Prediction Of HBeAg Seroconversion To Nucleos(t)ide Analogues For Hepatitis B E Antigen-positive Chronic Hepatitis B Using Quantitative Detection Of On-treatment Hepatitis B E Antigen

Objective To investigate the usefulness of the quantitative detection of hepatitis B eantigen(HBeAg) in serum for predicting HBeAg seroconversion in chronic hepatitisB(CHB) patients treated with nucleos(t)ide analogues.Methods Twenty-two HBeAg-positive CHB patients underwent NUCs antiviraltherapy were enrolled and followed up for2years. Serum HBV DNA load, ALTlevels, quantitative HBsAg(qHBsAg) and quantitative HBeAg(qHBeAg) were carriedout at baseline, weeks12,24,48and96.Results Seven patients had HBeAg seroconversion and15patients remainedHBeAg positive after2-year therapy. There were no statistical differences betweenthe two groups in serum HBV DNA load, qHBsAg, qHBeAg or ALT atbaseline(P>0.05). Compared to non-HBeAg seroconversion patients, HBeAgseroconversion patients experienced a more significant decline in HBV DNA level atweek12and qHBeAg at week12,24and48(P<0.05). Patients achieved HBV DNAundetected at week12still had36.4%chance of not achieving e antigenseroconversion within2years. Moreover, the area under receiver operatingcharacteristics curve for the rate of HBV DNA decline at week12, and the rate ofqHBeAg decline at week12and48from baseline to predict HBeAg seroconversionat year2were0.802,0.872and0.910(P<0.05). Predictive indices revealed56.2%,45.3%and82.1%to be the best cutoff levels with a sensitivity of85.7%,83.3%and 83.3%, and a specificity of69.2%,92.3%and100%, respectively. qHBsAg lowerthan3.49(log10IU/ml) at week12has the sensitivity of83.3%and specificity of76.9%to predict HBeAg seroconversion at year2(the area under ROC curve was0.795).Conclusions The sustained decline of qHBeAg from baseline during antiviraltherapy had high value to predict HBeAg seroconversion, especially after HBV DNAundetectable.