23
HBsAg LOSS IS HIGHER AMONG CAUCASIANS COMPARED
TO ASIANS AFTER STOPPING NUCLEOS(T)IDE ANALOGUE
THERAPY: RESULTS FROM A LARGE, GLOBAL, MULTIETHNIC
COHORT OF PATIENTS WITH CHRONIC HEPATITIS B
(RETRACT-B STUDY)
Grishma Hirode1,2, Hannah S.J. Choi1, Tung-Hung Su3,
Grace Lai-Hung Wong4, Wai-Kay Seto5, Stijn Van Hees6,
Margarita Papatheodoridi7, Sylvia Brakenhoff8, Sabela
Lens9, Arif Sarowar1, Rong-Nan Chien10, Xavier Forns9,
Milan J. Sonneveld8, George Papatheodoridis7, Thomas
Vanwolleghem6, Man-Fung Yuen11, Henry Lik Yuen Chan4,
Jia-Horng Kao3, Yao-Chun Hsu12, Chien-Hung Chen13, Bettina
E. Hansen1,2, Markus Cornberg14, Wen-Juei Jeng10, Harry
L.A. Janssen15 and RETRACT-B Study Group, (1)Toronto
Centre for Liver Disease, Toronto General Hospital, University
Health Network, (2)The Toronto Viral Hepatitis Care Network
(VIRCAN), Canada, (3)National Taiwan University Hospital,
(4)The Chinese University of Hong Kong, (5)The University
of Hong Kong, (6)Department of Gastroenterology and
Hepatology, Antwerp University Hospital, Belgium, (7)
Department of Gastroenterology, General Hospital of Athens
“Laiko”, Medical School of National & Kapodistrian University
of Athens, Greece, (8)Department of Gastroenterology and
Hepatology, Erasmus MC, University Medical Center, (9)
Hospital Clínic Barcelona, Idibaps and Ciberehd, (10)Chang
Gung Memorial Hospital, (11)Medicine, The University of
Hong Kong, (12)Fu-Jen Catholic University Hospital/E-DA
Hospital, (13)Kaohsiung Chang Gung Memorial Hospital,
(14)Department of Gastroenterology, Hepatology and
Endocrinology, Hannover Medical School, Hannover,
Germany, (15)Toronto Centre for Liver Disease/Viral Hepatitis
Care Network (VIRCAN), University Health Network
Background: Despite several recent studies, the efficacy of
finite nucleos(t)ide analogue (NA) therapy for CHB patients
has not yet been well established due to contradictory
findings and inadequate sample sizes. We aim to establish
and describe a global, multi-center cohort of CHB patients
who discontinued NA therapy, and evaluate outcomes
following cessation of NA therapy Methods: This is an ongoing
cohort study of CHB patients who discontinued NA
therapy between 2000-2020 from 12 participating centers
across North America, Europe and Asia Patients coinfected
with HIV, hepatitis C virus, hepatitis D virus, or those who
received (peg)interferon treatment within a year prior to NA
cessation were excluded We analyzed retreatment and off treatment
HBsAg loss using multivariable logistic regression
Only HBeAg negative patients with undetectable HBV DNA
at the time of NA cessation were included in this analysis
Results: Among 1,509 CHB patients who discontinued NA
therapy (mean age 52 7±11 3 years, 72 4% male, 11 4%
Caucasian, 86 5% Asian, 43 4% HBV genotype B), 70 5%
were HBeAg negative, 16 8% were HBeAg positive, and
12 7% had unknown HBeAg status at start of NA therapy
(SOT) Majority were treated with entecavir (ETV [51 7%]) or
tenofovir disoproxil fumarate (TDF [28 6%]) prior to cessation
Total median follow-up time was 16 4 (IQR:6 9-31 6) months,
median time to retreatment was 10 1 (IQR:5 6-19 8) months,
and median time to HBsAg loss was 17 0 (IQR:11 4-32 0)
months Overall, 42 9% were retreated and 8 1% (n = 111)
had HBsAg loss Odds of retreatment were higher among
Asians (vs Caucasians: OR 1 7; 95% CI 1 1-2 6; p=0 03),
and among those treated with ETV (vs TDF: OR 1 5; 95% CI
1 1-1 9; p=0 006) Older age was also associated with higher
odds of retreatment, and there were no significant differences
in retreatment by SOT HBeAg status Odds of HBsAg loss
were higher among males (vs females: OR 1 9; 95% CI 1 1-
3 6; p=0 04), and among Caucasians (vs Asians: OR 2 6;
95% CI 1.4-4.9; p=0.002). While not statistically significant,
HBsAg loss was higher among SOT HBeAg positive patients,
and among those treated with TDF (vs ETV) There were
12 deaths during follow-up of which, 8 were liver-related
Conclusion: Odds of HBsAg loss after NA cessation were
2 6 times higher among Caucasians compared to Asians, and
1 9 times higher among males compared to females There
was also a trend towards higher HBsAg loss in those treated
with TDF compared to those treated with ETV.