Acute hepatitis B in the vaccination era: Predictors of functional cure and chronicity

Table 1 Patient characteristics, n (%) or mean ± SD

	Total (n = 78)	Chronic HBV (n = 27)	Functional cure (n = 51)	P value1
Male	55 (71)	23 (85)	32 (63)	0.03
Ethnicity				0.3
Arab	20 (26)	9(33)	11 (22)
Jewish	58 (74)	18 (67)	40 (78)
Age (years)	39.2 ± 15.5	42.0 ± 17.2	37.7 ± 14.6	0.3
Region of birth				0.4
Israel	48 (62)	16 (59)	32 (63)
Africa	8 (10)	5 (19)	3(5.9)
Middle East	7 (9)	3 (11)	4 (7.8)
Russia/Former Union of Soviet Socialist Republics	8 (10)	1 (3.7)	7 (14)
Europe	2 (2.6)	1 (3.7)	1 (2)
Other	5 (6.4)	1 (3.7)	4 (7.8)
History of alcohol use	7 (9)	2 (7.4)	5 (9.8)	> 0.9
Active smoking	8 (16)	2 (15)	6 (17)	0.3
IV drug use	5 (6.4)	2 (7.4)	3 (5.9)	> 0.9
BMI (kg/m2)	25.4 ± 7.1	26.7 ± 6.1	24.7 ± 7.5	0.2
Diabetes mellitus	9 (12)	7 (26)	2 (3.9)	0.007
Hypertension	17 (22)	7 (26)	10 (20)	0.5
Dyslipidemia	5 (6.4)	3 (11)	2 (3.9)	0.3
Anti-HBs positive	30 (48)	8 (33)	22 (58)	0.059
HBeAg positive	49 (64)	18 (67)	31 (62)	0.7
HBV DNA (IU/mL)2	1.48 × 106 ± 3.5 × 106	1.25 × 106 ± 9.2 × 105	1.54 × 106 ± 3.9 × 106	0.8

¹Pearson’s χ² test; Wilcoxon rank sum test.

²Data available for only 25.9% and 58.8% of patients in the chronic hepatitis B virus and functional cure groups respectively.

HBV: Hepatitis B virus; BMI: Body mass index; HBeAg: Hepatitis B envelope antigen; Anti-HBs: Anti-hepatitis B surface.

Table 2 Clinical presentation of patients with chronic hepatitis B virus and patients who achieved functional cure, n (%) or mean ± SD

	Total (n = 78)	Chronic HBV (n = 27)	Functional cure (n = 51)	P value1
ALT (IU/mL)	1770 ± 1585	1103 ± 1540	2117 ± 1509	0.01
AST (IU/mL)	1193 ± 1111	838 ± 1166	1378 ± 1046	0.058
Total bilirubin (mg/dL)	10.2 ± 8.87	6.52 ± 8.62	12.0 ± 8.5	0.01
Direct bilirubin (mg/dL)	4.31 ± 3.98	4.26 ± 5.89	6.87 ± 4.99	0.07
Alkaline phosphatase (IU/mL)	190 ± 101	159 ± 87	207 ± 105	0.04
GGT (IU/mL)	219 ± 144	175 ± 128	236 ± 148	0.12
Albumin (g/dL)	3.78 ± 0.57	3.86 ± 0.54	3.74 ± 0.59	0.4
INR	1.39 ± 0.85	1.24 ± 0.42	1.46 ± 1.0	0.2
Creatinine (mg/dL)	0.81 ± 0.31	0.89 ± 0.43	0.77 ± 0.23	0.2
Hemoglobin (g/dL)	13.78 ± 1.88	14.26 ± 1.82	13.53 ± 1.89	0.1
Platelets (× 103/micL)	230 ± 99	216 ± 121	238 ± 85	0.4
Na (mEq/L)	138.5 ± 3.0	138.7 ± 3.1	138.4 ± 2.9	0.7
MELD-3	8.97 ± 3.16	8.19 ± 3.07	9.34 ± 3.17	0.2
NA treatment				0.4
Entecavir	6 (7.6)	2 (7.4)	4 (7.8)
Lamivudine	1 (1)	1 (3.4)	0 (0)
No treatment	71 (91)	24 (89)	47 (92)

¹Welch two sample t-test.

ALT: Alanine aminotransferase; AST: Aspartate aminotransferase; GGT: Gamma glutamyl transferase; INR: International normalized ratio; NA: Nucleos(t)ide analogue; HBV: Hepatitis B virus.

Table 3 Univariate analysis odds ratio analysis of factors leading to hepatitis B surface antigen persistence

Predictor	Odds ratio (confidence interval)	P value
Age	1.02 (0.99-1.05)	0.243
Gender	3.41 (1.11-12.97)	0.0458
BMI	1.04 (0.97-1.12)	0.264
Diabetes	8.57 (1.88-61.01)	0.0109
SES (high)	0.46 (0.22-0.89)	0.0289

BMI: Body mass index; SES: Socioeconomic status.