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Adding HBV RNA and HBcrAg to HBsAg Improves Prediction of HBsAg Seroclearance in NAs-Suppressed CHB Treated With Peg-IFN-α.

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ASAP-12 Score Predicts HBsAg Seroclearance and Seroconversion in Chronic Hepatitis B Patients Receiving Peg-IFNα

Jiayi Wang1,2,3, Ning Han1,2,3, Lang Bai1,2,3

  • 1Center of Infectious Diseases, West China Hospital of Sichuan University, Chengdu, China.

Journal of Medical Virology
|October 30, 2025
PubMed
Summary

A new ASAP-12 score effectively predicts treatment success for chronic hepatitis B (CHB) patients receiving Peg-IFNα therapy after nucleos(t)ide analogs (NUCs). This tool aids in personalizing CHB treatment decisions for better outcomes.

Keywords:
ALT/(qHBsAg×age) ratioHBsAg seroclearanceHBsAg seroconversionPeg‐IFNα therapychronic hepatitis B

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Area of Science:

  • Hepatology and Virology
  • Immunotherapy and Predictive Biomarkers

Background:

  • Chronic hepatitis B (CHB) management involves complex treatment regimens.
  • Predicting response to Peg-IFNα add-on therapy in NUCs-experienced patients is crucial for optimizing outcomes.
  • Current tools lack integration of host immune response and viral activity for therapy prediction.

Purpose of the Study:

  • To develop and validate a predictive tool for Peg-IFNα therapy efficiency in NUCs-treated CHB patients.
  • To integrate host immune response and viral markers for predicting HBsAg seroclearance and seroconversion.

Main Methods:

  • Post-hoc analysis of 758 NUCs-experienced, HBeAg-negative CHB patients receiving Peg-IFNα add-on therapy.
  • Data collected included clinical, biochemical, and viral markers (HBsAg, ALT, Age) every 12 weeks.
  • Development of the ASAP-12 score (ALT/[qHBsAg × Age] at Week 12) to predict HBsAg seroclearance and seroconversion at Week 48.

Main Results:

  • Age, qHBsAg, and ALT at Week 12 were significant predictors of HBsAg seroclearance and seroconversion.
  • The ASAP-12 score demonstrated strong predictive discrimination for both endpoints (AUROCs: 0.802 and 0.787).
  • Patients with higher ASAP-12 scores showed significantly higher rates of HBsAg seroclearance (63.4% vs. 17.8%) and seroconversion (47.3% vs. 11.0%).
  • Higher ASAP-12 scores independently correlated with elevated Week 48 HBsAb levels.

Conclusions:

  • The ASAP-12 score is a valuable tool for predicting HBsAg seroclearance and seroconversion at Week 48 of Peg-IFNα therapy in NUCs-experienced CHB patients.
  • This predictive score supports individualized therapeutic decisions for CHB management.
  • Integration of early clinical and virological markers can enhance prediction of treatment efficacy.