Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in prediction of treatment response to entecavir

May 3, 2011

Hepatology. 2011 May;53(5):1486-93. doi: 10.1002/hep.24221.

Quantitative hepatitis B surface antigen and hepatitis B e antigen titers in

prediction of treatment response to entecavir.

Lee JM, Ahn SH, Kim HS, Park H, Chang HY, Kim do Y, Hwang SG, Rim KS, Chon CY,

Han KH, Park JY.

Source

Department of Internal Medicine, Yonsei University College of Medicine, Seoul,

Korea; Department of Internal Medicine, CHA University, Seongnam-Si, Korea.

Abstract

Quantitative hepatitis B surface antigen (qHBsAg) and quantitative hepatitis B e

antigen (qHBeAg) titers are emerging as useful tools for measuring viral loads

and for predicting the virological response (VR) and serological response (SR)

to pegylated interferon therapy. However, the clinical utility of these assays

in patients taking entecavir (ETV) is largely unknown. Treatment-naive patients

with chronic hepatitis B (CHB) who were taking ETV for 2 years were enrolled.

The qHBsAg and qHBeAg levels were serially measured with the Architect assay.

From 95 patients, 60.0% of whom were hepatitis B e antigen-positive [HBeAg(+)],

475 samples were analyzed. The median baseline log hepatitis B virus (HBV) DNA,

log qHBsAg, and log qHBeAg values were 6.73 copies/mL (4.04-9.11 copies/mL),

3.58 IU/mL (1.17-5.10 IU/mL), and 1.71 Ehrlich (PE) IU/mL (-0.64 to 2.63 PE

IU/mL), respectively. For the prediction of VR (HBV DNA < 60 copies/mL at 24

months) in HBeAg(+) patients, baseline alanine aminotransferase (P = 0.013), HBV

DNA (P = 0.040), and qHBsAg levels (P = 0.033) were significant. For the

prediction of VR, the area under the curve for the baseline log qHBsAg level was

0.823 (P < 0.001); a cutoff level of 3.98 IU/mL (9550 IU/mL on a nonlogarithmic

scale) yielded the highest predictive value with a sensitivity of 86.8% and a

specificity of 78.9%. As for SR (HBeAg loss at 24 months), the reduction of

qHBeAg was significantly greater in the SR(+) group versus the SR(-) group. The

sensitivity and specificity were 75.0% and 89.8%, respectively, with a decline

of 1.00 PE IU/mL at 6 months. With ETV therapy, the correlation between HBV DNA

and qHBsAg peaked at 6 months in HBeAg(+) patients. Conclusion: Both qHBsAg and

qHBeAg decreased significantly with ETV therapy. The baseline qHBsAg levels and

the on-treatment decline of qHBeAg in HBeAg(+) patients were proven to be highly

useful in predicting VR and SR, respectively. The determination of qHBsAg and

qHBeAg can help us to select the appropriate strategy for the management of

patients with CHB. However, the dynamic interplay between qHBsAg, qHBeAg, and

HBV DNA during antiviral therapy remains to be elucidated. (Hepatology 2011;).

PMID: 21520167 [PubMed - in process]

May 3, 2011