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
Broquetas, Teresa (Universitat Autònoma de Barcelona. Departament de Medicina)
Hernandez, Juan-Jose (Laboratori de Referència de Catalunya (El Prat de Llobregat, Catalunya))
Garcia-Retortillo, M (Institut Hospital del Mar d'Investigacions Mèdiques)
Canillas, Lidia (Institut Hospital del Mar d'Investigacions Mèdiques)
Puigvehí, Marc (Institut Hospital del Mar d'Investigacions Mèdiques)
Cañete Hidalgo, Nuria (Institut Hospital del Mar d'Investigacions Mèdiques)
Coll, Susanna (Institut Hospital del Mar d'Investigacions Mèdiques)
Viu, Ana (Institut Hospital del Mar d'Investigacions Mèdiques)
Garrido, Esther (Institut Hospital del Mar d'Investigacions Mèdiques)
Mico, Miquel (Laboratori de Referència de Catalunya (El Prat de Llobregat, Catalunya))
Bessa Caserras, Xavier (Institut Hospital del Mar d'Investigacions Mèdiques)
Carrión Rodríguez, José Antonio (Universitat Autònoma de Barcelona. Departament de Medicina)

Data:	2022
Resum:	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. HBsAghepatitis B surface antigenHBeAghepatitis B e antigenNAnucleos(t)ides analoguesHBVhepatitis B virusORodds ratioCIconfidence intervalCHBchronic hepatitis BETVentecavirTDFtenofovir disoproxil fumarateEoTend of treatmentTEtransient elastographyVRvirological relapseCRclinical relapseALTalanine aminotransferaseULNupper limit of normalityILinterleukinIQRinterquartile rangePeg-IFNpegylated interferonAUROCarea under receiver operating characteristicSsensitivitySpspecificityPPVpositive predictive valueNPVnegative predictive value+LRpositive likelihood ratio-LRnegative likelihood ratio.
Ajuts:	Instituto de Salud Carlos III PI14/00540
Nota:	Altres ajuts: acords transformatius de la UAB
Drets:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, i la comunicació pública de l'obra, sempre que no sigui amb finalitats comercials, i sempre que es reconegui l'autoria de l'obra original. No es permet la creació d'obres derivades.
Llengua:	Anglès
Document:	Article ; recerca ; Versió publicada
Matèria:	Antiviral ; HBsAg ; HepatitisB ; Kinetics
Publicat a:	Digestive and Liver Disease, Vol. ??? Núm. ??? (01 2022) , ISSN 1878-3562

DOI: 10.1016/j.dld.2021.12.017

8 p, 988.0 KB

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