Spontaneous seroclearance of
hepatitis B e antigen (
HBeAg) and hepatitis B virus (HBV)
DNA undetectability are important milestones of
chronic hepatitis B and major treatment endpoints of
antiviral therapy. This study investigated the role of serum
hepatitis B surface antigen (
HBsAg) levels and established models for predicting
HBeAg seroclearance and HBV
DNA undetectability. A total of 2,139
HBsAg-seropositive, anti-HCV-seronegative, and treatment-naïve participants without
liver cirrhosis at study entry were included. Spontaneous
HBeAg seroclearance and HBV
DNA undetectability were analyzed in 431
HBeAg-seropositive participants and 1,708
HBeAg-seronegative participants, respectively. Regression coefficients of predictors in Cox proportional hazard models were converted into integer scores for predicting seroclearance and predictive accuracy was assessed with time-dependent receiver operating characteristic (ROC) curves. The HBV
DNA level was the most important predictor of
HBeAg seroclearance but serum
HBsAg level was the most significant predictor of HBV
DNA undetectability. Compared to individuals with
HBsAg levels ≥ 10,000 IU/mL, the multivariate-adjusted rate ratio (95% confidence interval) of HBV
DNA undetectability was 1.20 (0.62-2.30), 2.49 (1.31-4.75), and 6.08 (3.19-11.61) for those with serum
HBsAg levels of 1,000-9,999, 100-999, and <100 IU/mL, respectively. The area under the ROC curve (AUROC) of the prediction models for predicting the 5- and 10-year probabilities of
HBeAg seroclearance and HBV
DNA undetectability were 0.85 (0.80-0.90) and 0.78 (0.73-0.83) for
HBeAg seroclearance, and 0.77 (0.72-0.82) and 0.73 (0.70-0.76) for HBV
DNA undetectability.
CONCLUSION: