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Quantitation of HBsAg predicts response to entecavir therapy in HBV genotype C patients
Etsuro Orito1, Kei Fujiwara, Hiroshi Kanie
1Department of Gastroenterology, Nagoya Daini Red Cross Hospital, Nagoya, Japan.
Insights
Quantifying hepatitis B surface antigen (HBsAg) levels before treatment can predict entecavir therapy response in chronic hepatitis B patients with genotype C. Low pretreatment HBsAg levels indicate a better response to entecavir treatment.
Area of Science:
- Hepatology
- Virology
- Pharmacogenomics
Background:
- Chronic hepatitis B (CHB) infection remains a global health challenge.
- Entecavir is a widely used nucleoside analog for CHB treatment.
- Predicting treatment response is crucial for optimizing patient outcomes.
Purpose of the Study:
- To identify factors predicting entecavir therapy response in CHB patients with hepatitis B virus (HBV) genotype C.
- To evaluate the utility of quantitative hepatitis B surface antigen (qHBsAg) as a predictive marker.
Main Methods:
- Analysis of 50 CHB patients with HBV genotype C receiving entecavir therapy for over 2 years.
- Categorization of patients into rapid-responders (<3.0 log viral copies/mL) and slow-responders (≥3.0 log viral copies/mL) at year 2.
- Measurement of pretreatment quantitative hepatitis B surface antigen (qHBsAg), hepatitis B e antigen (HBeAg), HBV DNA, and detection of mutations.
Main Results:
- HBeAg-negative patients achieved rapid response, while 41.7% of HBeAg-positive patients were slow-responders.
- Slow-responders had significantly higher pretreatment median qHBsAg levels (4.57 log IU/mL) compared to rapid-responders (3.63 log IU/mL).
- Multivariate analysis identified low pretreatment qHBsAg level as the most significant predictor of a favorable entecavir response (P=0.03).
Conclusions:
- Quantitative HBsAg is a valuable and significant predictor of entecavir therapy response in CHB patients with HBV genotype C.
- This finding can aid in personalized treatment strategies for CHB management.
- Further studies may explore the role of qHBsAg in conjunction with other biomarkers.
Aim:
To analysis the factors that predict the response to entecavir therapy in chronic hepatitis patients with hepatitis B virus (HBV) genotype C.
Methods:
Fifty patients [hepatitis B e antigen (HBeAg)-negative:HBeAg-positive = 26:24] with HBV genotype C, who received naïve entecavir therapy for > 2 years, were analyzed. Patients who showed HBV DNA levels ≥ 3.0 log viral copies/mL after 2 years of entecavir therapy were designated as slow-responders, while those that showed < 3.0 log copies/mL were termed rapid-responders. Quantitative hepatitis B surface antigen (HBsAg) levels (qHBsAg) were determined by the Architect HBsAg QT immunoassay. Hepatitis B core-related antigen was detected by enzyme immunoassay. Pre-C and Core promoter mutations were determined using by polymerase chain reaction (PCR). Drug-resistance mutations were detected by the PCR-Invader method.
Results:
At year 2, HBV DNA levels in all patients in the HBeAg-negative group were < 3.0 log copies/mL. In contrast, in the HBeAg-positive group, 41.7% were slow-responders, while 58.3% were rapid-responders. No entecavir-resistant mutants were detected in the slow-responders. When the pretreatment factors were compared between the slow- and rapid-responders; the median qHBsAg in the slow-responders was 4.57 log IU/mL, compared with 3.63 log IU/mL in the rapid-responders (P < 0.01). When the pretreatment factors predictive of HBV DNA-negative status at year 2 in all 50 patients were analyzed, HBeAg-negative status, low HBV DNA levels, and low qHBsAg levels were significant (P < 0.01). Multivariate analysis revealed that the low qHBsAg level was the most significant predictive factor (P = 0.03).
Conclusion:
Quantitation of HBsAg could be a useful indicator to predict response to entecavir therapy.
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