Analysis of the characteristics and influencing factors of HBsAg change in chronic hepatitis B patients treated with NAs

ObjectiveTo observe the dynamic change of HBsAg serum level in chronic hepatitis B(CHB) patients treated with NAs for HBVDNA negative conversion, compare the change of HBsAg between HBeAg-positive and HBeAg-negative patients, estimate the time of HBsAg clearance, and explore the possible course of CHB treated with NAs.

MethodsThe quantitation of HBsAg in patients treated with NA HBVDNA negative conversion was set as the baseline value, the dynamic change of HBsAg levels were observed after 6 months, 1 year, 3 years, 5 years and 7 years of HBVDNA negative conversion, and the difference of HBsAg quantification between HBeAg(+) group and HBeAg(-) group was compared.

ResultsAmong 109 HBeAg-positive patients, the mean levels of HBsAg after 6 months, 1 year, 3 years, 5 years and 7 years of HBVDNA negative conversion were 3.347, 3.329, 3.107, 3.169, 2.960 and 2.164 log₁₀IU/mL, respectively.Among 116 HBeAg-negative patients, the mean levels of HBsAg after 6 months, 1 year, 3 years, 5 years and 7 years of HBVDNA negative conversion were 3.133, 3.193, 2.970, 2.967, 2.536 and 2.083 log₁₀IU/mL, respectively.After NAs treatment, the HBsAg levels in HBeAg-positive and HBeAg-negative patients showed a decreasing trend of fluctuation at 6 months, 1 year, 3 years, 5 years and 7 years after HBVDNA negative conversion(P < 0.01).According to the linear regression equation fitted by the quantitative decline trend of HBsAg, the HBsAg clearance time in HBeAg positive group and HBeAg negative group were calculated to be 25 years and 22 years, respectively.

ConclusionsAmong the CHB treated with NAs, the clearance time of HBsAg in HBeAg positive group and HBeAg negative group will take more than 20 years in theory.Therefore, the treatment of CHB with NAs requires a long course of treatment.