Baseline and on-treatment HBcrAg levels as predictors of HBeAg seroconversion in chronic hepatitis B patients treated with antivirals

Abstract

HBeAg seroconversion is an important treatment endpoint. We aimed to identify predictors

of seroconversion using serum HBsAg and hepatitis B core-related

antigen

(HBcrAg) in HBeAg-positive

patients treated with nucleos(t)ide analogs (NAs). Data

and samples from 70 HBeAg-positive

patients treated with entecavir or tenofovir between

January 2007 and December 2017 were retrospectively analysed. The mean

follow-up

period was 11 years. The predictive power for HBeAg seroconversion of

HBcrAg levels at baseline and 2 years after antiviral therapy was determined using

receiver operating curve analysis. Twenty-one

patients (30%) achieved HBeAg seroconversion

at a mean of 28 (range, 12–84)

months after antiviral treatment. The median

baseline HBcrAg and HBsAg levels were 6.9(5.7–7.0)

vs. 5.8(5.5–6.5)

log10U/mL

(p = .006), 4.9(4.5–5.1)

vs. 4.5(4.1–5.0)

log10IU/mL (p = .044) in the no seroconversion

group and seroconversion group, respectively. In the multivariate analysis, the serum

HBcrAg levels at baseline and 2 years after antiviral therapy were predictive factors

for HBeAg seroconversion ([HR]; 0.326; [CI], 0.111–0.958;

p = .042 and HR, 0.4555;

CI, 0.211–0.984;

p = .045). HBcrAg levels≤6.5log10U/mL at baseline and ≤5.3log10U/

mL at 2 years after antiviral therapy had sensitivities of 53.1% and 69.8%, specificities

of 95.2% and 70.6%, positive predictive values of 82.6% and 50.0%, and negative

predictive values of 82.6% and 84.5%, respectively, with AUROCs of 0.712 (95%CI,

0.596–0.830)

and 0.745 (95%CI, 0.599–0.891)

for predicting HBeAg seroconversion.

In chronic hepatitis B patients treated with NAs, HBcrAg levels≤6.5log10U/mL

at baseline and ≤5.3log10U/mL at 2 years after antiviral therapy were useful predictive

factors of HBeAg seroconversion.