title: Combining age and HBsAg level predicts post-treatment durability of nucleos(t)ide analogue-induced HBeAg seroconversion.
abstract: OBJECTIVE
  Previous studies have indicated that lamivudine-induced hepatitis B e antigen (HBeAg) seroconversion may not be durable in the Asian population. We investigated the useful predictors of post-treatment hepatitis B virus (HBV) relapse in patients with nucleos(t)ide analogue (NA)-induced HBeAg loss/seroconversion.
  
  
  METHODS
  A total of 157 non-cirrhotic patients with NA-induced HBeAg loss/seroconversion (78, lamivudine; 68, entecavir; 11, telbivudine) were retrospectively analyzed. All patients had at least 12 months of post-treatment follow-up and consolidation therapy duration.
  
  
  RESULTS
  The cumulative rate of post-treatment HBV relapse at 5 years was 57.1%. Multivariate analysis revealed that age and baseline hepatitis B surface antigen (HBsAg) levels independently predicted post-treatment HBV relapse. The post-treatment HBV relapse rate was significantly higher in patients aged > 40 years than in those < 40 years (P < 0.001). A baseline HBsAg level of 2000 IU/mL was the optimal cut-off value for predicting post-treatment HBV relapse (P = 0.002). The post-treatment HBV relapse risk further increased with the presence of both risk factors (age ≥ 40 years and baseline HBsAg level ≥ 2000 IU/mL; P < 0.001). A prolonged consolidation therapy period of ≥ 18 or 24 months had no positive effect on sustained viral suppression. There was no significant difference in post-treatment HBV relapse rates between patients with lamivudine- and entecavir-induced HBeAg loss/seroconversion during the off-treatment follow-up (P = 0.31).
  
  
  CONCLUSIONS
  The combination of an age of 40 years and a baseline HBsAg level of 2000 IU/mL was a useful marker for predicting post-treatment HBV relapse in patients with NA-induced HBeAg loss/seroconversion.
authors.affiliation: Division of Hepatogastroenterology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan.
authors.forename: Chih-Chien
authors.initials: CC
authors.lastname: Yao
authors.forename: Chuan-Mo
authors.initials: CM
authors.lastname: Lee
authors.forename: Chao-Hung
authors.initials: CH
authors.lastname: Hung
authors.forename: Jing-Houng
authors.initials: JH
authors.lastname: Wang
authors.forename: Tsung-Hui
authors.initials: TH
authors.lastname: Hu
authors.forename: Sheng-Nan
authors.initials: SN
authors.lastname: Lu
authors.forename: Chi-Sin
authors.initials: CS
authors.lastname: Changchien
authors.forename: Mei-Chin
authors.initials: MC
authors.lastname: Hsu
authors.forename: Chien-Hung
authors.initials: CH
authors.lastname: Chen
mesh_terms: D000328:Adult; D000375:Aging / Q000276:immunology*; D000998:Antiviral Agents / Q000627:therapeutic use; D060830:Consolidation Chemotherapy; D005260:Female; D005500:Follow-Up Studies; D005544:Forecasting; D006509:Hepatitis B / Q000188:drug therapy* / Q000453:epidemiology / Q000276:immunology*; D006513:Hepatitis B e Antigens / Q000097:blood* / Q000276:immunology*; D006801:Humans; D019259:Lamivudine / Q000627:therapeutic use; D008297:Male; D008875:Middle Aged; D008969:Molecular Sequence Data; D009711:Nucleotides / Q000276:immunology*; D012008:Recurrence; D012189:Retrospective Studies; D012306:Risk; D000069078:Seroconversion; D013997:Time Factors; D055815:Young Adult
chemical_list: D000998:Antiviral Agents; D006513:Hepatitis B e Antigens; D009711:Nucleotides; D019259:Lamivudine
keywords: HBV relapse; HBeAg seroconversion; HBsAg; entecavir; lamivudine