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. 2022 Dec;42(12):2674-2682.
doi: 10.1111/liv.15433. Epub 2022 Oct 5.

Low anti-HBc levels are associated with lower risk of virological relapse after nucleos(t)ide analogue cessation in HBe antigen-negative patients

Valerie Ohlendorf  1 , Maximilian Wübbolding  1   2   3 , Paul Gineste  4 , Christoph Höner Zu Siederdissen  1 , Birgit Bremer  1 , Heiner Wedemeyer  1   3 , Markus Cornberg  1   2   3 , Benjamin Maasoumy  1   2   3
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Low anti-HBc levels are associated with lower risk of virological relapse after nucleos(t)ide analogue cessation in HBe antigen-negative patients

Valerie Ohlendorf et al. Liver Int. 2022 Dec.

Abstract

Background and aims: Low anti-HBc serum levels at the time of therapy cessation were linked to a higher relapse risk in predominantly HBeAg-positive cohorts. We investigated the association of anti-HBc levels with relapse in HBeAg-negative patients.

Methods: Serum levels of anti-HBc, HBsAg and HBcrAg were determined in 136 HBeAg-negative patients, participating in a vaccination trial (ABX-203, NCT02249988), before treatment cessation or vaccination. Importantly, vaccination showed no impact on relapse. The correlation between the biomarkers and their predictive value for relapse (HBV DNA >2000 IU/ml ± ALT >2xULN) was investigated.

Results: After therapy cessation 50% (N = 68) of patients relapsed. Median anti-HBc prior to treatment stop was significantly higher among relapsers compared to off-treatment responders (520 IU/ml vs. 330 IU/mL, p = .0098). The optimal anti-HBc cut-off to predict relapse was 325 IU/ml according to the Youden-Index. About 35% of patients with anti-HBc level < 325 IU/ml versus 60% of those with values ≥325 IU/mL relapsed (p = .0103; sensitivity 50%, specificity 75%). Combining the optimal cut-offs of HBsAg (>3008 IU/mL) or HBcrAg (≥1790 U/ml) with anti-HBc increased the proportion of patients with relapse to 80% (p < .0001) and 74% (p = .0006), respectively.

Conclusion: In contrast to predominantly HBeAg-positive cohorts, in our cohort of HBeAg-negative patients lower anti-HBc levels are associated with a significantly lower relapse risk after nucleos(t)ide analogue cessation. The vast majority of included patients were either genotype B or C and the applicability to other genotypes has to be further evaluated. However, anti-HBc level as an indicator of the host response might be prospectively further explored for prediction models.

Keywords: chronic hepatitis B; nucleos(t)ide analogue; treatment cessation; virological relapse.

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References

REFERENCES

    1. World Health Organization. Global Hepatitis Report 2017. World Health Organization; 2017. Licence: CC BY-NC-SA 3.0 IGO; 2017. 10.1149/2.030203jes
    1. Chan SL, Wong VWS, Qin S, Chan HLY. Infection and cancer: the case of hepatitis B. J Clin Oncol. 2016;34(1):83-90. doi:10.1200/JCO.2015.61.5724
    1. Marcellin P, Wong DK, Sievert W, et al. Ten-year efficacy and safety of tenofovir disoproxil fumarate treatment for chronic hepatitis B virus infection. Liver Int. 2019;39(10):1868-1875. doi:10.1111/liv.14155
    1. Lampertico P, Agarwal K, Berg T, et al. EASL 2017 clinical practice guidelines on the management of hepatitis B virus infection. J Hepatol. 2017;67(2):370-398. doi:10.1016/j.jhep.2017.03.021
    1. Gish R, Jia JD, Locarnini S, Zoulim F. Selection of chronic hepatitis B therapy with high barrier to resistance. Lancet Infect Dis. 2012;12(4):341-353. doi:10.1016/S1473-3099(11)70314-0

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