2026-04-13T07:22:21Zhttps://recercat.cat/oai/requestoai:recercat.cat:11351/81362025-10-24T10:22:52Zcom_2072_378070com_2072_378040col_2072_378092
RECERCAT
author
Chiu, Shao-Ming
author
Seto, Wai-Kay
author
Sonneveld, Milan
author
Brakenhoff, Sylvia
author
Kaewdech, Apichat
author
Park, Jun Yong
author
Buti Ferret, Maria
2025-10-24T10:22:52Z
2025-10-24T10:22:52Z
2022-09-12T08:18:44Z2022-09-12T08:18:44Z2022-05
http://hdl.handle.net/11351/8136
HBV genotype; Viral antigenGenotipo VHB; Antígeno viralGenotip del VHB; Antigen viralBackground & 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.The CREATE study was supported by Fujirebio. No additional funding was obtained for this follow-up analysis.
Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess
Medicaments antivírics - Ús terapèutic
Hepatitis B - Tractament
CHEMICALS AND DRUGS::Chemical Actions and Uses::Pharmacologic Actions::Therapeutic Uses::Anti-Infective Agents::Antiviral Agents
Other subheadings::Other subheadings::/therapeutic use
DISEASES::Virus Diseases::DNA Virus Infections::Hepadnaviridae Infections::Hepatitis B::Hepatitis B, Chronic
COMPUESTOS QUÍMICOS Y DROGAS::acciones y usos químicos::acciones farmacológicas::usos terapéuticos::antiinfecciosos::antivíricos
Otros calificadores::Otros calificadores::/uso terapéutico
ENFERMEDADES::virosis::infecciones por virus ADN::infecciones por Hepadnaviridae::hepatitis B::hepatitis B crónica
Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels
info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion