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HBcrAg Dynamic Change During Treatment Predicts HBsAg Loss in Pediatric Patients With Chronic Hepatitis B

Ling Ye1, Wenxian Ouyang2, Yingping Gu1

  • 1Department of Maternal and Child Health, Xiangya School of Public Health, Central South University, Changsha, China.

Journal of Medical Virology
|April 11, 2025
PubMed

Insights

In children with chronic hepatitis B, a rapid decline in Hepatitis B core-related antigen (HBcrAg) during antiviral therapy predicts Hepatitis B surface antigen (HBsAg) loss, a key marker for functional cure. This finding aids in monitoring treatment effectiveness in pediatric patients.

Area of Science:

  • Hepatology
  • Virology
  • Pediatric Infectious Diseases

Background:

  • Hepatitis B surface antigen (HBsAg) loss signifies functional cure in chronic hepatitis B (CHB) patients.
  • The kinetics of Hepatitis B core-related antigen (HBcrAg) and its association with HBsAg loss in pediatric CHB patients undergoing antiviral therapy remain under-investigated.

Purpose of the Study:

  • To investigate the association between the rate of HBcrAg decline and the achievement of HBsAg loss in children with CHB receiving antiviral treatment.
  • To identify predictors of HBsAg loss in pediatric CHB patients.

Main Methods:

  • A prospective cohort study involving 86 treatment-naive pediatric CHB patients.
  • Calculation of HBcrAg decline speed during antiviral therapy, categorizing patients into rapid and slow decline groups.
  • Analysis of HBsAg loss as the primary outcome, utilizing Kaplan-Meier and Receiver Operating Characteristic (ROC) curves.

Main Results:

  • 26.2% of participants achieved HBsAg loss by the end of follow-up.
  • Independent predictors for HBsAg loss included lower baseline HBsAg levels and a faster speed of HBcrAg decline (HR=1.30).
  • The rapid HBcrAg decline group showed a significantly higher cumulative incidence of HBsAg loss, with the speed of decline effectively predicting HBsAg loss (AUC=0.735).

Conclusions:

  • The speed of HBcrAg decline during antiviral therapy is a significant predictor of HBsAg loss in pediatric CHB patients.
  • Monitoring HBcrAg kinetics can aid in assessing the likelihood of functional cure in children with CHB.
  • Combining HBcrAg decline speed with baseline HBsAg levels enhances prediction accuracy for HBsAg loss.

Keywords:
CHBHBcrAgHBsAg lossdecline speedpediatric

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