HBcrAg, HBsAb levels tied to persistent functional chronic hepatitis B cure

In chronic hepatitis B (CHB) patients treated with pegylated interferon alpha (peg-IFN-α)-based interventions, lower levels of the HB core-related antigen (HBcrAg) and higher levels of the HB surface antibody (HbsAb) are associated with durable functional cure, a recent study has found,

Researchers enrolled 80 patients who had undergone 96 weeks of Peg-IFN-α-based treatment, followed by 24 weeks of off-treatment follow-up.

Treatment response was defined as loss of the HB surface antigen (HBsAg) or the appearance of the HBsAb by the end of treatment. Durable functional cure, meanwhile, was defined as the persistence of HBsAg loss, with or without antibody presence, until the end of follow-up.

By end of treatment, 45.0 percent (n=36) of patients showed treatment response. Of these, 58.3 (n=21) saw durable functional cure lasting until end of follow-up.

Both HBcrAg and HBsAb at end of treatment were significantly correlated with sustained treatment response, with corresponding areas under the receiver operating curve (AUROC) of 0.697 (p=0.047) and 0.744 (p=0.013).

Of note, a combination of HBcrAg <4 log₁₀U/mL and HBsAb >2 log₁₀IU/L achieved a 100-percent positive predictive value for sustained response, and an AUROC of 0.822 (p=0.001).

“Functional cure can be sustained in a proportion of patients with CHB after pegylated interferon alpha-based treatment. However, predicting who will achieve durable functional cure remains challenging,” the researchers said.

“Herein, we show that low levels of HB core-related antigen and higher levels of HB surface antibodies at the end of treatment are linked to immunological responses and are associated with durable functional cure,” they added.