Time-varying serum gradient of hepatitis B surface antigen predicts risk of relapses after off-NA therapy

• Published in: BMC gastroenterology 2017-12, Vol.17 (1), p.154-154, Article 154
• Main Authors: Chien, Nai-Hsuan, Huang, Yen-Tsung, Wu, Chun-Ying, Chang, Chi-Yang, Wu, Ming-Shiang, Kao, Jia-Horng, Mo, Lein-Ray, Tai, Chi-Ming, Lin, Chih-Wen, Yang, Tzeng-Huey, Lin, Jaw-Town, Hsu, Yao-Chun
• Format: Article
• Language: English
• Subjects: Chronic hepatitis B; Diagnosis; Drug therapy; Hepatitis B; Hepatitis B surface antigen; Hepatitis B surface antigen quantification; Measurement; Nucleos(t)ide analogs; Patient outcomes; Physiological aspects; Recurrence (Disease); Risk factors; Time-dependent Cox proportion hazards model
• ISSN: 1471-230X; 1471-230X
• DOI: 10.1186/s12876-017-0697-3

The serum gradient of hepatitis B surface antigen (HBsAg) varies over time after cessation of nucleos(t)ide analog (NA) treatment in patients with chronic hepatitis B (CHB). The association between the time-varying HBsAg serum gradient and risk of relapse has not been elucidated. This multicenter cohort study prospectively enrolled CHB patients who discontinued 3 year-NA treatment. Eligible patients were serologically negative for HBeAg and viral DNA at NA cessation. The participants (n = 140) were followed every 3 months through HBsAg quantification. Virological and clinical relapses were defined as viral DNA levels >2000 IU/mL and alanine aminotransferase (ALT) levels >80 U/mL, respectively. The association of time-varying HBsAg levels with relapses was assessed through a time-dependent Cox analysis. During a median follow-up of 19.9 (interquartile range [IQR], 10.6-25.3) months, virological and clinical relapses occurred in 94 and 49 patients, with a 2-year cumulative incidence of 79.2% (95% confidence interval [CI], 70.9%-86.4%) and 42.9% (95% CI, 34.1%-52.8%), respectively. The serum level of HBsAg was associated with virological (P