Quantitative Change of Hepatitis B Surface Antigen Leading to Final Hepatitis B Surface Antigen Loss in Patients with Chronic Hepatitis B Receiving Nucleos(t)ide Analogs in China.
Tianhui Zhou, Meng Shu, Fangyun Luo, Sijia Dong, Jiaming Teng, Yanan Du, Hong Qiu, Wei Cai
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引用次数: 0
Abstract
Introduction: Loss of hepatitis B surface antigen (HBsAg) is the pivotal component of functional cure in patients suffering from chronic hepatitis B (CHB). The predictive value of quantitative HBsAg (qHBsAg) in HBsAg loss among those undergoing nucleos(t)ide analog (NAs) therapy is an area of ongoing investigation.
Methods: A retrospective cohort study using electronic medical records was performed. CHB patients with NAs treatment between January 1, 2012, and December 31, 2020 were enrolled and followed up until discontinuation of NAs, as indicated by a gap more than 12 months in prescription refills, past medical record, or study end. Patients were grouped into NAs treatment-naïve cohort and treatment-experienced cohort. In both cohorts, Cox regression models assessed associations between 12-month reduction in qHBsAg, baseline qHBsAg, and HBsAg loss.
Results: Overall, 2,627 CHB patients with NAs treatment was identified, including 1,179 in treatment-naïve cohort and 1,448 in treatment-experienced cohort. In treatment-naïve cohort, 9 patients had HBsAg loss (0.51/100 person-years). In treatment-experienced cohort, 30 patients had HBsAg loss (1.03/100 person-years). HBsAg loss was significantly associated with a 0.5-1 log10 (treatment-naïve: adjusted hazard ratio [aHR] 8.06, 95% confidence interval [CI] 1.29-50.40; treatment-experienced: aHR 4.34, 95% CI 1.40-13.47) and >1 log10 qHBsAg decrease (treatment-naïve: aHR 9.19, 95% CI 1.47-57.65; treatment-experienced: aHR 8.02, 95% CI 1.76-36.57) compared with qHBsAg not reduced. HBsAg loss was significantly associated with lower baseline qHBsAg in treatment-experienced cohort, while such difference was not significant in treatment-naïve cohort.
Discussion: A rapid decline of qHBsAg in 12 months during NAs therapy, as opposed to merely maintaining a low level of qHBsAg, was associated with HBsAg loss.
期刊介绍：
Clinical and Translational Gastroenterology (CTG), published on behalf of the American College of Gastroenterology (ACG), is a peer-reviewed open access online journal dedicated to innovative clinical work in the field of gastroenterology and hepatology. CTG hopes to fulfill an unmet need for clinicians and scientists by welcoming novel cohort studies, early-phase clinical trials, qualitative and quantitative epidemiologic research, hypothesis-generating research, studies of novel mechanisms and methodologies including public health interventions, and integration of approaches across organs and disciplines. CTG also welcomes hypothesis-generating small studies, methods papers, and translational research with clear applications to human physiology or disease.
Colon and small bowel
Endoscopy and novel diagnostics
Esophagus
Functional GI disorders
Immunology of the GI tract
Microbiology of the GI tract
Inflammatory bowel disease
Pancreas and biliary tract
Liver
Pathology
Pediatrics
Preventative medicine
Nutrition/obesity
Stomach.
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