Change in Serum Hepatitis B Surface Antigen Level and Its Clinical Significance in Treatment-naive, Hepatitis B e Antigen-positive Patients Receiving Entecavir

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Journal of Clinical Gastroenterology:

October 2010 - Volume 44 - Issue 9 - pp 653-657

doi: 10.1097/MCG.0b013e3181d52946

LIVER, PANCREAS AND BILIARY TRACT: Original Articles

Change in Serum Hepatitis B Surface Antigen Level and Its Clinical Significance

in Treatment-naive, Hepatitis B e Antigen-positive Patients Receiving Entecavir

Jung, Young Kul MD; Kim, Ji Hoon MD, PhD; Lee, Young Sun MD; Lee, Hyun Jung MD;

Yoon, Eileen MD; Jung, Eun Suk MD; Hong, Seung Kwon MD; Joo, Moon Kyung MD, PhD;

Yeon, Jong Eun MD, PhD; Park, Jong Jae MD, PhD; Kim, Jae Seon MD, PhD; Bak,

Young-Tae MD, PhD; Byun, Kwan Soo MD, PhD

Abstract

Background/Aim: We investigated changes in hepatitis B surface antigen (HBsAg)

level and its correlation with clinical outcomes in treatment-naive chronic

hepatitis B (CHB) patients undergoing entecavir therapy.

Patients and Methods: Among 51 hepatitis B e antigen (HBeAg)-positive

treatment-naive CHB patients receiving entecavir for more than 1 year, 28 were

enrolled. HBsAg levels were measured at baseline, 6 months, and 12 months after

treatment using the Architect HBsAg QT assay (Abbott, dynamic; range: 0.05 to

125,000 IU/mL). Serum alanine aminotransferase, HBeAg, anti-HBe, and hepatitis

B virus (HBV) DNA (Cobas Taqman: low detection limit 1.84 log10 copies/mL)

were measured at baseline and every 3 months. The HBsAg response was defined as

an HBsAg level that decreased more than 1 log10 IU/mL from baseline level at

12 months after entecavir treatment.

Results: Twenty-eight patients were treated for a median period of 21 months

(range: 18 to 24 mo). Serum HBsAg level showed a mean of 4.0, 3.7, and

3.6 log10 IU/mL at pretreatment, 6, and 12 months, respectively, and declined

significantly (P<0.001). Serum HBV DNA level showed a mean of 8.1, 3.1, and

2.4 log10 copies/mL at pretreatment, 6, and 12 months, respectively, and

declined significantly (P<0.001). The decline in HBsAg level was significantly

correlated with that of the HBV DNA level at 12 months from baseline (γ=0.391,

P=0.044). Five patients showed an HBsAg response, and cumulative incidence of

HBeAg loss at 1 year after entecavir treatment was 80% versus 30% in patients

with an HBsAg response and those without, respectively (P=0.034).

Conclusions: Monitoring changes in quantitative HBsAg level could be a useful

parameter for assessing the response to entecavir therapy in HBeAg-positive

treatment-naive CHB patients.

© 2010 Lippincott & Wilkins, Inc