Early Serum HBsAg Kinetics as Predictor of HBsAg Loss in Patients with HBeAg-Negative Chronic Hepatitis B after Treatment with Pegylated Interferonα-2a  

作　　者：Minghui Li Lu Zhang Yao Lu Qiqi Chen Huihui Lu Fangfang Sun Zhan Zeng Gang Wan Linqing Zhao Yao Xie 

机构地区：[1]Department of Hepatology Division 2,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China [2]Department of Hepatology Division 2,Peking University Ditan Teaching Hospital,Beijing 100015,China [3]Department of Biostatistics,Beijing Ditan Hospital,Capital Medical University,Beijing 100015,China [4]Laboratory of Virology Capital Institute of Pediatrics,Beijing 100020,China

出　　处：《Virologica Sinica》2021年第2期311-320,共10页中国病毒学（英文版）

基　　金：funded in part by the Beijing Hospitals Authority of Hospitals Clinical Medicine Development of Special Funding Support(XMLX 201706);the National Science and Technology Major Project of China(2017ZX10203202-003,2017ZX10201201-001-006,and 2017ZX10201201-002-006);Beijing Science and Technology Commission(D161100002716002);the Digestive Medical Coordinated Development Center of Beijing Hospitals Authority(XXZ0302 and XXT28)。

摘　　要：Hepatitis B surface antigen(HBsAg)loss is an ideal treatment endpoint for patients with chronic hepatitis B(CHB).We investigated the predictive value of on-treatment HBsAg levels for HBsAg loss in hepatitis B e antigen(HBe Ag)-negative CHB patients who received 120-week PEG-IFNα-2a treatment.Serum HBV DNA,HBsAg,and anti-HBs levels were assayed at baseline and every 3 months during the treatment.Of 81 patients,12 achieved HBsAg loss,20 achieved HBsAg\100 IU/mL,and 49 maintained HBs Ag C 100 IU/mL.HBsAg loss rate was only 3.7%at 48 weeks,while it reached to 11.1%and 14.8%after treatment of 96 weeks and 120 weeks.The cutoff HBs Ag levels at 12 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 400 IU/mL and 750 IU/mL,with AUC 0.725 and 0.722,positive predictive value(PPV)29.41%and 30.56%,and negative predictive value(NPV)93.75%and 97.78%,respectively.The cutoff HBsAg levels at 24 weeks predicting HBsAg loss at 96 weeks and 120 weeks of treatment were 174 IU/m L and 236 IU/mL respectively,with AUC 0.925 and 0.922,PPV 40.0%and 46.15%,and both NPV 100%.The predictive ability of the cutoff HBsAg levels at 24 weeks was better than that at 12 weeks for HBs Ag loss at either 96 or 120 weeks(χ~2=3.880,P=0.049 andχ~2=4.412,P=0.036).These results indicate that extended therapy is critical to HBsAg loss in HBe Ag-negative CHB patients during PEG-IFN treatment,and the HBsAg level at 24 weeks can be used to predict HBsAg loss during tailoring PEG-IFN therapy.

关 键 词：Chronic hepatitis B(CHB) Hepatitis B surface antigen(HBsAg) Pegylated interferon HBsAg loss HBeAg negative 

分 类 号：R512.62[医药卫生—内科学]