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Predictors of Functional Cure of Chronic Hepatitis B Virus Infection: A Long-Term Follow-Up Study

Jia-Feng Wu1, Chi-San Tai2, Kai-Chi Chang2

  • 1Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan; Department of Pediatrics, College of Medicine, National Taiwan University, Taipei, Taiwan.

Clinical Gastroenterology and Hepatology : the Official Clinical Practice Journal of the American Gastroenterological Association
|August 29, 2024
PubMed

Insights

Achieving a functional cure for chronic hepatitis B virus (HBV) infection is possible. Early hepatitis B e antigen (HBeAg) seroconversion, specific antiviral therapies, and low HBsAg levels predict successful outcomes.

Area of Science:

  • Hepatology
  • Virology
  • Immunology

Background:

  • Functional cure is a key goal for managing chronic hepatitis B virus (HBV) infection.
  • Evaluating predictors of functional cure after hepatitis B e antigen (HBeAg) seroconversion is crucial.

Purpose of the Study:

  • To assess the cumulative probability of functional cure in chronic HBV patients post-HBeAg seroconversion.
  • To identify significant predictors associated with achieving functional cure.

Main Methods:

  • Retrospective analysis of 413 HBeAg-positive chronic HBV patients with long-term follow-up (mean 26.36 years).
  • Definition of functional cure: sustained loss of HBsAg and HBV DNA without treatment for >24 weeks.
  • Multivariate Cox proportional hazards analysis to determine predictors of functional cure.

Main Results:

  • Cumulative functional cure probability was 14.53% over 10,888 person-years.
  • Predictors of functional cure included HBeAg seroconversion before age 18, high-genetic-barrier nucleos(t)ide analogue therapy, and HBsAg titer <1000 IU/mL at 18 months post-seroconversion.
  • Annual functional cure rate increased significantly after HBeAg seroconversion.

Conclusions:

  • Childhood HBeAg seroconversion, specific antiviral therapies, and early low HBsAg titers are significant predictors of functional cure in chronic HBV.
  • These findings can inform treatment strategies aiming for functional cure in HBV patients.
Abstract

Keywords:
Functional CureHepatitis B Surface AntigenHepatitis B e Antigen Seroconversion

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