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- Title
Combining the HBcrAg decline and HBV mutations predicts spontaneous HBeAg seroconversion in chronic hepatitis B patients during the immune clearance phase.
- Authors
Xie, Yandi; Ma, Hui; Feng, Bo; Song, Guangjun
- Abstract
To assess predictive ability of hepatitis B virus (HBV) markers and genome mutations for spontaneous hepatitis B e antigen (HBeAg) seroconversion. A total of 113 chronic hepatitis B (CHB) patients were followed up for 76 weeks without antiviral treatment. Baseline basal core promoter (BCP) and precore mutations were detected and serum hepatitis B surface antigen (HBsAg), HBeAg, hepatitis B core‐related antigen (HBcrAg), and HBV DNA levels were serially quantified. Eighteen patients experienced spontaneous HBeAg seroconversion (Group A), and the remaining 95 patients did not experience spontaneous HBeAg seroconversion (Group B). At Week 28, HBsAg (p = 0.03) and HBcrAg (p = 0.01) levels were significantly different between Groups A and B. Reduced HBsAg (p = 0.02) and HBcrAg (p < 0.01) levels from baseline to Week 28 were significantly different between two groups. Multivariate logistic regression showed that lower HBcrAg (odds ratio [OR] = 1.02, p = 0.03) levels at Week 28, and HBcrAg levels with sharp decrease at Week 28 (OR = 0.19, p = 0.02) were related with spontaneous HBeAg seroconversion. The areas under the receiver operating characteristic curve (AUROC) showed that reduction in HBcrAg levels from baseline to Week 28 (0.93, p = 0.001, 95% CI: 0.74–1.08) have excellent prediction value. The mutation frequencies of A1574T (51.11% vs. 18.18%, p = 0.001), G1862A (30.00% vs. 13.03%, p = 0.001), G1896A (27.22% vs. 5.45%, p = 0.001), and C1913G (32.78% vs. 12.73%, p = 0.001) in Group A were significantly higher than Group B. Baseline A1574T, G1862A, G1896A, and C1913G mutations and HBcrAg levels with a sharp decrease at Week 28 were associated with spontaneous HBeAg seroconversion. Key points: This prospective study found that baseline A1574T, G1862A, G1896A, and C1913G mutations and the dynamic of serum hepatitis B surface antigen (HBsAg) and hepatitis B core‐related antigen (HBcrAg) levels especially sharp decrease in the HBcrAg levels at Week 28 were associated with spontaneous HBeAg seroconversion. The results provided necessary clinical data for the spontaneous hepatitis B e antigen (HBeAg) seroconversion and may be significant in making decisions for hepatitis B virus (HBV) treatment.
- Subjects
SEROCONVERSION; CHRONIC hepatitis B; HEPATITIS associated antigen; HEPATITIS B virus; HEPATITIS B; RECEIVER operating characteristic curves
- Publication
Journal of Medical Virology, 2022, Vol 94, Issue 6, p2694
- ISSN
0146-6615
- Publication type
Article
- DOI
10.1002/jmv.27545