The Brazilian Journal of Infectious Diseases The Brazilian Journal of Infectious Diseases
Braz J Infect Dis 2017;21:213-8 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.03.001
Original article
Predictors of HBeAg seroconversion after long-term nucleos(t)ide analogues treatment for chronic hepatitis B: a multicenter study in real clinical setting
Weiyan Yua, Yadong Wanga, Chuan Shena, Ru Jia, Li Zhanga, Xin Zhaoa, Miao Sua, Ying Zhangb, Wenyan Hec, Jianguo Caod, Yanshuang Haod, Shengpeng Chene, Caiyan Zhaoa,,
a Department of Infectious Diseases, The Third Affiliated Hospital of Hebei Medical University, Shijiazhuang, China
b Cangzhou Contagious Hospital of Hebei Province, Cangzhou, China
c Central Hospital of China National Petroleum Corporation, Langfang, China
d General Hospital of Jizhong Energy Fengfeng Group, Handan, China
e The 260 Hospital of PLA, Shijiazhuang, China
Received 16 November 2015, Accepted 10 March 2017
Abstract
Aims

To evaluate the HBeAg seroconversion rate in real clinical setting and explore its predictors in long-term nucleos(t)ide analogues (NAs) treatment for chronic hepatitis B (CHB).

Methods

251 patients were recruited from January 2001 to September 2009 in four hospitals in Hebei province, China, for this retrospective study. Clinical and laboratory data before and after treatment with lamivudine (LAM, 100mg daily), adefovir (ADV, 10mg daily), telbivudine (LDT, 600mg daily), entecavir (ETV, 0.5mg daily), and LAM/ADV combination were compared among three groups according to treatment outcomes: synchronous HBeAg loss and HBeAg seroconversion, anti-HBe development after treatment, and no anti-HBe. Adherence was also evaluated.

Results

In real clinical setting, cumulative HBeAg seroconversion rates were 14.3%, 32.7%, 43.0%, 46.9%, and 50.5% after 1, 2, 3, 5, and 8 years, respectively. 45 patients (17.9%) were non-adherent. Adherence (p<0.001, Hazard Ratio (HR)=2.203), elevated alanine aminotransferase (ALT) levels (p<0.001, HR=2.049), and non-vertical transmission (p=0.006, HR=1.656) were predictors of HBeAg seroconversion.

Conclusion

Adherence, elevated ALT, and non-vertical transmission are predictors of HBeAg seroconversion in CHB patients treated with NAs.

Keywords
Chronic hepatitis B, Hepatitis B and antigens, Nucleos(t)ide analogue, Adherence
Braz J Infect Dis 2017;21:213-8 - Vol. 21 Num.3 DOI: 10.1016/j.bjid.2017.03.001