Exploring the persistence of hepatitis B surface antigen serum clearance using real-world data from electronic health records

In a study published in the journal Genes and diseasesResearchers from the Second Affiliated Hospital of Chongqing Medical University analyzed data from an extensive dataset of more than 70,000 HBsAg-positive individuals at the Second Affiliated Hospital of Chongqing Medical University.

They compared two groups: patients who achieved HBsAg seroclearance with NAs monotherapy (168 patients) and patients who achieved HBsAg seroclearance with IFN monotherapy (30 patients). Patients treated with NAs monotherapy were older and had a higher proportion of HBsAg serum clearance during treatment (48.8% vs. 30.0%). They also have a more favorable immune response with a higher rate of producing anti-HBs.

More patients in the NAs monotherapy group had normal ALT levels (78.6% vs. 40.0%). The time to HBsAg serum clearance and treatment duration were similar between groups, but NAs monotherapy showed a trend towards longer times. During follow-up, patients receiving NAs monotherapy had a significantly lower HBsAg seroreversion rate compared with patients receiving IFN monotherapy (4.9% vs. 33.3%).

The probability of confirming HBsAg seroclearance was significantly higher one and three years after NAs treatment (one year: 0.960 vs. 0.691; three years: 0.931 vs. 0.641), indicating a more durable functional cure. NAs monotherapy was independently associated with a reduced risk of HBsAg seroreversion.

Most patients experience HBsAg seroreversion within the first year after seroclearance. Anti-HBs-positive IFN monotherapy patients had a higher likelihood of confirmed HBsAg seroclearance during follow-up, whereas this difference was not observed in NAs monotherapy patients.

This study provides valuable insights into the durability of HBsAg serum clearance induced by NA or IFN monotherapy, with NA monotherapy showing better outcomes and lower risk of relapse. Age and ALT levels have also been identified as factors associated with HBsAg seroreversion. Understanding these findings can guide clinicians in making informed treatment decisions for patients with chronic hepatitis B, ensuring better clinical outcomes.

The researchers anticipate that these findings will help develop more effective and personalized treatment strategies for patients with chronic hepatitis B in the future. The study highlights the importance of continued research in this area and the potential of using electronic health record data to gain a deeper understanding of disease management and treatment outcomes.