Trajectories of serum hepatitis B surface antigen kinetics in patients with chronic hepatitis B receiving long‐term nucleos(t)ide analogue therapy
Wei‐Fan Hsu
Chuen‐Fei Chen
Hsueh‐Chou Lai
Wen‐Pang Su
Chia‐Hsin Lin
Po‐Heng Chuang
Sheng‐Hung Chen
Ching‐Hsiang Chen
Hung‐Wei Wang
Guan‐Tarn Huang
Cheng‐Yuan Peng
First published: 31 August 2017
https://doi.org/10.1111/liv.13564
Cited by: 1
Funding informationThis study was supported by a grant (No. DMR‐101‐011) from China Med ... More
Handling Editor: Chun‐Jen Liu
Abstract
Background & Aims
The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long‐term nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients remains unclear. We investigated the patterns of serum HBsAg kinetics and their association with therapeutic outcomes in genotype B‐ or C‐infected CHB patients receiving long‐term NA therapy.
Methods
We enrolled 329 treatment‐naive CHB patients receiving NA therapy for >5 years to analyse the kinetic patterns by using group‐based trajectory models (GBTMs).
Results
Most patients (82.4%) received entecavir therapy. The median treatment duration was 83.6 (68.5‐89.7) months. The GBTMs revealed three groups for both the hepatitis B e antigen (HBeAg)‐positive and ‐negative patients. The median annual decline in serum HBsAg levels during the first 5 years was significantly higher in Group 1 than in Groups 2 and 3 in HBeAg‐positive (0.78 vs 0.10 vs 0.10 log10IU/mL) and HBeAg‐negative (0.71 vs 0.08 vs 0.09 log10IU/mL) patients. HBsAg levels at the baseline and 12 months combined with an HBsAg decline from the baseline to 12 months of treatment predicted trajectory pattern 1 in HBeAg‐positive (sensitivity, 77.8%; specificity, 99.1%; positive predictive value [PPV], 87.5%; and negative predictive value [NPV], 98.2%) and HBeAg‐negative (sensitivity, 100%; specificity, 99.5%; PPV, 88.9%; and NPV, 100%) patients. The trajectory patterns were significantly associated with HBeAg loss in the HBeAg‐positive patients and the achievement of HBsAg <100 IU/mL or HBsAg loss in HBeAg‐positive and HBeAg‐negative patients.
Conclusions
The trajectory of serum HBsAg levels predicts HBsAg loss in CHB patients receiving long‐term NA therapy.
大多数患者（82.4％）接受恩替卡韦治疗。中位治疗时间为83.6（68.5-89.7）个月。 GBTMs揭示了乙肝e抗原（HBeAg）阳性和阴性患者的三个组。在HBeAg阳性组中，前5年血清HBsAg水平每年中位数下降的幅度显着高于组2和组3（分别为0.78 vs 0.10 vs 0.10 log10IU / mL）和HBeAg阴性（0.71 vs 0.08 vs 0.09 log10IU / mL）患者。在基线和12个月时HBsAg水平与治疗12个月HBsAg下降联合预测HBeAg阳性（敏感度为77.8％;特异性为99.1％;阳性预测值[PPV]为87.5％;和阴性预测值[NPV]，98.2％）和HBeAg阴性（敏感性，100％;特异性，99.5％; PPV，88.9％;和NPV，100％）患者。 HBeAg阳性患者的HBeAg消失和HBeAg阳性和HBeAg阴性患者HBsAg <100 IU / mL或HBsAg消失的实现轨迹模式显着相关。
结论