENCE 700 1- Arends J. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut NATIONALLICENCE 700 1- van den Hoek A. Department of Infectious diseases, Public Health Service of Amsterdam (GGD), Amsterdam, The Netherlands aut NATIONALLICENCE 700 1- van Erpecum K. Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Boland G. Department of Medical Microbiology, University Medical Center Utrecht, Utrecht, The Netherlands aut NATIONALLICENCE 700 1- Hoepelman A. Department of Internal Medicine and Infectious Diseases, University Medical Center Utrecht, Heidelberglaan 100, P.O. Box 85500, F02.126, 3508, Utrecht, GA, The Netherlands aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/11(2015-11-01), 2183-2189 0934-9723 34:11<2183 2015 34 10096