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Predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric chronic hepatitis B

Sukjin Hong1, Jun Hyun Hwang2, Keumoung Kim3

  • 1Department of Pediatrics, School of Medicine, Daegu Catholic University, Daegu, Republic of Korea.

Frontiers in Pediatrics
|April 18, 2025
PubMed

Insights

Younger age and early declines in HBeAg levels predict HBsAg loss in pediatric chronic hepatitis B (CHB) patients. A new model uses these factors to forecast treatment success, aiding personalized pediatric CHB management.

Area of Science:

  • Pediatric Hepatology
  • Virology
  • Immunology

Background:

  • Functional cure of chronic hepatitis B (CHB) is more achievable in children than adults.
  • Identifying predictors of HBsAg loss in pediatric CHB is vital for optimizing treatment.
  • HBeAg titer dynamics are potential indicators of treatment response in pediatric CHB.

Purpose of the Study:

  • To assess the predictive value of HBeAg titer dynamics for HBsAg clearance in pediatric CHB.
  • To develop a predictive model for HBsAg clearance probability in children with CHB.

Main Methods:

  • Retrospective cohort study of 119 children (aged 1-18 years) with CHB treated with nucleos(t)ide analogues.
  • Evaluation of HBsAg loss status and age stratification (≤6 vs. >6 years).
  • Longitudinal HBeAg titer measurements during the first 12 months and logistic regression modeling.

Main Results:

  • Younger age (≤6 years) was the sole significant predictor of HBsAg loss in multivariate analysis (HR 7.69).
  • Steeper HBeAg titer decline trajectories were observed in patients who achieved HBsAg loss.
  • A predictive model incorporating age and HBeAg titer dynamics demonstrated high accuracy.

Conclusions:

  • Early HBeAg titer dynamics and age at treatment initiation predict HBsAg clearance in pediatric CHB.
  • A predictive model using semi-quantitative HBeAg measurements can aid clinical decision-making.
  • Individualized treatment strategies for pediatric CHB can be enhanced by this predictive approach.
Abstract

Keywords:
antiviral agentschildrenhepatitis B e antigenshepatitis B surface antigensseroconversion

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