Marcellin, PatrickButi, MariaKrastev, Zaharide Man, Robert A.Zeuzem, StefanLou, LillianGaggar, AnujFlaherty, John F.Massetto, BenedettaLin, LanjiaDinh, PhillipSubramanian, G. ManiMcHutchison, John G.Flisiak, RobertGürel, SelimDusheiko, Geoffrey M.Heathcote, E. Jenny2024-08-152024-08-152014-07-110168-8278https://www.sciencedirect.com/science/article/pii/S0168827814005182https://hdl.handle.net/11452/44041Background & Aims: In a study of 266 chronic hepatitis B e antigen (HBeAg)-positive patients, 23 experienced hepatitis B surface antigen (HBsAg) loss with up to 5 years of tenofovir disoproxil fumarate (TDF) treatment. HBsAg kinetics in patients with and without HBsAg loss and predictors of HBsAg loss were evaluated.Methods: HBsAg levels were quantified every 12 weeks. A multivariable regression analysis, involving prespecified baseline characteristics and on-treatment response parameters, was performed; a stepwise procedure identified independent predictors of HBsAg loss.Results: Among patients with HBsAg loss, 14 (61%), 1 (4%), 0 and 7 (30%) were genotypes A through D, respectively; 1 (4%) was genotype F. HBsAg loss was preceded by viral suppression (HBV DNA < 29 IU/ml; n = 23) and HBeAg loss (n = 19). Among treated patients the strongest independent predictors of HBsAg loss were Caucasian race with genotype A/D and 64 years of infection (HR = 14.3, 95% confidence interval [CI] 4.7-43.4; p < 0.0001) and an HBsAg decline of >= 1 log(10) IU/ml at week 24 (HR = 13.7, 95% CI 5.6-33.7; p < 0.0001). Among TDF-treated patients, a reduction in HBsAg level of >= 1-log(10) by week 12 or 24 had a positive predictive value of 35%-45%, respectively, and a negative predictive value of 94%-97%, respectively.Conclusions: HBsAg loss in HBeAg-positive patients receiving TDF involves a chronology of virologic and serologic responses; patients with HBV genotypes A or D and a rapid early decline in HBsAg are more likely to lose HBsAg.eninfo:eu-repo/semantics/openAccessSustained virological responsePolymerase chain-reactionTerm-follow-upPeginterferon alpha-2aNucleos(t)ide analogNegative patientsHbsag lossVirus-dnaSerumTherapyChronic hepatitis bHepatitis b surface antigenTenofovir disoproxil fumarateGastroenterology & hepatologyArticle0003451156000081228123761610.1016/j.jhep.2014.07.019