Trajectories of serum hepatitis B surface antigen kinetics in patients with chronic hepatitis B receiving long-term nucleos(t)ide analogue therapy.
BACKGROUND & AIMS
The kinetics of serum hepatitis B surface antigen (HBsAg) levels during long-term nucleos(t)ide analogue (NA) therapy in chronic hepatitis B (CHB) patients remains unclear. We investigated the patterns of serum HBsAg kinetics and their association with therapeutic outcomes in genotype B- or C-infected CHB patients receiving long-term NA therapy.


METHODS
We enrolled 329 treatment-naive CHB patients receiving NA therapy for >5 years to analyse the kinetic patterns by using group-based trajectory models (GBTMs).


RESULTS
Most patients (82.4%) received entecavir therapy. The median treatment duration was 83.6 (68.5-89.7) months. The GBTMs revealed three groups for both the hepatitis B e antigen (HBeAg)-positive and -negative patients. The median annual decline in serum HBsAg levels during the first 5 years was significantly higher in Group 1 than in Groups 2 and 3 in HBeAg-positive (0.78 vs 0.10 vs 0.10 log10 IU/mL) and HBeAg-negative (0.71 vs 0.08 vs 0.09 log10 IU/mL) patients. HBsAg levels at the baseline and 12 months combined with an HBsAg decline from the baseline to 12 months of treatment predicted trajectory pattern 1 in HBeAg-positive (sensitivity, 77.8%; specificity, 99.1%; positive predictive value [PPV], 87.5%; and negative predictive value [NPV], 98.2%) and HBeAg-negative (sensitivity, 100%; specificity, 99.5%; PPV, 88.9%; and NPV, 100%) patients. The trajectory patterns were significantly associated with HBeAg loss in the HBeAg-positive patients and the achievement of HBsAg <100 IU/mL or HBsAg loss in HBeAg-positive and HBeAg-negative patients.


CONCLUSIONS
The trajectory of serum HBsAg levels predicts HBsAg loss in CHB patients receiving long-term NA therapy.
['Hsu|Wei-Fan|WF|', 'Chen|Chuen-Fei|CF|', 'Lai|Hsueh-Chou|HC|', 'Su|Wen-Pang|WP|', 'Lin|Chia-Hsin|CH|', 'Chuang|Po-Heng|PH|', 'Chen|Sheng-Hung|SH|', 'Chen|Ching-Hsiang|CH|', 'Wang|Hung-Wei|HW|', 'Huang|Guan-Tarn|GT|', 'Peng|Cheng-Yuan|CY|0000-0001-9030-6086']
D000328:Adult D000998:Antiviral Agents D004279:DNA, Viral D005260:Female D006147:Guanine D006514:Hepatitis B Surface Antigens D006513:Hepatitis B e Antigens D006515:Hepatitis B virus D019694:Hepatitis B, Chronic D006801:Humans D007700:Kinetics D008297:Male D008875:Middle Aged D015999:Multivariate Analysis D016016:Proportional Hazards Models D012680:Sensitivity and Specificity D013624:Taiwan
hepatitis B surface antigen chronic hepatitis B nucleos(t)ide analogue group-based trajectory models HBsAg loss