Seventy-six
HBeAg-positive CHB patients received 96-wk
NAs optimized
therapy (
lamivudine and
adefovir dipivoxil) were studied retrospectively. Serum
hepatitis B surface antigen,
HBeAg,
hepatitis B core antibody, hepatitis B virus (HBV)
DNA and
alanine aminotransferase levels were quantitatively measured before and during the treatment at 12 and 24 wk. Stepwise logistic regression analyses were performed to identify predictors for treatment response, and areas under the receiver operating characteristic curves (AUROC) of the independent predictors were calculated.
RESULTS: Forty-three CHB patients (56.6%) achieved virological response (VR: HBV
DNA ≤ 300 copies/mL) and 15 patients (19.7%) developed
HBeAg seroconversion (SC) after the 96-wk
NAs treatment. The
HBeAg level (OR = 0.45, P = 0.003) as well as its declined value (OR = 2.03, P = 0.024) at 24-wk independently predicted VR, with the AUROC of 0.788 and 0.736, respectively. The combination of
HBeAg titer < 1.3 lg PEIU/mL and its decreased value > 1.6 lg PEIU/mL at 24-wk predicted VR with a sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV) of 85%, 100%, 100% and 83%, respectively, and the AUROC increased to 0.923. The
HBeAg level (OR = 0.37, P = 0.013) as well as its declined value (OR = 2.02, P = 0.012) at 24-wk also independently predicted
HBeAg SC, with the AUROC of 0.828 and 0.814, respectively. The
HBeAg titer < -0.5 lg PEIU/mL combined with its declined value > 2.2 lg PEIU/mL at 24-wk predicted
HBeAg SC with a sensitivity, specificity, PPV, NPV of 88%, 98%, 88% and 98%, respectively, and the AUROC reached 0.928.
CONCLUSION: