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Sustained off‐treatment viral control is associated with high hepatitis B surface antigen seroclearance rates in Caucasian patients with nucleos(t)ide analogue–induced HB eAg seroconversion
Author(s) -
Van Hees Stijn,
Chi Heng,
Hansen Bettina,
Bourgeois Stefan,
Van Vlierberghe Hans,
Sersté Thomas,
Francque Sven,
Wong David,
Sprengers Dirk,
Moreno Christophe,
Nevens Frederik,
Janssen Harry L. A.,
Vanwolleghem Thomas
Publication year - 2019
Publication title -
journal of viral hepatitis
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.329
H-Index - 100
eISSN - 1365-2893
pISSN - 1352-0504
DOI - 10.1111/jvh.13084
Subject(s) - seroconversion , virology , medicine , antigen , immunology , virus
Nucleos(t)ide Analogue withdrawal has been described to result in significant Hepatitis B surface antigen (HBsAg) loss rates in patients with long-term viral suppression and negative HBeAg at the start of treatment. In these patients off-treatment HBsAg loss is often preceded by viral rebound with concomitant Alanine Aminotransferase flares. In the present study, we investigated off-treatment HBsAg loss in a multicentric, international observational cohort of patients with Nucleos(t)ide Analogue induced HBeAg seroconversion. Ninety eight mono-infected, predominantly male (74.4%) chronic hepatitis B patients of mixed ethnicity (43.9% Asians, 49.0% Caucasians) who stopped treatment at a median of 11.4 (6.1-18.0) months after HBeAg seroconversion were included. A total of 16 patients experienced Hepatitis B surface Antigen loss during a median follow-up of 42.8 (22.7-83.2) months after treatment cessation: 14 off-treatment and 2 after retreatment initiation with subsequent long-term viral suppression. All patients with off-treatment HBsAg loss showed persistently low ALT (<1.5xULN) and HBV DNA (<2000 IU/mL) levels after HBeAg seroconversion. Persistent viral control was associated with significantly higher annual HBsAg seroclearance rates (8.4%) than relapse with (1.5%; p=0.008) or without (0.0%; p=0.009) subsequent retreatment. In addition, Caucasian patients with sustained off-treatment viral control had >6-fold higher annual HBsAg loss rates compared to non-Caucasian patients (14.8% vs 2.3% respectively; p=0.004).Persistent viral control after treatment cessation following NA induced HBeAg seroconversion was associated with high HBsAg loss rates in Caucasian patients.