Prediction for HBsAg seroconversion in children with chronic hepatitis B

Area of Science:

• Hepatology
• Virology
• Pediatric Infectious Diseases

Background:

• Chronic hepatitis B (CHB) affects children globally, necessitating predictive markers for treatment.
• Hepatitis B surface antigen (HBsAg) seroconversion is a key treatment goal in CHB management.
• Accurate prediction of HBsAg seroconversion aids in optimizing therapeutic strategies for pediatric CHB patients.

Purpose of the Study:

• To establish a predictive model for HBsAg seroconversion in children with CHB.
• To identify key factors influencing HBsAg seroconversion.
• To assist clinicians in selecting appropriate treatment strategies and resource allocation.

Main Methods:

• Sixty-three children with HBeAg-positive CHB (aged 1-17 years) treated with interferon-alpha (IFNα) were analyzed.
• Patients were categorized into seroconversion (S) and non-seroconversion (NS) groups based on week 48 outcomes.
• Multivariate COX regression and Area Under the Receiver Operating Characteristic Curve (AUROC) were employed to identify predictors and assess model performance.

Main Results:

• Age, baseline intrahepatic cccDNA, and serum HBsAg levels were independent predictors of HBsAg seroconversion.
• Intrahepatic cccDNA showed a positive correlation with serum HBsAg levels (r=0.464, p=0.000).
• AUROC values for intrahepatic cccDNA and baseline HBsAg were 0.83 and 0.77, respectively, demonstrating good predictive capability.

Conclusions:

• Baseline serum HBsAg levels and intrahepatic cccDNA are reliable predictors of HBsAg seroconversion in pediatric CHB.
• The developed prediction index can guide clinical decision-making for CHB treatment.
• Improved prediction can lead to more personalized therapies and efficient use of medical resources.