The Durability of Hepatitis B Surface Antigen Seroclearance: A Comparative Study

The Durability of Hepatitis B Surface Antigen Seroclearance: A Comparative Study

A recent study conducted by researchers from The Second Affiliated Hospital of Chongqing Medical University aimed to analyze the durability of hepatitis B surface antigen (HBsAg) seroclearance in patients treated with nucleos(t)ide analogs (NAs) or interferon (IFN) monotherapy. The study, published in the journal Genes & Diseases, examined a dataset that included over 70,000 HBsAg-positive individuals.

The researchers compared two groups: those who achieved HBsAg seroclearance through NAs monotherapy (168 patients) and those who achieved seroclearance through IFN monotherapy (30 patients). The study found that the NAs monotherapy group had a higher proportion of patients who achieved HBsAg seroclearance during treatment (48.8% vs. 30.0%) and a more favorable immune response, as indicated by a higher percentage of patients developing concomitant anti-HBs antibodies.

Additionally, the NAs-monotherapy group had a higher number of patients with normal alanine aminotransferase (ALT) levels (78.6% vs. 40.0%). The time to achieve HBsAg seroclearance and therapy duration were similar between the groups, but NAs monotherapy showed a trend towards longer times. Notably, during follow-up, patients on NAs monotherapy had a significantly lower rate of HBsAg seroreversion compared to patients on IFN monotherapy (4.9% vs. 33.3%).

The study demonstrated that the one-year and three-year probabilities of confirmed HBsAg seroclearance were significantly higher with NAs therapy, indicating a more sustained functional cure. Furthermore, NAs monotherapy was independently associated with a lower risk of HBsAg seroreversion. Most patients experienced HBsAg seroreversion within the first year after seroclearance, and IFN monotherapy patients with positive anti-HBs antibodies had a higher probability of confirmed seroclearance during follow-up.

These findings provide valuable insights into the durability of HBsAg seroclearance induced by NAs or IFN monotherapy, with NAs monotherapy showing better outcomes and a lower risk of recurrence. Age and ALT levels were also identified as factors associated with HBsAg seroreversion. Understanding these findings can aid clinicians in making informed treatment decisions for patients with chronic Hepatitis B, leading to better clinical outcomes.

The researchers believe that these findings will contribute to the development of more effective and personalized therapeutic strategies for patients with chronic hepatitis B. The study emphasizes the importance of continued research in this area and highlights the potential for leveraging electronic health record data to gain deeper insights into disease management and treatment outcomes.

Zongqi Shi et al, Durability of Hepatitis B surface antigen seroclearance in patients experienced nucleoside analogs or interferon monotherapy: A real-world data from Electronic Health Record, Genes & Diseases (2023). DOI: 10.1016/j.gendis.2022.03.003. Chongqing Medical University.

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