Prediction for HBsAg seroconversion in children with chronic hepatitis B

BMC Infectious Diseases

Xiu-Chang Zhang¹  Jie Liu¹  Yan-Jie Bai²  Ce Shi³  Min Zhang³  Yan-Min Shi³  Peng Liu³  Xiao-He Xiao³  Fang Chu³  Yan-Wei Zhong³  Jiao-Jiao Xu⁴ 

[1] Hebei North University, South Diamond Road No.11, High Tech Zone, 075000, Zhangjiakou Province, Hebei, China;Peking University Third Hospital, 49 North Garden Rd., 100191, Beijing, China;Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Xisihuan Mid-Road No.100, 100039, Beijing, China;Senior Department of Hepatology, the Fifth Medical Center of Chinese PLA General Hospital, Xisihuan Mid-Road No.100, 100039, Beijing, China;Hebei North University, South Diamond Road No.11, High Tech Zone, 075000, Zhangjiakou Province, Hebei, China;

关键词: Children;    Chronic hepatitis B;    HBsAg seroconversion;    HBV cccDNA;    HBsAg;   

DOI  :  10.1186/s12879-021-06883-1

来源: Springer

【 摘 要 】

BackgroundTo establish a prediction of HBsAg seroconversion in children with chronic hepatitis B (CHB), so as to help clinicians to choose therapeutic strategy.MethodsA total of 63 children with HBeAg-positive CHB aged 1 to 17 years, who admitted to the fifth medical center of Chinese PLA general hospital and treated with interferon α (IFNα) 48 weeks were enrolled, the clinical data were measured. Based on the results of HBsAg seroconversion (HBsAg < 0.05 IU/mL and anti-HBsAg > 10 IU/L) at week 48, the patients were divided into HBsAg seroconversion (S) group and non-HBsAg seroconversion (NS) group. Multivariate COX regression was used to identify the impact factors associated with HBsAg seroconversion. A novel prediction index was established and the area under the receiver operating characteristic curve (AUROC) was used to assess the prediction for HBsAg seroconversion.ResultsThe 63 patients were divided into S group (20.6%, 13/63) and NS group (79.4%, 50/63). Univariate and multivariate analysis identified age, baseline intrahepatic cccDNA and serum HBsAg levels were independent impact factors for HBsAg seroconversion. Intrahepatic cccDNA was positively correlated with serum HBsAg (r = 0.464, p = 0.000). AUROC of HBV cccDNA was 0.83 (95% CI 0.71 to 0.95) and AUROC of baseline HBsAg was 0.77 (95% CI 0.61 to 0.92). Intrahepatic cccDNA ≤ 0.08 log10 copies/106 cell is regarded as cutoff value, the positive predictive value(PPV) and negative predictive value(NPV) for HBsAg seroconversion were 86.8% and 60.0%, respectively, with a sensitivity of 92.0% and specificity of 56.2%. HBsAg ≤ 3.68 log10 IU/mL is used as cut off value, the PPV and NPV for HBsAg seroconversion were 91.2% and 56.3%, respectively; the sensitivity and specificity was 86.0% of 69.2%, respectively. There was no statistical difference between them for predicting HBsAg seroconversion (p = 0.146).ConclusionsHBsAg seroconversion can be predicted by the baseline serum HBsAg or intrahepatic cccDNA in children with CHB. Using the index, clinicians can choose more reasonable therapeutic strategy and reduce the waste of medical resources.

【 授权许可】

CC BY