Lower end of treatment HBsAg and HBcrAg were associated with HBsAg loss after nucleos(t)ide analog cessation

BMC Gastroenterology

Research

Bo Feng¹  Yandi Xie¹  Sujun Zheng²  Minghui Li³  Lai Wei⁴  Anlin Ma⁵  Xiaoyuan Xu⁶  Yinjie Gao⁷  Ying Yang⁸  Huanwei Zheng⁹  Jia Li^1,10  Yuemin Nan^1,11  Xiaojuan Ou^1,12  Juan Liu^1,13 

[1] Beijing Key Laboratory of Hepatitis C and Immunotherapy for Liver Diseases, Peking University People’s Hospital, Peking University Hepatology Institute, Beijing International Cooperation Base for Science and Technology on NAFLD Diagnosis, 100044, Beijing, China;Complicated Liver Diseases and Artificial Liver Treatment and Training Center, Beijing Municipal Key Laboratory of Liver Failure and Artificial Liver Treatment and Research, Beijing Youan Hospital, Capital Medical University, 100069, Beijing, China;Department of Hepatology Division, Beijing Ditan Hospital, Capital Medical University, 100015, Beijing, China;Department of Hepatopancreatobiliary Disease, Beijing Tsinghua Changgung Hospital, School of Clinical Medicine, Tsinghua University, 102218, Beijing, China;Department of Infectious Disease, Friendship Hospital, 100029, Beijing, China;Department of Infectious Diseases, Peking University First Hospital, 100034, Beijing, China;Department of Infectious Diseases, The Fifth Medical Center, General Hospital of PLA, 100039, Beijing, China;Department of Infectious Diseases, The Second Hospital of Xingtai, 054001, Xingtai, Hebei, China;Department of Liver Disease, Shijiazhuang Fifth Hospital, 050021, Shijiazhuang, Hebei, China;Department of Liver Disease, Tianjin Second People’s Hospital, 300192, Tianjin, China;Department of Traditional and Western Medical Hepatology, The Third Hospital of Hebei Medical University, 050051, Shijiazhuang, Hebei, China;Liver Research Center, Beijing Friendship Hospital, Capital Medical University, 100050, Beijing, China;Research Center for Technologies in Nucleic Acid-Based Diagnostics, 410205, Changsha, Hunan, China;

关键词: Nucleos(t)ide analog;    Cessation;    Hepatitis B surface antigen;    Hepatitis B core-related antigen;    Hepatitis B virus RNA;   

DOI  :  10.1186/s12876-023-02852-x

 received in 2023-02-21, accepted in 2023-06-13,  发布年份 2023

来源: Springer

【 摘 要 】

BackgroundSince hepatitis B surface antigen (HBsAg) loss is rarely achieved with nucleos(t)ide analog (NA) treatment, most patients require life-long NA treatment. Previous studies have shown that some patients remain virologically responsive even after NA cessation. However, there is still controversy surrounding whether NA discontinuation increases the HBsAg loss rate. Therefore, this study aimed to assess the cumulative rate of HBsAg loss and identify the predictors of HBsAg loss after NA discontinuation.MethodsThis multicenter prospective study included HBV e antigen (HBeAg)-positive patients without cirrhosis from 12 hospitals in China who met the inclusion criteria. The enrolled patients stopped NA and were followed up with clinical and laboratory assessments every 3 months for 24 months after NA cessation or until clinical relapse (CR) occurred.ResultsOverall, 158 patients were classified into two groups. Group A included patients with HBsAg positivity at NA cessation (n = 139), and Group B included patients with HBsAg negativity at NA cessation (n = 19). In Group A, the 12-month and 24-month cumulative rates of HBsAg loss were4.3%and 9.4%, respectively. End of treatment (EOT) HBsAg (hazard ratio (HR) = 0.152, P < 0.001) and EOT hepatitis B core-related antigen (HBcrAg) (HR = 0.257, P = 0.001) were associated with HBsAg loss. The areas under the receiver operating characteristic curves for EOT HBsAg and HBcrAg levels were 0.952 (P < 0.001) and 0.765 (P < 0.001), respectively. Patients with EOT HBsAg ≤ 135 IU/mL (59.2% vs. 1.3%, P < 0.001) or HBcrAg ≤ 3.6 logU/mL (17% vs. 5.4%, P = 0.027) had a higher 24-month cumulative HBsAg loss rate. In Group B, none of the patients experienced virological relapse after NA cessation. Only 1 (5.3%) patient had HBsAg reversion.ConclusionsEOT HBsAg ≤ 135 IU/mL or HBcrAg ≤ 3.6 logU/mL can be used to identify patients with a higher likelihood of HBsAg loss after NA cessation. Patients with HBsAg negativity after NA cessation have favorable clinical outcomes, and HBsAg loss was durable in most cases.

【 授权许可】

CC BY   
© The Author(s) 2023

【 图 表 】

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