2026-04-19T16:08:42Zhttps://recercat.cat/oai/request

oai:recercat.cat:11351/81362025-10-24T10:22:52Zcom_2072_378070com_2072_378040col_2072_378092

Probability of HBsAg loss after nucleo(s)tide analogue withdrawal depends on HBV genotype and viral antigen levels Chiu, Shao-Ming Seto, Wai-Kay Sonneveld, Milan Brakenhoff, Sylvia Kaewdech, Apichat Park, Jun Yong Buti Ferret, Maria 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 HBV genotype; Viral antigen Genotipo VHB; Antígeno viral Genotip del VHB; Antigen viral 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. The CREATE study was supported by Fujirebio. No additional funding was obtained for this follow-up analysis. 2025-10-24T10:22:52Z 2025-10-24T10:22:52Z 2025-10-24T10:22:52Z 2022-09-12T08:18:44Z 2022-09-12T08:18:44Z 2022-05 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion http://hdl.handle.net/11351/8136 Journal of Hepatology;76(5) https://doi.org/10.1016/j.jhep.2022.01.007 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess Elsevier Scientia