Predictors of HBeAg loss after nucleos(t)ide analogues treatment for chronic hepatitis B: A preliminary finding

Entecavir (ETV) and tenofovir (TDF) are both potent antiviral agents for the treatment of chronic hepatitis B virus (HBV) infection. The primary effective endpoints of treatment have been a sustained disappearance of HBV DNA and hepatitis B e-antigen (HBeAg) loss or seroconversion. We compared the efficacy of ETV and TDF and determined clinical factors that contributed to HBeAg loss at Pao-Chien Hospital in Pingtung city. We conducted a retrospective study. A total of 36 consecutive patients with chronic hepatitis B (CHB) (e-positive) antigens were treated with ETV (n = 19) and TDF (n = 17) between January 2010 and January 2018. Demographic and baseline characteristics were used for Cox proportion hazard regression models to identify variables that were predictive of ETV and TDF-induced HBeAg loss. The alfa fetal protein (AFP) levels were higher in patients with HBeAg loss than in those without loss (P = .006). Of which, 17 (47.2%) of 36 patients achieved HBeAg loss and 12 (33.3%) patients achieved HBeAg seroconversion. None of these seroconversion patients developed serum reversion after consolidation therapy and off treatment. The cumulative rate of HBeAg loss at years 1, 2, and 3 of therapy was 22.2% (8/36), 37.0% (10/27), and 57.7% (15/26), respectively. In cumulative rate at years 1 and 2, the frequency of HBeAg loss was observed greater in virological response at 6 months (13.9% vs 8.3%, P = .013; 40% vs 22%, P = .028, respectively). In multivariate Cox regression analysis for factors associated with HBeAg loss, an increase in virological response at 6 months (adjusted hazard ratio [HR] = 4.780; 95% CI, 1.013-22.565; P = .048) was only significant factor associated with cumulative HBeAg loss rate at year 2 (adjusted HR = 0.183; 95% CI, 0.043-0.774; P = .021). The rapidity and efficacy of HBV DNA reduction to undetectable is the predictor of nucleos(t)ide analogue (NUC)-induced HBeAg loss. Early undetectable HBV DNA in 6 months might be used to predict a higher likelihood of HBeAg loss within 2-year therapy with NUC.