Reliable predictors of outcomes
after treatment discontinuation in
HBeAg-negative
chronic hepatitis B (CHB) patients have not been established. We investigated the role of
hepatitis B surface antigen (
HBsAg),
interferon-inducible protein-10 (IP10) and
hepatitis B core-related
antigen (HBcrAg) serum levels as predictors of
HBsAg loss, relapse and
retreatment in noncirrhotic
HBeAg-negative CHB patients who discontinued long-term
antiviral therapy. All
HBsAg-positive (n = 57) patients of the prospective DARING-B study were included and followed monthly for 3 months, every 2/3 months until month-12 and every 3/6 months thereafter.
HBsAg, IP10 and HBcrAg levels were measured by
enzyme immunoassays, and SCALE-B score was calculated. Twelve patients achieved
HBsAg loss before
retreatment with 18-month cumulative incidence of 25%. Independent predictors of
HBsAg loss were baseline
HBsAg and month-1 IP10 levels. Of 10 patients with baseline
HBsAg ≤100 IU/mL, 70% cleared
HBsAg and 10% required
retreatment. Of 23 patients with baseline
HBsAg >1000 IU/mL, 4% cleared
HBsAg and 43% required
retreatment. Of 24 patients with intermediate baseline
HBsAg (100-1000 IU/mL), 17% cleared
HBsAg and 21% required
retreatment; in this subgroup, month-1 IP10 was significantly associated with
HBsAg loss, which occurred in 30% and 7% of cases with IP10 >150 and ≤150 pg/mL, respectively. Baseline HBcrAg was undetectable in all patients who cleared
HBsAg and was associated with
retreatment. SCALE-B was associated with
HBsAg loss but not with relapse or
retreatment. In conclusion,
HBsAg, IP10 and HBcrAg serum levels can be useful for the decisions and management of treatment discontinuation in noncirrhotic Caucasian patients with
HBeAg-negative CHB.