J Viral Hepat. 2019 Sep 28. doi: 10.1111/jvh.13211. [Epub ahead of print]
Predictors of HBsAg loss, relapse and retreatment after discontinuation of effective oral antiviral therapy in non-cirrhotic HBeAg-negative chronic hepatitis B.
Papatheodoridi M1, Hadziyannis E2, Berby F3, Zachou K4, Testoni B3, Rigopoulou E4, Gatselis NK4, Lyberopoulou A4, Vlachogiannakos I1, Manolakopoulos S1,2, Dalekos GN4, Zoulim F3, Papatheodoridis GV1.
Author information
1
Department of Gastroenterology, Medical School of National, Kapodistrian University of Athens, General Hospital of Athens "Laiko", Athens, Greece.
2
Department of Internal Medicine, Medical School of National, Kapodistrian University of Athens, General Hospital of Athens "Hippokratio", Athens, Greece.
3
INSERM U1052 - Cancer Research Center of Lyon (CRCL), 69008, Lyon, France.
4
Department of Medicine and Research Laboratory of Internal Medicine, Thessaly University Medical School, Larissa, Greece.
Abstract
Reliable predictors of outcomes after treatment discontinuation in HBeAg-negative chronic hepatitis B (CHB) patients have not been established. We investigated the role of hepatitis B surface antigen (HBsAg), interferon inducible protein-10 (IP10) and hepatitis B core related antigen (HBcrAg) serum levels as predictors of HBsAg loss, relapse and retreatment in non-cirrhotic HBeAg-negative CHB patients who discontinued long-term antiviral therapy. All HBsAg-positive (n=57) patients of the prospective DARING-B study were included and followed monthly for 3 months, every 2/3 months until month-12 and every 3/6 months thereafter. HBsAg, IP10 and HBcrAg levels were measured by enzyme immunoassays and SCALE-B score was calculated. Twelve patients achieved HBsAg loss before retreatment with 18-month cumulative incidence of 25%. Independent predictors of HBsAg loss were baseline HBsAg and month-1 IP10 levels. Of 10 patients with baseline HBsAg≤100 IU/mL, 70% cleared HBsAg and 10% required retreatment. Of 23 patients with baseline HBsAg>1000 IU/mL, 4% cleared HBsAg and 43% required retreatment. Of 24 patients with intermediate baseline HBsAg (100-1000 IU/mL), 17% cleared HBsAg and 21% required retreatment; in this subgroup, month-1 IP10 was significantly associated with HBsAg loss, which occurred in 30% and 7% of cases with IP10 >150 and ≤150 pg/mL, respectively. Baseline HBcrAg was undetectable in all patients who cleared HBsAg and was associated with retreatment. SCALE-B was associated with HBsAg loss but not with relapse or retreatment. In conclusion, HBsAg, IP10 and HBcrAg serum levels can be useful for the decisions and management of treatment discontinuation in non-cirrhotic Caucasian patients with HBeAg-negative CHB.