For patients with hepatitis B (HBV) who are HBV e antigen (HBeAg)-positive, the presence of HBV surface antigen (HBsAg) and/or HBV core-related antigen (HBcrAg) can predict likelihood of achieving treatment endpoints with nucleos(t)ide analogues, according to results published online in the Journal of Viral Hepatitis.
The results indicated that the combination of HBsAg and HBcrAg had the greatest predictive value for HBeAg seroconversion.
The study included 118 participants who were HBeAg-positive who started on nucleos(t)ide analogues between January 2005 and September 2016. The researchers used receiver operating curve analysis and cutoff values determined by maximized Youden’s index to determine the predictive power of on-treatment levels of HBsAg and HBcrAg.
After a median of 39 months of treatment, 36.4% of participants achieved HbeAg seroconversion.
A combination of HBsAg and HBcrAg had the greatest predictive value for HBeAg seroconversion. At 6 months, HBsAg of 3.9 log10 IU/mL and HBcrAg of 5.7 log10 U/mL had a sensitivity of 71.4%, specificity of 79.5%, positive predictive value of 65.2%, and negative predictive value of 83.8%, with the area under the receiver operator curve of 0.769 (95% CI, 0.668-0.869).
At 12 months, HBsAg 3.8 log10 IU/mL and HBcrAg 5.5 log10 U/mL had a sensitivity of 73.7%, specificity of 79.5%, positive predictive value of 63.6%, and negative predictive value of 86.1%, with an area under the receiver operator curve of 0.807 (95% CI, 0.713-0.901).
“[O]ur results may be used to identify patients who are unlikely to achieve treatment end-points, which will be important as the future management of chronic hepatitis B looks to therapies that offer functional cure,” the researchers wrote.
Wang B, Carey I, Bruce M, et al. HBsAg and HBcrAg as predictors of HBeAg seroconversion in HBeAg-positive patients treated with nucleos(t)ide analogues [published online April 2, 2018]. J Viral Hepat. doi: 10.1111/jvh.12889.