Predictors of Clinical Cure and off-treatment HBsAg Reversion in Patients with Chronic Hepatitis B receiving Peg-interferon-α-based Therapy

Background: Currently, pegylated interferon-α (Peg-IFN-α)-based antiviral therapy brings dawn to the clinical cure of chronic hepatitis B(CHB). Our aim was to investigate markers associated with clinical cure and off-treatment hepatitis B surface antigen (HBsAg) reversion in CHB receiving Peg-IFN-α-based therapy. Methods In total, 101 patients with hepatitis B e antigen-negative CHB who were treatment-naive or nucleotide analogs(NAs) treated patients were enrolled, then they were all received Peg-IFN-α-based therapy. Hepatitis B core-related antigen (HBcrAg), HBsAg and hepatitis B surface antibody (HBsAb) levels were examined dynamically and used to investigate the predictive value for HBsAg clearance and off-treatment reversion. Results Out of 101 patients, 41(40.59%) individuals achieved HBsAg clearance at the end of treatment (EOT). High baseline HBsAg (2.32 log 10 IU/mL) combined with HBcrAg (3.90 log 10 U/mL) was strongly associated with the HBsAg clearance (AUC = 0.714, P<0.001). The HBcrAg and HBsAg decline from baseline to week 12 showed good ability to predict HBsAg clearance (AUC = 0.807, P<0.001), while the HBsAg decline from week 12 to 24 were associated with HBsAg clearance (AUC = 0.745, P<0.001). A combination of HBcrAg < 3.80 log 10 U/mL and HBsAb ≥ 51.50 IU/L at EOT had a negative predictive value of 85.71% for off-treatment HBsAg reversion (AUC = 0.840, P  < 0.001). Conclusions HBcrAg and HBsAg can be used to predict clinical cure, while the HBcrAg and HBsAb were closely related to the off-treatment HBsAg reversion in patients with CHB receiving Peg-IFN-α-based therapy.