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On-therapy HBsAg kinetics can predict HBsAg loss after nucleos(t)ide analogues interruption in HBeAg-negative patients. The cup is half full and half empty
Teresa Broquetas 1 , Juan-Jose Hernandez 2 , Montserrat Garcia-Retortillo 3 , Lidia Canillas 3 , Marc Puigvehí 3 , Nuria Cañete 3 , Susanna Coll 3 , Ana Viu 3 , Esther Garrido 3 , Miquel Mico 2 , Xavier Bessa 3 , José A Carrión 4
Affiliations
Affiliations
1
Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
2
Laboratori de Referència de Catalunya, El Prat de Llobregat, Spain.
3
Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain.
4
Liver Section, Gastroenterology Department, Hospital del Mar, 25-29 Passeig Marítim, Barcelona 08003, Spain; Departament de Medicina, Universitat Autònoma de Barcelona, Barcelona, Spain. Electronic address: [email protected].
PMID: 35063365 DOI: 10.1016/j.dld.2021.12.017
Abstract
Background: Nucleos(t)ide analogues withdrawal may improve HBsAg loss rates. However, conditions to select patients are not well established.
Aims: to evaluate the impact of HBsAg kinetics before treatment interruption on post-treatment response.
Methods: Longitudinal, ambispective study in non-cirrhotic chronic hepatitis B HBeAg-negative patients, analysing on-treatment and post-treatment HBsAg kinetics. On-treatment HBsAg kinetics diagnostic accuracy (AUROC) to identify HBsAg loss was evaluated.
Results: 52 HBeAg-negative patients stopped treatment after 8.2 years, and 6 (11.5%) achieved HBsAg loss one year after withdrawal. Multivariate analysis showed that on-treatment HBsAg kinetics was related to HBsAg loss (OR=0.10; 95%CI=0.016-0.632; p = 0.014) with a high diagnostic accuracy (AUROC=0.935). A significant HBsAg decline ≥1 log10 IU/mL showed a positive and negative predictive value of 50% and of 97.6%, respectively. After treatment interruption, HBsAg decline speed (log10 IU/mL/year) accelerated in patients treated >6 years (from -0.06 to -0.20, p<0.05) and remained stable in treated <6 years (from -0.12 to -0.12 p=ns).
Conclusions: On-treatment HBsAg kinetics can predict post-treatment HBsAg loss rate. Half of patients with a significant HBsAg decline can eliminate HBsAg the first year after withdrawal. Post-treatment HBsAg decline is faster not only in patients who lost the HBsAg but also in those who remain HBsAg-positive.
Keywords: Antiviral; HBsAg; Hepatitis B; Kinetics.
Copyright © 2022. Published by Elsevier Ltd. |
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