Dynamics of hepatitis B e antigen index ratio correlate with treatment response in chronic hepatitis B patients

Background/Aim: Hepatitis B e antigen (HBeAg) seroconversion is an important event in the natural history of chronic hepatitis B virus (HBV) infection. Whether early dynamics of HBeAg index ratio could predict therapeutic endpoint of HBeAg seroconversion in patients receiving lamivudine remains unclear and thus deserves investigation. Methods: A total of 52 patients (males/females, 40/12; mean age, 31.1±7.5 years) with HBeAg‐positive chronic hepatitis B and serum alanine aminotransferase (ALT) level ≥5 × upper limit of normal were enrolled. They received daily 100 mg lamivudine for at least 1 year. Pretreatment HBeAg index ratio and the dynamics during treatment [early serologic response (ESR) and serologic breakthrough (SB)] between responders and non‐responders were compared. Results: Of these 52 patients, mean pretreatment serum ALT level was 580 IU/l and baseline HBeAg index ratio (S/N) was 37.9. The overall 1‐year on‐treatment combined response rate was 50%. By using linear regression analysis, HBeAg index ratio was positively correlated with serum HBV DNA level (Pearson's correlation coefficient: 0.62, P <0.0001). By using multivariate logistic regression analysis, ESR could predict the success of treatment response ( P =0.0302), and SB had a 90% positive predictive value of treatment failure. Conclusions: HBeAg index ratio is closely correlated with serum HBV DNA level, and the dynamics of HBeAg index ratio may predict 1‐year on‐treatment combined response to lamivudine in HBeAg‐positive chronic hepatitis B patients.