{"title":"Trajectories and Decline of Serum Hepatitis B Surface Antigen Predict Outcomes in Patients With Chronic Hepatitis B.","authors":"Wei-Fan Hsu, Chuen-Fei Chen, Hsueh-Chou Lai, Wen-Pang Su, Hung-Wei Wang, Sheng-Hung Chen, Guan-Tarn Huang, Cheng-Yuan Peng","doi":"10.1093/ofid/ofae699","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long-term nucleos(t)ide analogue (NA) therapy remains unclear. We delineated the kinetics of HBsAg and analyzed its association with long-term treatment outcomes.</p><p><strong>Methods: </strong>We enrolled 912 treatment-naïve patients with chronic hepatitis B (CHB) who had received NA therapy for >12 months and analyzed the kinetic patterns through group-based trajectory models (GBTMs).</p><p><strong>Results: </strong>The median treatment duration for the entire cohort was 60.3 months. GBTMs revealed 4 patterns in patients achieving HBsAg loss (groups 1-4) in the study population and in patients achieving HBsAg <100 IU/mL among those with HBeAg-negative CHB with baseline HBsAg ≥100 IU/mL (groups A-D). Patients in groups 1 and A had the highest rates of HBsAg loss (22.2%, 6/27) and of achieving HBsAg <100 IU/mL (47.5%, 56/118), respectively. HBsAg <40 IU/mL and <400 IU/mL at 12 months of treatment predicted group 1 and group A membership among all patients and those with HBeAg-negative CHB, respectively. Multivariable Cox regression analysis identified HBsAg trajectory group (group 1 vs groups 3 and 4: hazard ratio [HR], 179.46; <i>P</i> < .001; group 2 vs groups 3 and 4: HR, 24.34; <i>P</i> < .001) and HBsAg decline (HR, 82.14; <i>P</i> < .001) as independent predictors of both HBsAg loss and achieving HBsAg <100 IU/mL.</p><p><strong>Conclusions: </strong>Serum HBsAg trajectories and decline can predict HBsAg loss and the achievement of HBsAg <100 IU/mL in patients with CHB receiving long-term NA therapy.</p>","PeriodicalId":19517,"journal":{"name":"Open Forum Infectious Diseases","volume":"11 12","pages":"ofae699"},"PeriodicalIF":3.8000,"publicationDate":"2024-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11639628/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Open Forum Infectious Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1093/ofid/ofae699","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/12/1 0:00:00","PubModel":"eCollection","JCR":"Q2","JCRName":"IMMUNOLOGY","Score":null,"Total":0}
引用次数: 0
Abstract
Background: The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long-term nucleos(t)ide analogue (NA) therapy remains unclear. We delineated the kinetics of HBsAg and analyzed its association with long-term treatment outcomes.
Methods: We enrolled 912 treatment-naïve patients with chronic hepatitis B (CHB) who had received NA therapy for >12 months and analyzed the kinetic patterns through group-based trajectory models (GBTMs).
Results: The median treatment duration for the entire cohort was 60.3 months. GBTMs revealed 4 patterns in patients achieving HBsAg loss (groups 1-4) in the study population and in patients achieving HBsAg <100 IU/mL among those with HBeAg-negative CHB with baseline HBsAg ≥100 IU/mL (groups A-D). Patients in groups 1 and A had the highest rates of HBsAg loss (22.2%, 6/27) and of achieving HBsAg <100 IU/mL (47.5%, 56/118), respectively. HBsAg <40 IU/mL and <400 IU/mL at 12 months of treatment predicted group 1 and group A membership among all patients and those with HBeAg-negative CHB, respectively. Multivariable Cox regression analysis identified HBsAg trajectory group (group 1 vs groups 3 and 4: hazard ratio [HR], 179.46; P < .001; group 2 vs groups 3 and 4: HR, 24.34; P < .001) and HBsAg decline (HR, 82.14; P < .001) as independent predictors of both HBsAg loss and achieving HBsAg <100 IU/mL.
Conclusions: Serum HBsAg trajectories and decline can predict HBsAg loss and the achievement of HBsAg <100 IU/mL in patients with CHB receiving long-term NA therapy.
期刊介绍:
Open Forum Infectious Diseases provides a global forum for the publication of clinical, translational, and basic research findings in a fully open access, online journal environment. The journal reflects the broad diversity of the field of infectious diseases, and focuses on the intersection of biomedical science and clinical practice, with a particular emphasis on knowledge that holds the potential to improve patient care in populations around the world. Fully peer-reviewed, OFID supports the international community of infectious diseases experts by providing a venue for articles that further the understanding of all aspects of infectious diseases.