dc.contributor
Institut Català de la Salut
dc.contributor
[Sonneveld MJ, Brakenhoff SM] Departments of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. [Chiu SM] Department of Internal Medicine, Koahsiung Chang Gung Memorial Hospital, Kaohsiung, Taiwan. [Park JY] Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea. [Kaewdech A] Faculty of Medicine, Prince of Songkla University, Hatyai, Thailand. [Seto WK] Department of Medicine, State Key Laboratory for Liver Research, The University of Hong Kong, Hong Kong. [Buti M] Unitat del Fetge, Servei de Medicina Interna, Vall d’Hebron Hospital Universitari, Barcelona, Spain. Ciberehd del Intituto Carlos III de Barcelona, Spain
dc.contributor
Vall d'Hebron Barcelona Hospital Campus
dc.contributor.author
Chiu, Shao-Ming
dc.contributor.author
Seto, Wai-Kay
dc.contributor.author
Sonneveld, Milan
dc.contributor.author
Brakenhoff, Sylvia
dc.contributor.author
Kaewdech, Apichat
dc.contributor.author
Park, Jun Yong
dc.contributor.author
Buti Ferret, Maria
dc.date.accessioned
2025-10-24T10:22:52Z
dc.date.available
2025-10-24T10:22:52Z
dc.date.issued
2022-09-12T08:18:44Z
dc.date.issued
2022-09-12T08:18:44Z
dc.identifier
Sonneveld MJ, Chiu SM, Park JY, Brakenhoff SM, Kaewdech A, Seto WK, et al. Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels. J Hepatol. 2022 May;76(5):1042–50.
dc.identifier
https://hdl.handle.net/11351/8136
dc.identifier
10.1016/j.jhep.2022.01.007
dc.identifier
000823493800007
dc.identifier.uri
https://hdl.handle.net/11351/8136
dc.description.abstract
HBV genotype; Viral antigen
dc.description.abstract
Genotipo VHB; Antígeno viral
dc.description.abstract
Genotip del VHB; Antigen viral
dc.description.abstract
Background & Aims
Nucleo(s)tide analogue (NUC) withdrawal may result in HBsAg clearance in a subset of patients. However, predictors of HBsAg loss after NUC withdrawal remain ill-defined.
Methods
We studied predictors of HBsAg loss in a global cohort of HBeAg-negative patients with undetectable HBV DNA who discontinued long-term NUC therapy. Patients requiring retreatment after treatment cessation were considered non-responders.
Results
We enrolled 1,216 patients (991 with genotype data); 98 (8.1%) achieved HBsAg loss. The probability of HBsAg loss was higher in non-Asian patients (adjusted hazard ratio [aHR] 8.26, p <0.001), and in patients with lower HBsAg (aHR 0.243, p <0.001) and HBV core-related antigen (HBcrAg) (aHR 0.718, p = 0.001) levels. Combining HBsAg (<10, 10-100 or >100 IU/ml) and HBcrAg (<2log vs. ≥2 log) levels improved prediction of HBsAg loss, with extremely low rates observed in patients with HBsAg >100 IU/ml with detectable HBcrAg. HBsAg loss rates also varied with HBV genotype; the highest rates were observed for genotypes A and D, and none of the patients with HBV genotype E experienced HBsAg loss (p <0.001 for the overall comparison across genotypes; p <0.001 for genotypes A/D vs. genotypes B/C). HBV genotype C was independently associated with a higher probability of HBsAg loss when compared to genotype B among Asian patients (aHR 2.494; 95% CI 1.490–4.174, p = 0.001).
Conclusions
The probability of HBsAg loss after NUC cessation varies according to patient ethnicity, HBV genotype and end-of-treatment viral antigen levels. Patients with low HBsAg (<100 IU/ml) and/or undetectable HBcrAg levels, particularly if non-Asian or infected with HBV genotype C, appear to be the best candidates for treatment withdrawal.
dc.description.abstract
The CREATE study was supported by Fujirebio. No additional funding was obtained for this follow-up analysis.
dc.format
application/pdf
dc.relation
Journal of Hepatology;76(5)
dc.relation
https://doi.org/10.1016/j.jhep.2022.01.007
dc.rights
Attribution 4.0 International
dc.rights
http://creativecommons.org/licenses/by/4.0/
dc.rights
info:eu-repo/semantics/openAccess
dc.subject
Medicaments antivírics - Ús terapèutic
dc.subject
Hepatitis B - Tractament
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CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiviral Agents
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Other subheadings::Other subheadings::/therapeutic use
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DISEASES::Virus Diseases::DNA Virus Infections::Hepadnaviridae Infections::Hepatitis B::Hepatitis B, Chronic
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COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antivíricos
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Otros calificadores::Otros calificadores::/uso terapéutico
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ENFERMEDADES::virosis::infecciones por virus ADN::infecciones por Hepadnaviridae::hepatitis B::hepatitis B crónica
dc.title
Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels
dc.type
info:eu-repo/semantics/article
dc.type
info:eu-repo/semantics/publishedVersion
