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HBcrAg Identifies Patients Failing to Achieve HBeAg Seroconversion Treated with Pegylated Interferon Alfa-2b
Hui Ma1, Rui-Feng Yang2, Xiao-He Li1
1Department of Hepatology, Peking University People's Hospital, Beijing 100044, China.
Insights
Serum hepatitis B virus core-related antigens (HBcrAg) effectively predict hepatitis B e antigen (HBeAg) seroconversion in chronic hepatitis B patients treated with interferon. High negative predictive values indicate HBcrAg
Area of Science:
- Hepatology
- Virology
- Immunology
Background:
- Chronic hepatitis B (CHB) management requires monitoring treatment efficacy.
- Hepatitis B e antigen (HBeAg) seroconversion is a key indicator of treatment response in CHB.
- Interferon (IFN) alfa-2b and pegylated IFN are conventional treatments for CHB.
Purpose of the Study:
- To evaluate the predictive value of serum hepatitis B virus core-related antigens (HBcrAg) for HBeAg seroconversion.
- To assess HBcrAg dynamics during and after interferon treatment in HBeAg-positive CHB patients.
Main Methods:
- Fifty-eight HBeAg-positive CHB patients treated with IFN were divided into training (n=29) and validation (n=29) groups.
- Serum HBcrAg levels were measured at baseline, week 12, end of treatment (EOT), and 12- and 24-week follow-ups.
- Long-term follow-up (LTFU) was conducted for 16 patients in the training group to monitor HBcrAg dynamics.
Main Results:
- Serum HBcrAg levels significantly declined during treatment in patients who achieved HBeAg seroconversion.
- HBcrAg levels <19,565 kU/ml at week 24 post-treatment demonstrated 100% negative predictive value (NPV) for HBeAg seroconversion.
- Positive predictive values (PPVs) for HBeAg seroconversion were below 31%, indicating limited utility for early prediction.
Conclusions:
- Serum HBcrAg levels decrease with effective antiviral treatment in CHB patients.
- HBcrAg has a 100% NPV for predicting HBeAg seroconversion at 24 weeks post-treatment, but low PPVs.
- Sustained HBeAg seroconversion is associated with steadily declining or undetectable HBcrAg levels during long-term follow-up.
Background:
We aimed to evaluate the usefulness of serum hepatitis B virus core-related antigens (HBcrAg) for predicting hepatitis B e antigen (HBeAg) seroconversion in HBeAg-positive chronic hepatitis B patients treated with conventional interferon (IFN) alfa-2b or pegylated IFN.
Methods:
Fifty-eight patients were enrolled: 29 for the training group and 29 for the validating group. HBcrAg was measured at baseline, week 12, end of the treatment, and 12- and 24-week follow-ups. Sixteen patients in the training group were enrolled in the long-term follow-up (LTFU), during which time the dynamics of the HBcrAg was monitored.
Results:
The serum HBcrAg level gradually declined during treatment among the HBeAg seroconversion patients of the training group (from baseline, week 12, end of the treatment, 12-week follow-up to 24-week follow-up were 110,245 kU/ml, 3760 kU/ml, 7410 kU/ml, 715 kU/ml, 200 kU/ml, respectively). HBcrAg <19,565 kU/ml at week 24, HBcrAg <34,225 kU/ml at 12-week follow-up, and HBcrAg decrease ≥0.565 log10kU/ml from the baseline to the end of treatment (EOT) had negative predictive values (NPVs) of 100% for HBeAg seroconversion at the end of follow-up, whereas the positive predictive values (PPVs) were 30.77%, 26.67%, and 25.00%, respectively. The patients with HBeAg seroconversion at the end of 24-week follow-up remained in seroconversion during the LTFU, during which time their serum HBcrAg levels steadily declined or even became undetectable, ranging from 0 to 2.1 kU/ml.
Conclusions:
Effective antiviral treatment can decrease HBcrAg levels in the serum. The NPVs of HBcrAg for predicting HBeAg seroconversion at 24-week follow-up was 100%, but the PPVs were not satisfactory (all <31%). The serum HBcrAg levels of the patients with HBeAg seroconversion at the end of the 24-week follow-up steadily declined or even became undetectable during the LTFU.
