J Viral Hepat. 2019 Mar 21. doi: 10.1111/jvh.13097. [Epub ahead of print]
Relationship between hepatitis B Core related antigen levels and sustained HBeAg seroconversion in patients treated with nucleo(s)tide analogues.
Sonneveld MJ1, Van Oord GW1, van Campenhout MJ1, de Man RA1, Janssen HLA2, de Knegt RJ1, Boonstra A1, van der Eijk AA2.
Author information
1
Departments of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands.
2
Division of Gastroenterology, University Health Network, Toronto, Canada.
Abstract
HBeAg seroconversion experienced during nucleo(s)tide analogue (NUC) therapy is often not sustained. We aimed to study whether hepatitis B core related antigen (HBcrAg) levels predict sustained HBeAg seroconversion in patients treated with NUCs. We studied HBeAg-positive patients treated with NUCs for at least six months. We quantified HBcrAg at baseline and at the time of HBeAg seroconversion and studied the relationship with HBeAg seroconversion and subsequent relapse. HBcrAg was quantified at baseline in 196 patients; levels varied significantly by HBV genotype, and correlated with HBsAg, HBV DNA and HBeAg. Baseline HBcrAg levels were lower in patients who achieved HBeAg seroconversion than in those who did not; the unadjusted Hazard Ratio (HR) was 0.802 (95% CI: 0.656 - 0.980, p=0.031); this association was not sustained in multivariate analysis. HBcrAg remained detectable in all patients at the time of HBeAg seroconversion. Higher HBcrAg at the time of seroconversion was an independent predictor of relapse (adjusted HR 1.855 (95% CI: 1.099 - 3.133, p=0.021) and none of the patients with HBcrAg <4.90 log U/mL experienced relapse. Baseline HBcrAg is not an independent predictor of HBeAg seroconversion during NUC therapy. HBcrAg remains detectable in patients after HBeAg seroconversion. Patients with lower levels at the time of seroconversion have a higher probability of sustained HBeAg seroconversion. This article is protected by copyright. All rights reserved.
This article is protected by copyright. All rights reserved.
KEYWORDS:
HBeAg seroconversion; entecavir; hepatitis B core related antigen; nucleo(s)tide analogues; tenofovir