Value of HBsAg quantification in evaluation of long-term efficacy of nucleoside analogues for patients with chronic hepatitis B after antiviral therapy

Abstract

Objective To observe the relationship between the quantity of hepatitis B surface antigen (HBsAg) and the long-term recurrence rate detecting the HBsAg at the termination of drug administration in patients treated by nucleoside analogues, and to guide the clinical doctors rationally choose the drug termination time. Methods The patients with chronic hepatitis B who were in accordance with the antiviral treatment standards since entecavir came into the market in China in 2007 were followed up and observed. And 62 patients stopped treatment according to the drug termination standards of Prevention and Treatment Guidelines of Chronic Hepatitis B (2010 Edition) from July, 2014 to July, 2015 were included as observation objects. 1, 2, 3, 6, and 12 months after drug termination, the serum alanine aminotransferase (ALT) , hepatitis B virus DNA quantitative (HBV DNA) , and HBsAg quantity were detected and the patients were examined by ultrasound. The data were collected before July, 2016. Results Univariate analysis suggested that the high HBsAg quantity, long treatment time to drug withdrawal standard, big population with negative baseline HBeAg, high HBcAb quantity at drug termination, and the high baseline ALT level might cause recurrence after drug withdrawal (P=0.004, 0.028, 0.009, 0.003, 0.013) . And multivariate regression analysis showed that the HBsAg quantity at drug termination (OR=6.31, P=0.032) , the treatment time to drug withdrawal standard (OR=7.66, P=0.000) , the HBcAb quantity at drug termination (OR=7.91, P=0.027) , and the baseline ALT (OR=4.33, P=0.008) were independent risk factors for the relapse after drug withdrawal. 24 cases (38.71%) relapsed at the end of the follow-up. The recurrence rates 1, 2, 3, 6, and 12 months after drug termination were 0, 0, 1.61%, 17.74%, and 39.70%, respectively. The recurrence first occurred 3 months after drug termination and occurred more 6 months after. Conclusions HBsAg quantity at drug termination, treatment time to drug withdrawal standard, HBcAb quantity at drug termination, and the baseline ALT are independent risk factors of chronic hepatitis B recurrence after the termination of treatment by nucleoside analogues. The recurrence rate decreases, as the continuous treatment after the termination of antiviral treatment prolongs. Key words: Drug termination; Chronic hepatitis B; HBsAg; Quantitative detection; Prediction