Hsu WF, et al. - In this work, the patterns of serum hepatitis B surface antigen (HBsAg) kinetics and their association with therapeutic outcomes in genotype B- or C-infected chronic hepatitis B (CHB) patients receiving long-term nucleos(t)ide analogue (NA) therapy were investigated. Researchers realized that the trajectory of serum HBsAg levels was predictive of HBsAg loss in CHB patients receiving long-term NA therapy.

Methods

• 329 treatment-naive CHB patients receiving NA therapy for >5 years were enrolled to analyse the kinetic patterns by using group-based trajectory models (GBTMs).

Results

• Entecavir therapy was administered to most patients (82.4%).
• Treatment was provided for a median period of 83.6 (68.5-89.7) months.
• In this work, the GBTMs revealed three groups for both the hepatitis B e antigen (HBeAg)-positive and -negative patients.
• Serum HBsAg levels indicated significantly higher median annual decline during the first 5 years in Group 1 than in Groups 2 and 3 in HBeAg-positive (0.78 vs 0.10 vs 0.10 log₁₀IU/mL) and HBeAg-negative (0.71 vs 0.08 vs 0.09 log₁₀ IU/mL) patients.
• HBsAg levels at the baseline and 12 months combined with an HBsAg decline from the baseline to 12 months of treatment seemed predicting trajectory pattern 1 in HBeAg-positive (sensitivity, 77.8%; specificity, 99.1%; positive predictive value [PPV], 87.5%; and negative predictive value [NPV], 98.2%) and HBeAg-negative (sensitivity, 100%; specificity, 99.5%; PPV, 88.9%; and NPV, 100%) patients.
• There appeared a significant association of the trajectory patterns with HBeAg loss in the HBeAg-positive patients and the achievement of HBsAg