Retrospective Study
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jul 28, 2015; 21(28): 8653-8659
Published online Jul 28, 2015. doi: 10.3748/wjg.v21.i28.8653
Hepatitis B surface antigen levels of cessation of nucleos(t)ide analogs associated with virological relapse in hepatitis B surface antigen-negative chronic hepatitis B patients
Guo-Hong Ge, Yun Ye, Xin-Bei Zhou, Li Chen, Cong He, Dan-Feng Wen, You-Wen Tan
Guo-Hong Ge, Yun Ye, Xin-Bei Zhou, Li Chen, Cong He, Dan-Feng Wen, You-Wen Tan, Department of Hepatosis, The Third Hospital of Zhenjiang Affiliated Jiangsu University, Zhenjiang 212000, Jiangsu Province, China
Author contributions: Ge GH and Ye Y wrote the manuscript; Chen L, Zhou XB and He C provided analytical tools and were involved in editing the manuscript; Weng DF provided all of the human material; Ye Y designed the study; and Tan YW provided support for this work.
Supported by Natural Science Foundation of Jiangsu Province, China, No. BK2011515; Medical Project of Health Department Jiangsu Province, No. H201248; Preventive Medicine research projects of Jiangsu Province, No. Y2012016; and the Social Development Project of Zhenjiang City, No. SH2013056.
Institutional review board statement: The study protocol was conducted within the guidelines of the 1975 Declaration of Helsinki and was approved by the ethics committee of The Third Hospital of Zhenjiang Affiliated Jiangsu University.
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: No potential conflicts of interest relevant to this article were reported.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yun Ye, Associate Professor, Department of Hepatosis, The Third Hospital of Zhenjiang Affiliated Jiangsu University, No. 300 Daijiamen, Runzhou Distinct, Zhenjiang 212000, Jiangsu Province, China. tyw915@sina.com
Telephone: +86-511-88925605 Fax: +86-511-88970779
Received: January 29, 2015
Peer-review started: January 30, 2015
First decision: March 10, 2015
Revised: March 26, 2015
Accepted: May 2, 2015
Article in press: May 4, 2015
Published online: July 28, 2015
Processing time: 181 Days and 13.4 Hours
Abstract

AIM: To investigate the virological relapse rate in hepatitis B e antigen (HBeAg)-negative patients after antiviral therapy discontinuation and analyze the factors associated with virological relapse.

METHODS: Among patients diagnosed with chronic hepatitis B infection between May 2005 and July 2010, 204 were eligible for analysis. The Kaplan-Meier method and log-rank test were used to calculate the cumulative rate of relapse and compare cumulative relapse rates between groups. The Cox proportional hazards regression model was used to evaluate the predictive factor of virological relapse.

RESULTS: The 2 and 1 year cumulative risks of virological relapse after antiviral therapy discontinuation were 79.41% (162/204) and 43.82% (71/162), respectively. Multivariate analysis revealed that only post treatment hepatitis B surface antigen (HBsAg) level was associated with virological relapse (P = 0.011). The cumulative risk of virological relapse was higher in the patients with HBsAg levels ≥ 1500 IU/L than in those with HBsAg levels < 1500 IU/L (P = 0.0013). The area under the curve was 0.603 (P = 0.033). The cutoff HBsAg value for predicting virological relapse was 1443 IU/L.

CONCLUSION: We found that the virological relapse rate remained high after antiviral therapy discontinuation in the HBeAg-negative patients and that the post treatment HBsAg levels predicted virological relapse.

Keywords: Chronic hepatitis B; Virological relapse; Hepatitis B surface antigen

Core tip: To study the rate of virological relapse in hepatitis B e antigen (HBeAg)-negative patients after stopping antiviral therapy. Two hundred and four patients were eligible for this analysis. The cumulative probability of virological relapse after stopping antiviral therapy was 79.41% (162/204) in 2 years and 43.82% (71/162) in 1 year. Cumulative probability of virological relapse in levels of the hepatitis B surface antigen (HBsAg) ≥ 1500IU/L group was higher than that of levels of the HBsAg < 1500 IU/L group. The cutoff value for predicting virological relapse was 1443 IU/L. We found that the virological relapse rate maintained a high level after stopping NUCs in HBeAg-negative patients and HBsAg levels of cessation of nucleos(t)ide analogs predicted virological relapse.