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Predicting hepatitis B e Antigen seroconversion after pregnancy-The SydPregScore.

Cynthuja Thilakanathan1,2, Tahrima Kayes1, Julia Di Girolamo1

  • 1Department of Gastroenterology and Hepatology, Liverpool Hospital, Sydney, Australia.

Liver International : Official Journal of the International Association for the Study of the Liver
|July 21, 2022
PubMed
Summary
This summary is machine-generated.

Hepatitis B e antigen seroconversion (HBeAg SC) is more likely in pregnant women under 35 with lower viral load and elevated ALT. The SydPreg Score predicts HBeAg SC post-pregnancy, aiding management strategies.

Keywords:
HBeAg positiveHBeAg seroconversionchronic hepatitis Bpredictorspregnancy

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Area of Science:

  • Hepatology
  • Virology
  • Obstetrics

Background:

  • Hepatitis B e antigen seroconversion (HBeAg SC) is crucial for better prognosis in Hepatitis B Virus (HBV) infection.
  • Earlier HBeAg SC is associated with improved long-term outcomes.
  • Understanding factors influencing HBeAg SC post-pregnancy is vital for maternal and child health.

Purpose of the Study:

  • To identify baseline and postpartum factors predicting HBeAg SC after pregnancy.
  • To develop a predictive tool, the SydPreg Score, for estimating HBeAg SC likelihood.
  • To guide management strategies for HBeAg-positive pregnant women.

Main Methods:

  • Retrospective analysis of 220 pregnancies in 149 HBeAg-positive women (2006-2019).
  • Collection of baseline data: age, parity, ALT, HBV viral load, HBsAg levels, antiviral use.
  • Multivariate Cox regression analysis to identify predictors and develop the SydPreg Score.

Main Results:

  • HBeAg SC occurred in 33.6% of women post-pregnancy (median follow-up 814 days).
  • Positive predictors for HBeAg SC included: baseline viral load <8 log10 IU/mL, baseline ALT ≥2x ULN, and age <35.
  • The SydPreg Score accurately estimated the probability of HBeAg SC at 2000 days based on the number of predictors present.

Conclusions:

  • The SydPreg Score effectively predicts HBeAg SC in the years following pregnancy.
  • Younger age (<35), lower viral load (<8 log10 IU/mL), and elevated ALT identify women with a good chance of HBeAg SC.
  • Women without these predictors may benefit from antiviral therapy for viral suppression.