Department of Infectious Diseases, Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, Guangdong, China.
Guangdong Key Laboratory of Liver Disease Research, The Third Affiliated Hospital of Sun Yat-sen University, Guangzhou, China.
J Viral Hepat. 2022 Oct;29(10):899-907. doi: 10.1111/jvh.13734. Epub 2022 Aug 13.
It is unclear whether hepatitis B surface antibody (HBsAb) confers clinical benefits after HBsAg seroclearance, especially in hepatitis B surface antigen (HBsAg) seroreversion and maintenance of HBsAb. We evaluated this in patients (n = 222) with HBsAg loss following treatment with pegylated interferon (PEG-IFN)-based therapy who completed a 48-week follow-up period. Serum hepatitis B virus (HBV) markers and biochemical indicators were evaluated every 3 months. The primary endpoint was HBsAg seroreversion. Factors associated with HBsAg seroreversion were also investigated. HBsAb ≥100 mIU/ml resulted in a lower HBsAg seroreversion rate than an HBsAb-negative status (5.5% vs. 29.5%, p < .001); however, the seroreversion rate was not significantly different between patients with HBsAb 10-100 mIU/ml and those in the HBsAb-negative group. Patients with HBsAb ≥100 mIU/ml had a lower HBsAb loss rate than those with HBsAb 10-100 mIU/ml (7.3% vs. 21.7%, p = .005). The final HBsAg seroreversion and HBV DNA relapse rates were 13.5% and 1.8%, respectively. HBsAb ≥100 mIU/ml at the off-treatment time (odds ratio [OR] 0.110, 95% confidence interval [CI]: 0.034-0.353, p < .001) and treatment time to attain HBsAg loss >28 weeks (OR 2.508, 95% CI: 1.068-5.890, p = .035) were predictors of HBsAg seroreversion. Consolidation therapy for 12-24 weeks resulted in higher HBsAb titres than consolidation therapy for ≤12 weeks in HBsAb-negative patients at the off-treatment time (p < .001). HBsAg seroconversion with HBsAb ≥100 mIU/ml decreases HBsAg seroreversion and provides an efficient maintenance rate of HBsAb. HBsAg seroconversion with high HBsAb titres may be clinically beneficial for chronic hepatitis B treated with PEG-IFN-based therapy.
尚不清楚乙肝表面抗体 (HBsAb) 在乙肝表面抗原 (HBsAg) 清除后是否能带来临床获益，尤其是在 HBsAg 血清学转换和 HBsAb 维持方面。我们在 222 名接受聚乙二醇干扰素 (PEG-IFN) 治疗后 HBsAg 丢失的患者中评估了这一点，这些患者完成了 48 周的随访期。每 3 个月评估一次血清乙型肝炎病毒 (HBV) 标志物和生化指标。主要终点是 HBsAg 血清学转换。还研究了与 HBsAg 血清学转换相关的因素。HBsAb ≥100mIU/ml 导致 HBsAg 血清学转换率低于 HBsAb 阴性状态 (5.5%比 29.5%，p <.001)；然而，HBsAb 为 10-100mIU/ml 的患者与 HBsAb 阴性组之间的血清学转换率没有显著差异。HBsAb ≥100mIU/ml 的患者 HBsAb 丢失率低于 HBsAb 为 10-100mIU/ml 的患者 (7.3%比 21.7%，p =.005)。治疗结束时的最终 HBsAg 血清学转换和 HBV DNA 复发率分别为 13.5%和 1.8%。治疗结束时 HBsAb ≥100mIU/ml (比值比 [OR] 0.110，95%置信区间 [CI]：0.034-0.353，p <.001) 和达到 HBsAg 丢失的治疗时间 >28 周 (OR 2.508，95%CI：1.068-5.890，p =.035) 是 HBsAg 血清学转换的预测因素。与治疗结束时的 12-24 周巩固治疗相比，HBsAb 阴性患者的 12 周巩固治疗导致 HBsAb 滴度更高 (p <.001)。HBsAb ≥100mIU/ml 导致的 HBsAg 血清学转换可降低 HBsAg 血清学转换率，并提供高效的 HBsAb 维持率。高 HBsAb 滴度导致的 HBsAg 血清学转换可能对接受 PEG-IFN 治疗的慢性乙型肝炎具有临床益处。
