A model with combined viral and metabolic factors effectively predicts HBeAg status under long term entecavir therapy: a prospective cohort study

Abstract

Background & AimThe aim was to extract factors from virologic and biochemical profiles at baseline and 24 weeks of treatment to predict HBeAg seroconversion in patients treated with ETV.MethodsHBeAg positive chronic hepatitis B patients receiving ETV naïve-treatment were enrolled. HBV DNA, ALT, and serological markers were prospectively monitored every 6 months for 240 weeks. The cumulative rates of virologic response (VR), biochemical response (BR), and HBeAg seroconversion were determined, and potential predictors for HBeAg seroconversion were identified through uni/multivariate analysis.Result Two hundred twenty nine patients were eligible for this study. The cumulative rates of VR, BR, and HBeAg seroconversion at 240 weeks were 88.4 %, 100 %, and 36.7 %, respectively. Multivariate analysis showed that HBV DNA (OR, 2.8, p = 0.003), ALT (OR, 2.6, p = 0.005) at baseline, undetectable HBV DNA within 24 weeks (OR = 3.2, p < 0.001), and body mass index (BMI) ≥24kg/m2 (OR = 0.038, p = 0.013) were associated with HBeAg seroconversion. A prediction model for probability of HBeAg seroconversion was constructed. Patients can be classified into high (>40 %), intermediate (20–40 %), or low (≤20 %) groups based on the calculated probability of HBeAg seroconversion. The cumulative rates of HBeAg seroconversion were different among the three groups (p < 0.001). About 58 % patients in the high probability group achieved HBeAg seroconversion while almost 90 % patients within the low group remained HBeAg positive.ConclusionA combination of HBV DNA, ALT and BMI values at baseline, and undetectable HBV DNA level within 24 weeks can predict HBeAg seroconversion. Both viral and metabolic factors likely determine HBeAg status with ETV treatment.Trial registrationCTR20132358

Upgrade Combination Response Is Limited by Prolonged Nucelos(t)ide Analogue Therapy in HBeAg-positive Chronic Hepatitis B: A Real-life Study

“… 13 Another study showed that the HBeAg/anti-HBe seroconversion rate was 36.7% with 5-year ETV treatment in HBeAg-positive CHB. 17 In an ETV 7-year treatment study, HBeAg/anti-HBe seroconversion rates at years 3 and 7 were 26.7% and 37.5%, respectively. 18 Additionally, many investigations have shown that ETV and LDT have a higher rate of HBeAg/anti-HBe seroconversion in patients with HBeAg-positive CHB.…”

“…It also agrees with previous reports of baseline ALT >5 ULN as a positive predictor for HBeAg seroconversion, 13 , 14 and serum HBV DNA <9 log 10 copies/mL as a strong predictor for better virological outcomes. 13 – 17 …”

A scoring model predicts hepatitis B e antigen seroconversion in chronic hepatitis B patients treated with nucleos(t)ide analogs: real-world clinical practice

“…Previous studies have identified the association between pretreatment alanine aminotransferase (ALT), HBV DNA, hepatitis B surface antigen (HBsAg), quantitative HBeAg (qHBeAg), platelets (PLT), gamma-glutamyl transpeptidase (GGT), and quantitative anti-hepatitis B core antibody (qAnti-HBc) levels with HBeAg seroconversion (Chi et al, 2015;Fan et al, 2016;Fried et al, 2008;Li et al, 2014;Wang et al, 2015a;Hou et al, 2015;Huang et al, 2015). Although several clinically useful models have been established for assessing HBeAg seroconversion, they require complex calculations or concentrate on the response to interferon (Wang et al, 2015b;Lee et al, 2014;Lee et al, 2011;Liu et al, 2015). Thus, it appears that no other study has developed a multiparameter scoring model to clearly define the relationships between these factors.…”