|
KMID : 1040620240300010098
|
|
Clinical and Molecular Hepatology
2024 Volume.30 No. 1 p.98 ~ p.108
|
|
|
Hepatitis B core-related antigen dynamics and risk of subsequent clinical relapses after nucleos(t)ide analog cessation
|
|
Ying-Nan Tsai
Jia-Ling Wu
Cheng-Hao Tseng
Tzu-Haw Chen
Yi-Ling Wu
Chieh-Chang Chen
Yu-Jen Fang
Tzeng-Huey Yang
Mindie H. Nguyen
Jaw-Town Lin
Yao-Chun Hsu
|
|
|
Abstract
|
|
|
Background/Aims: Finite nucleos(t)ide analog (NA) therapy has been proposed as an alternative treatment strategy for chronic hepatitis B (CHB), but biomarkers for post-treatment monitoring are limited. We investigated whether measuring hepatitis B core-related antigen (HBcrAg) after NA cessation may stratify the risk of subsequent clinical relapse (CR).
Methods: This retrospective multicenter analysis enrolled adults with CHB who were prospectively monitored after discontinuing entecavir or tenofovir with negative HBeAg and undetectable HBV DNA at the end of treatment (EOT).
Patients with cirrhosis or malignancy were excluded. CR was defined as serum alanine aminotransferase > two times the upper limit of normal with recurrent viremia. We applied time-dependent Cox proportional hazard models to clarify the association between HBcrAg levels and subsequent CR.
Results: The cohort included 203 patients (median age, 49.8 years; 76.8% male; 60.6% entecavir) who had been treated for a median of 36.9 months (interquartile range [IQR], 36.5?40.1). During a median post-treatment follow-up of 31.7 months (IQR, 16.7?67.1), CR occurred in 104 patients with a 5-year cumulative incidence of 54.8% (95% confidence interval [CI], 47.1?62.4%). Time-varying HBcrAg level was a significant risk factor for subsequent CR (adjusted hazard ratio [aHR], 1.53 per log U/mL; 95% CI, 1.12?2.08) with adjustment for EOT HBsAg, EOT anti-HBe, EOT HBcrAg and time-varying HBsAg. During follow-up, HBcrAg <1,000 U/mL predicted a lower risk of CR (aHR, 0.41; 95% CI, 0.21?0.81).
Conclusions: Dynamic measurement of HBcrAg after NA cessation is predictive of subsequent CR and may be useful to guide post-treatment monitoring.
|
|
|
KEYWORD
|
|
|
Chronic hepatitis B, Antiviral treatment, Finite nucleos(t)ide analog therapy, Hepatitis B core-related antigen
|
|
|
FullTexts / Linksout information
|
|
|
|
|
|
Listed journal information
|
|
|
|
|