Thai Journal of Gastroenterology

Article :
Serum Hepatitis B Surface Quantification is Predictive of A Sustained Response in Chronic Hepatitis B Patients after Cessation of Anti-Viral Therapy

Author :
Pinyomahakul P
Leerapun A
Thongsawat S

Abstract :
Background and Aims: In the current international guideline for management of chronic hepatitis B (CHB), there was no clear consensus when long-term oral nucleos(t)ide analogs (NUCs) therapy should be stopped. This was mainly because of the ideal endpoint with HBsAg seroclearance is rarely achieved by oral anti-viral therapy and also because of the high relapse rate after stopping treatment. We evaluated whether quantification of HBsAg could predict a sustained response and a seroclearance in chronic hepatitis B patients after stopping oral NUCs. Methods: Seventy-seven CHB patients (35 HBeAg-positive and 42 HBeAg-negative patients) who had received long-term oral NUCs 61.86 ± 25.82 months and had maintained normal ALT and undetectable HBV DNA were enrolled for stopping oral NUCs. Results: The cumulative incidence of HBsAg seroclearance and the sustained response in both HBeAg- positive and -negative patients at 12 months after stopping oral NUCs treatment were 13% and 62.3% respectively. The re-treatment rate in HBeAg-positive with HBeAg seroclearance was higher significant than in HBeAg-nega- tive patients (p<0.001), but not significant in HBeAg-positive with HBeAg seroconversion patients (p=0.74). Lower serum HBsAg at the end of treatment (EOT) was associated with a higher rate of HBsAg seroclearance and a sustained response. The optimal cut-off value for predicting HBsAg seroclearance was 100 IU/mL (p=0.007) and for predicting a sustained response was and 345 IU/mL (p=0.048). Conclusion: Serum HBsAg level at the end of treatment is a useful predictor for HBsAg seroclearance and a sustained response in both HBeAg-positive and -negative after stopping oral NUCs.

Keyword :
Hepatitis B surface quantificaiton, HBsAg, chronic hepatitis B

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